Last year, President Donald Trump created a commission to study the opioid epidemic. The commission released its recommendations in November. But since then, we’ve heard very little about what’s going on with the commission’s proposals.

Now, two Democratic senators are looking for answers. In an April 9 letter to Trump obtained exclusively by Vox, Sens. Elizabeth Warren (D-MA) and Patty Murray (D-WA) have asked the White House for an update on each of the commission’s recommendations — how far along they are, which ones the Trump administration believes will require congressional action, and who is overseeing the White House’s response to the opioid crisis.

“We are concerned, however, by reports that in spite of the opioid epidemic’s devastating impact on American communities, your Administration has failed to act aggressively to combat it,” Warren and Murray wrote. “You declared the opioid epidemic a national public health emergency on October 26, 2017, but there has been little evidence that your Administration has taken advantage of the supplemental executive branch authorities and resources provided by this designation.”

The letter is part of a broader effort to hold the Trump administration accountable for its response to the opioid crisis. In January, Warren and Murray also asked the Government Accountability Office to study the Trump administration’s response to the crisis so far.

The opioid commission released two sets of proposals last year. Trump reacted to the first set of preliminary proposals by declaring a public health emergency over the crisis, which was the commission’s top recommendation at the time. But the Trump administration has done very little, at least publicly, about the broader final set of 56 proposals — which generally focused on expanding access to addiction treatment by, for example, streamlining federal funding for drug addiction.

Meanwhile, Trump announced a vague plan to confront the opioid crisis in March. But instead of taking up the commission’s largely public health–oriented proposals, Trump’s plan focuses largely on harsher criminal justice measures, including a scheme to use the death penalty more often for drug traffickers — which the commission did not recommend. Trump’s plan also made some ambiguous promises to encourage fewer opioid painkiller prescriptions and scale up addiction treatment.

Trump even seemed to dismiss the concept of his own commission in the speech unveiling his plan.

“These are terrible people, and we have to get tough on those people,” he said, referring to drug dealers and traffickers, “because we can have all the blue ribbon committees we want, but if we don’t get tough on the drug dealers, we’re wasting our time. Just remember that. We’re wasting our time. And that toughness includes the death penalty.”

The opioid epidemic is now the deadliest drug overdose crisis in US history. Nearly 64,000 people died of drug overdoses in the US in 2016, and at least two-thirds of those deaths were linked to opioids such as fentanyl, heroin, and prescribed painkillers. The total drug overdose deaths were higher than the number of deaths linked to guns, car crashes, or HIV/AIDS during any single year in America. Based on preliminary data from the Centers for Disease Control and Prevention (CDC), 2017 was even worse.

Experts want a public health approach to the opioid crisis

If you ask experts, we have a fairly good idea of what’s needed to combat the opioid crisis: more treatment (particularly medications like methadone and buprenorphine), more harm reduction (including better access to the opioid overdose antidote naloxone), fewer painkiller prescriptions (while ensuring the drugs are available to those who really need them), and policies that can help address the root cause of addiction (like mental health issues and socioeconomic despair).

Experts actually deemphasize the role of the criminal justice system — arguing that it has, historically, done a very poor job of dealing with drug epidemics, and that public health policies are a better fit. Sarah Wakeman, an addiction medicine doctor and medical director at the Massachusetts General Hospital Substance Use Disorder Initiative, previously told me that “greater criminalization would be not only ineffective but actually harmful.”

Congress has taken some action on the public health end. The latest federal budget added $3.3 billion to confront the opioid crisis in fiscal year 2018. That’s still far from the tens of billions that some experts say is necessary to fully deal with the epidemic, but advocates and experts welcomed the additional dollars.

Some lawmakers have proposed going broader. Warren and Rep. Elijah Cummings (D-MD) proposed treating the opioid crisis like the HIV/AIDS epidemic, and enacting a program similar to the Ryan White program, which was passed in response to the HIV/AIDS epidemic. As proposed, the new program would provide $100 billion in federal funding over the next 10 years to the communities that have been hardest hit by the opioid crisis, with a focus on greater access to treatment and other medical services related to addiction.

This level of funding would go to a serious problem: According to a 2016 report by the surgeon general, about 10 percent of people in the US with a drug use disorder get specialty treatment — which the report attributed to a lack of access to care. And even when treatment is available, other federal data suggests that fewer than half of facilities offer opioid addiction medications like methadone and buprenorphine, which are considered the gold standard of treatment and, studies show, cut mortality among opioid addiction patients by half or more.

This is the kind of gap that the Trump opioid commission’s recommendations set out to address. But with very little public movement by the White House on the proposals, some senators are wondering what, exactly, is going on.

For more on solutions to the opioid epidemic, read Vox’s explainer.