(Trends Wide) — With a growing number of Americans dying from drug overdoses and growing concern about addictions, the Biden administration has encountered a national crisis that continues to escalate as the covid-19 pandemic drags on.
In the election campaign, Biden presented a comprehensive plan to tackle the opioid epidemic, but his public advocacy on the issue has largely been relegated by focusing his presidency on his legislative agenda and the coronavirus pandemic. Now, more than halfway through Biden’s first year in office, as National Recovery Month draws to a close, his administration is faced with calls to do more to avoid the crisis.
So far, among the administration’s efforts, the White House has proposed landmark investments to address the overdose crisis in its budget request for fiscal year 2022. And significant funding for Biden’s ambitious legislative goals, which includes historic funding aligned with the White House drug policy agenda, still in negotiations between the White House and Congress.
But experts say even more needs to be done to address the impact the pandemic has had on addictions.
More than 93,000 people died from drug overdoses in 2020, according to preliminary data from the U.S. Centers for Disease Control and Prevention (CDC), making last year the longest deadly recorded in terms of drug overdose. Alcohol use by American adults appears to have increased during the pandemic as well, with nearly 1 in 4 adults reporting drinking more to cope with their stress in a survey by the American Psychological Association.
Regina LaBelle, Acting Director of the White House Office of National Drug Control Policy, stressed in an interview with Trends Wide that the
Overdose deaths “were already on the rise before the pandemic and worsened during it.”
Covid-19 has caused complications across the board, including the weakening of traditional support systems to help people recover from addiction. When the pandemic began, access to treatment and community programs changed dramatically. Meetings from programs like Alcoholics Anonymous moved to Zoom. People isolated themselves in their homes. The capacity of addiction treatment centers decreased.
The pandemic also triggered a mental health crisis that may have led more people to self-medicate with drugs and alcohol, experts say. People changed their way of coping with illness and death to prevent the spread of COVID-19, sometimes being banned from family beds in hospitals or prevented from attending funerals in person. And many struggled with job insecurity or faced the potential for health hazards on the job.
Dr. Stephen Taylor, an Alabama physician and medical director for Pathway Healthcare, which has outpatient addiction treatment offices throughout the South, said he sees people responding to the stress of the pandemic with increased consumption of substances. He also noted that, across the country, “people who do not even have a substance use disorder have increased their use.”
“What we are experiencing more in Alabama than perhaps other parts of the country is simply the stress of the pandemic – the anguish of so many people who are getting sick and being hospitalized and dying,” Taylor said. “Many people respond to that with increased substance use.”
More work to do
Across the spectrum, experts also say there is much more work to be done by the Biden administration, particularly in fighting the spread of fentanyl, an extremely potent synthetic opioid.
Jim Carroll, who was director of the White House Office of National Drug Control Policy (ONDCP) during the Trump administration, expressed concern about the influx of fentanyl seizures on the southern border, comparing the drug to a “weapon of mass destruction”.
“I think that’s one of the ways we have to approach this issue,” he said.
“The prevention aspect is very important, but we have to know that drugs will not enter our country. We cannot have a porous border for drugs,” he added. “That is really key to achieving the goals of the ONDCP … reducing the drugs that are on our streets.”
The administration also continues to face the challenge of the influx of illicitly manufactured fentanyl that appears throughout the drug supply, LaBelle said.
“And that is why we are seeing an increase in the rates of overdose deaths related to methamphetamine and cocaine. It is because fentanyl is everywhere. When someone uses illegal drugs, it is likely that there is fentanyl in that drug,” LaBelle said .
Methamphetamine-related overdose deaths, for example, nearly tripled from 2015 to 2019 among people ages 18 to 64, and many of these deaths involve simultaneous opioid use, according to a study by the National Institute on Abuse. of drugs.
There are areas where observers say the Biden administration is falling short of what the president promised in the campaign.
Maritza Pérez, director of the Office of National Affairs of the Drug Policy Alliance, a non-profit organization that affirms that its objective is to promote policies that best reduce the harms of drug use and drug prohibition, argued that, Although candidate Biden mentioned “clemency, the need to revise our drug laws, that no one should serve time for drug-related activities, (and) that he would prioritize racial justice” in the campaign, his administration has done little to address those concerns.
The American Society for Addiction Medicine, whose board of directors Taylor is a member, urges the White House to support a series of measures in its 2022 National Drug Control Strategy, which will be presented to Congress early next year.
Taylor stressed the importance of the funding proposed in the sweeping $ 3.5 trillion spending bill from the House of Representatives. Democrats had originally settled on that maximum number, but some Senate moderates in the party have indicated that they will not support such a high number.
“We recognize that it would be the most important piece of legislation for people with substance use disorders, literally since the passage of the (Affordable Care Act,“ Obamacare ”),” said Taylor, adding that it is “also an opportunity to really advance equity. “
The spending bill includes a provision to provide incarcerated people with Medicaid in the lead up to their release from prison, an important step that advocates argue will help an extremely vulnerable population access mental health and substance use treatment, possibly preventing recidivism. The spending proposal would also expand the child tax credit, but its inclusion could be reduced.
LaBelle said that “poverty puts people at greater risk of experiencing some of the conditions that can lead to early substance use,” arguing that extending credit “will help prevent people from developing substance use disorders by reduction of conditions that can lead to trauma (and) homelessness. “
Addressing the addiction epidemic at the federal level
Experts from across the political spectrum are encouraged by some aspects of the Biden administration’s approach to the overdose issue.
Pérez said he acknowledges the Biden administration for using the term “harm reduction” in public statements and saying that the federal government supports those measures.
“That has never happened before. So the fact that they say we have to support people, get to them where they are, make sure people use drugs safely. They haven’t said that. But that’s essentially to what harm reduction is about is making sure people have the tools they need to use drugs safely. And, you know, that in itself is historic. We haven’t seen anything like it, “said Pérez.
Experts praised efforts to exempt healthcare providers from certification requirements to be able to prescribe buprenorphine, a drug used in combination with behavioral therapy to treat opioid use disorder.
The administration has also lifted a moratorium on a mobile component of opioid treatment programs, making it easier for treatment to reach the most isolated communities. And experts underscored the importance of the nearly $ 4 billion in funding made available through the American Rescue Plan to expand access to mental health and substance use disorder services, which included $ 30 million for services. harm reduction.
Carroll particularly praised Biden’s candidate to head the White House Office of National Drug Control Policy, Dr. Rahul Gupta. Gupta, a former West Virginia public health official, would be the first doctor to serve as drug czar if his appointment is confirmed.