Trump says Miriam Adelson is "somebody who's worked so hard. Doesn't have to do it, but she does, 24 hours a day, this is what she does."
"Through decades of innovative research, philanthropy and treatment, Miriam has helped thousands break free from their addiction to drugs and alcohol," Trump said. "I know the work you've done, and you have been truly incredible."
Miriam Adelson is an Israeli-born, naturalized U.S. citizen who earned a medical degree from Tel Aviv University and founded drug abuse treatment and research centers in Las Vegas and Tel Aviv. She and her husband own the Las Vegas Review-Journal and Israel Hayom newspapers.
The Adelsons are also avid supporters of Israel. Trump noted how "very happy" they were that he moved the U.S. Embassy from Tel Aviv to Jerusalem.
Trump also honored Sen. Orrin Hatch of Utah. One of the longest-serving Republican senators in U.S. history, Hatch is retiring in January after more than 40 years. Trump called Hatch a "great friend of mine" who "liked me right from the beginning, and therefore I like him."
Retired Minnesota Supreme Court justice Alan Page, who played with the NFL's Minnesota Vikings and Chicago Bears before transitioning to a career in law, and Roger Staubach, the Hall of Fame quarterback for the Dallas Cowboys, were also honored.
Posthumous honors were given to Elvis Presley, baseball's Babe Ruth and Antonin Scalia, the conservative Supreme Court justice. Six of the nine justices currently serving on the U.S. Supreme Court, including newest member Brett Kavanaugh, attended the White House ceremony.
Trump said Ruth and Presley are "true legends" whose legacies will live on forever.
Some questioned Trump's decision to recognize Miriam Adelson so soon after the Nov. 6 election.
Robert Weissman, president of the public interest group Public Citizen, said the decision was "emblematic of the corrupt and transactional presidency of Donald Trump."
But Elliott Abrams, who held foreign policy positions under Presidents Ronald Reagan and George W. Bush, called the complaints "ridiculous."
Abrams noted that Miriam Adelson has donated her time and money to combating addiction. He contrasted her award with those given by President Barack Obama to Chita Rivera, Robert De Niro, Barbra Streisand, Ellen DeGeneres and Warren Buffett, among others.
"People who said nothing about all of that and now criticize the medal for Dr. Adelson are simply being nasty and partisan, and are not actually taking a look at her remarkable knowledge and charity in the chemical addiction field," Abrams said.
White House spokeswoman Lindsay Walters said Trump used the process previous administrations followed to select his nominees. It was coordinated by the staff secretary's office, incorporating recommendations from the public, relevant presidential advisory bodies, the Cabinet and senior White House staff.
Presidents have total discretion over whom they honor with a Presidential Medal of Freedom.
The award is given to individuals "who have made especially meritorious contributions to the security or national interests of the United States, to world peace, or to cultural or other significant public or private endeavors."
Miriam Adelson said she is "deeply humbled and moved by this exceptional honor."
"Liberty is at the heart of my decades of work against substance abuse. Drug dependency is enslavement, for the user and his or her family and society, and treatment an emancipation," she said in a statement Thursday.