Today, Trump is celebrating a year of “accomplishments” combating the opioid epidemic. But the truth is Trump has not made significant progress addressing the crisis. In fact, his actions have threatened to make the crisis even worse.

Here are 10 ways Trump broke his promise to take meaningful action to address the opioid epidemic:

1. Trump ignored his own opioid commission’s advice by failing to declare the opioid crisis a full-on national emergency, settling instead for a more limited declaration that lacked new funding sources.

2. A new report from the Government Accountability Office found that Trump’s declaration of a public health emergency led to very little.

3. Trump’s decision to promote the use of short-term junk insurance plans would lead to more policies that don’t cover substance abuse treatment.

4. Trump’s budget would have limited access to existing opioid treatment options by repealing the ACA.

5. Trump’s budget sought to undermine the office that coordinates White House drug policies.

6. Trump tried to cut $250 billion from Medicaid, which helps about one in three Americans who need substance abuse treatment.

7. Trump tried to cut $688 million from the Substance Abuse and Mental Health Services Administration.

8. The repeal of the ACA individual mandate in Trump’s tax law could harm addiction treatment, as millions more Americans become uninsured.

9. Trump’s decision to make it easier for states to impose Medicaid work requirements could hurt those fighting drug addiction.

10. Despite hard evidence that the Affordable Care Act has helped extend opioid treatment, Trump has repeatedly promised to fully repeal the law.