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As US overdose deaths hit record highs, Biden administration grapples with US addiction


On the campaign trail, Biden presented a comprehensive plan to tackle the opioid epidemic, but his public advocacy on the issue has largely been dropped as he focuses his presidency on his legislative agenda and the coronavirus pandemic. . Now, more than half of Biden’s first year in office, as National Recovery Month draws to a close, his administration faces calls for more to be done to avert the crisis.

But experts say more needs to be done to deal with the pandemic’s impact on drug addiction.

More than 93,000 people died from drug overdoses in 2020, according to preliminary data from the United States Centers for Disease Control and Prevention, making last year the deadliest on record for drug overdoses. Alcohol consumption among American adults also appears to have increased during the pandemic, with nearly one in four adults reporting drinking more to deal with their stress in a survey by the American Psychological Association.

Regina LaBelle, acting director of the White House’s Office of National Drug Control Policy, pointed out in an interview with CNN that overdose deaths “were already on the rise before the pandemic and were exacerbated during the pandemic.”

Covid-19 has caused complications at all levels, including shaking up traditional support systems to help people recover from addiction. When the pandemic began, access to treatment and community programs changed dramatically. Meetings for programs like Alcoholics Anonymous have moved to Zoom. Individuals isolated at home. The capacity of drug treatment centers has diminished.

The pandemic has also sparked a mental health crisis that may have led more people to self-medicate with drugs and alcohol, experts say. People have changed the way they deal with illness and death to prevent the spread of Covid-19, sometimes being excluded from family members’ bedside in hospital or unable to mourn at funerals in person. And many have struggled with job insecurity or faced the possibility of occupational health risks.

Dr Stephen Taylor – an Alabama-based physician who is the chief medical officer of Pathway Healthcare, which has outpatient drug treatment offices in the South – said he was seeing people responding to the stress of the pandemic with a increased substance use. He also pointed out that across the country, “people who don’t even have a substance use disorder have increased their alcohol consumption.”

“What we’re experiencing more in Alabama than maybe other parts of the country is just the stress of the pandemic – the plight of so many people who are getting sick and being hospitalized and dying,” Taylor said. “A lot of people react to this with increased substance use.”

More work to do

Across the board, experts also say the Biden administration still has a lot of work to do, especially to tackle the spread of fentanyl, an extremely potent synthetic opioid.

Jim Carroll, who was the director of the White House’s Office of National Drug Control Policy during the Trump administration, expressed concern about the influx of seizures of fentanyl to the southern border, likening the drug to a “weapon of mass destruction”.

“I think that’s one of the ways we kind of have to approach this issue,” he said.

“The prevention aspect is essential, but we just need to know that drugs do not enter our country. We cannot have a porous border for drugs,” he added. “This is really essential for what ONDCP wants to accomplish… reduce the drugs that are on our streets.”

The administration also continues to face the challenge of an influx of illicitly manufactured fentanyl showing up in the drug supply, LaBelle said.

“And that’s why we’re seeing an increase in overdose death rates involving methamphetamine and cocaine. It’s because fentanyl is everywhere. When a person uses illegal drugs, it’s likely that it there is fentanyl in this drug, ”LaBelle said.

Overdose deaths involving methamphetamine, for example, nearly tripled from 2015 to 2019 among people aged 18 to 64, many of those deaths involving opioid use at the same time, according to a National Institute on Drug Abuse.

There are areas where observers say the Biden administration is falling short of what the president discussed during the election campaign.

Maritza Perez – the director of the Office of National Affairs of the Drug Policy Alliance, a nonprofit that says it aims to advance policies that best reduce the harms of drug use and drug prohibition – argued that if candidate Biden brought up “leniency, the need to review our drug laws, that no one should be serving time for drug-related activity, (and) that he would prioritize racial justice “during the election campaign, his administration did little to address these concerns.

The American Society of Addiction Medicine, where Taylor sits on the board, urges the White House to support a number of measures in its 2022 National Drug Control Strategy, which is due to be presented to Congress earlier this year. next.
Taylor stressed the importance of the funding proposed in the House spending bill of $ 3.5 trillion. Democrats initially set their sights on that high-profile figure, but some moderate party senators have indicated they would not support such a high number.

“We recognize that this would be the most important law for people with substance use disorders, literally since the passage of the (Affordable Care Act),” Taylor said, adding that it was “also an opportunity to really advance equity”.

The spending bill includes a provision to provide inmates with Medicaid prior to release from prison, a major step that advocates say will help an extremely vulnerable population access mental health and addiction treatment, potentially preventing the recidivist. The spending proposal would also extend the child tax credit, but its inclusion could be on the chopping block.

LaBelle said, “Poverty puts people at a greater risk of suffering from some of the conditions that can lead to early substance use,” arguing that extending credit “will help prevent people from developing related disorders. to substance use by reducing conditions that can lead to trauma (and) homelessness. ”

Addressing the drug addiction epidemic at the federal level

Experts from all political backgrounds are encouraged by some aspect of the Biden administration’s approach to the overdose problem.

Perez said she credits the Biden administration for using the term “harm reduction” in public statements and said the federal government supports such measures.

“This has never happened before. So the fact that they say we have to support people, meet them where they are, make sure people use drugs safely. They don’t have it. But that’s basically what hurting reduction is – it’s making sure people have the tools they need to use drugs safely. And, you know, that’s in itself historic. We haven’t seen anything like it, “Perez said.

Experts have lauded efforts to exempt healthcare providers from certification requirements to be able to prescribe buprenorphine, a drug used in conjunction with behavior therapy to treat opioid use disorders.

The administration also lifted a moratorium on a mobile component of opioid treatment programs, making it easier to access treatment in more isolated communities. And experts stressed the importance of the nearly $ 4 billion in funding made available through the US bailout to expand access to mental health and substance use disorders services, including $ 30 million for harm reduction services.

Carroll in particular praised Biden’s candidate for head of 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 fill the role of drug czar if confirmed.

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Cnn