Donald Trump’s commission on the opioid crisis has called for more drug courts, more training for doctors, and penalties for insurers that dodge covering addiction treatment.

The panel’s final report stopped short, however, of calling for new dollars to address the worst drug crisis in US history.

Instead, the commission asked Congress for “sufficient funds” and suggested giving the White House drug czar’s office the ability to review federal spending on the problem.

Q&A Why is there an opioid crisis in America? Show Almost 100 people are dying every day across America from opioid overdoses – more than car crashes and shootings combined. The majority of these fatalities reveal widespread addiction to powerful prescription painkillers. The crisis unfolded in the mid-90s when the US pharmaceutical industry began marketing legal narcotics, particularly OxyContin, to treat everyday pain. This slow-release opioid was vigorously promoted to doctors and, amid lax regulation and slick sales tactics, people were assured it was safe. But the drug was akin to luxury morphine, doled out like super aspirin, and highly addictive. What resulted was a commercial triumph and a public health tragedy. Belated efforts to rein in distribution fueled a resurgence of heroin and the emergence of a deadly, black market version of the synthetic opioid fentanyl. The crisis is so deep because it affects all races, regions and incomes

“If we are to invest in combating this epidemic, we must invest in only those programs that achieve quantifiable goals and metrics,” the report said. The drug czar’s office “must establish a system of tracking and accountability”.

But adding a new layer of oversight was met with skepticism from addiction treatment advocates. The Office of National Drug Control Policy, known as the drug czar’s office, “is not a watchdog agency”, said Andrew Kessler, a behavioral health consultant in Washington DC.

Trump launched the commission seven months ago, tapping his friend and former rival Governor Chris Christie of New Jersey to lead the fight. Since then, it has held five meetings and, in July, issued an interim report urging the president to elevate attention by declaring a national emergency.

Last week, Trump did so, talking in a White House speech about his brother’s alcoholism and declaring the crisis a national public health emergency.

“The president did exactly what I asked him to do,” Christie said on Wednesday, addressing reports that a different type of emergency declaration, one overseen by the Federal Emergency Management Agency would have been stronger. Christie said he wanted the Department of Health and Human Services to take the lead, not Fema.

“It’s now incumbent on Congress to step up and put money in the public health emergency fund,” Christie said. Congress has not replenished the fund for years and it contains just $57,000.

More than 64,000 Americans died from drug overdoses last year, most involving a prescription painkiller or an illicit opioid such as heroin.

The panel’s report contained 56 new recommendations and called for streamlining funding to states by using block grants, which would give states more flexibility.

What’s missing is more money, said Dr Mitchell Rosenthal of Phoenix House, a not-for-profit addiction treatment provider. “We need significantly more funding to the states on the front lines of this crisis, otherwise they won’t be able to implement the prevention and treatment programs that can save so many lives,” Rosenthal said.

The commission urged White House support for the Prescription Drug Monitoring Act, which would require states with federal grants to share information on narcotics users in a federal data-sharing hub.

The panel recommended training doctors who prescribe opioids and allowing more emergency responders to administer overdose reversal drugs.

It called for establishing drug courts in all 93 federal judicial districts to get more treatment to drug offenders rather than send them to prison.

Alternatives to incarceration are needed, said Lindsey Vuolo of the National Center on Addiction and Substance Abuse and author of a recent strategy guide for states.

“It’s not enough to say addiction is a disease. We have to treat it as one,” Vuolo said.