President Joe Biden promotes enhanced response to opioids

When it came to containing the coronavirus last year, public health experts warned that social isolation, lack of access to treatment and the growing lethality of street drugs. countries can lead to a large increase in drug overdose deaths—a potential disease in an epidemic.

However, 100,000 people died in a 12-month period, according to data recently released by the Centers for Disease Control and Prevention, up 28.5% year-over-year, prompting questions from healthcare providers, treatment advocates and addiction specialists. asked if the crisis was being taken seriously enough at the federal level.

Dr Shawn Ryan, medical director of BrightView Health, one of the largest addiction treatment providers, said: “If a person were a diabetic, we would never wait for treatment. for them until they were in a coma or had to have their limbs amputated. service in the Midwest. “That’s how often we get into a substance use disorder before we do anything about it. People just need to realize how under-budgeted our field of treatment is.”

“Don’t act like you’re going to change something big with these over-the-top responses,” says Ryan.

The Biden administration has been committed from the outset to tackle the nation’s addiction crisis, from raking in $4 billion in American rescue plan to expand access to treatment to promote increased availability of naloxone — essentially an antidote to opioid overdoses — nationally. The president’s “Build Back Better” framework includes $11 billion in additional funding to stop drug trafficking and address treatment inequality.

In a statement marking the milestone, President Joe Biden pledged not to “forget this epidemic of loss, which has touched families and communities across the country.”

“To all the families mourning a loved one and all those facing addiction or in recovery: you are in our hearts, and you are not alone” , Biden added, in a possible nod to his own family struggle with substance use. “Together, we will turn the tide on this epidemic.”

Kevin Roy, policy director of Shatterproof, a nonprofit that works to expand access to addiction treatment nationally, takes the poll to even stricter terms.

“This is just a tragic increase in drug overdose deaths,” said Roy. “To put it bluntly, just think about the 20-year trajectory: As recently as 2000, 17,000 people died a year from overdoses, and now we’re at 100,000.”

However, barriers to adequately addressing the substance use crisis are higher than simple financial resources. Experts say a range of regulatory obstacles to treatment delivery, poor access to health insurance, limited treatment limits for those with insurance and patchy laws The availability of naloxone has all made an appropriate response to the epidemic nearly impossible.

Patrick Kennedy, a former congressman from Rhode Island and founder, said: “Access to treatment is still subject to too many limitations to non-quantitative treatment, prior authorization, concurrent review, review. retroactively — people were kicked out of treatment too soon.” of the Kennedy Forum, which works to promote mental health and care for addicts.

Kennedy, whose substance use past has made him a prominent advocate for addiction treatment, pointed out that Biden decided not to bring in the director of the National Office of Drug Control Policy. cabinet — and didn’t even confirm a director until last week — as proof the White House isn’t taking the matter as seriously as it normally does.

“We have no leadership,” said Kennedy, noting other important priorities for addiction treatment advocates, including faster approval of opioid addiction medications. “I mean, if we can get a COVID vaccine during an emergency, why in the world did it take us so long?”

Experts have praised several aspects of the administration’s approach to the crisis, particularly its focus on harm reduction for Americans struggling with substance use. The White House has specifically emphasized that the composition of the overall drug response is the country’s most pressing priority in addressing the overdose epidemic, pointing to the Build Back Better framework as the next best step.

“Tackling the addiction and overdose epidemic is an urgent priority for his administration — that’s why we’ve taken important steps to tackle it, including eliminating the barriers to prescription drugs for opioid use disorders, funding harm reduction services, announced a new overdose prevention strategy last month that will build on progress this level,” White House deputy press secretary Chris Meagher told reporters last week before the release of the CDC data.

Meagher also noted Biden’s $41 billion investment proposal in national drug program agencies, up $670 million from the previous year, is “a prime example of this being an administration priority.”

But without access, these efforts can bring valuable resources to a dead end, said Dr. Lawrence Weinstein, medical director of the American Center for Addiction.

“While focused efforts are being made to stamp out the growing number of drug overdose deaths, it seems that some approaches do not focus directly on the part of the problem that needs to be tackled,” Weinstein said. get the most attention,” Weinstein said. “For example, while increasing the availability of naloxone is a great idea and can make a difference, people with substance use disorders often don’t access facilities that benefit from it. such an approach. Buyers of any kind on the street — where these fentanyl-containing substances are a problem — are likely not patrons of libraries, healthcare providers, social service organizations and other areas in which the availability of naloxone will increase”.

Experts told The Daily Beast the first place is to prevent addiction and overdose, as the number of drug overdose deaths has increased fivefold over the past two decades despite huge resources. dedicated to stopping drug trafficking.

“If you look at the history of supply and demand and drugs in the US, there’s not so much that interferes with or thwarts supply-side efforts,” Ryan said. “Thinking we’re going to stop this because we’re stopping it from coming in, that’s not how it works. That’s not how humans work. If demand continues to grow, supply will find its way. ”

While addiction services and treatment are critical to preventing long-term substance use disorders, experts say the administration is not spending enough energy or resources educating Americans about the relationship between addiction and addiction. The dangers of fentanyl are present in nearly 60% of overdose deaths. reported by the CDC. This drug, which is more potent than morphine, is increasingly being cut into other illicit drugs, from cocaine and methamphetamine to MDMA and counterfeit pharmaceuticals – meaning even casual drug users now also face the risk of accidental overdose.

“A 20 year heroin addict would never be able to tolerate these things, let alone kids who are on any kind of drug…everything is cut off with this,” Kennedy said. speak. “The single biggest change in mortality that we are seeing is due to the lethality of the new drug on the market.”

But apart from more and more popular word of mouth About cocaine laced with fentanyl in major cities, treatment experts say too many Americans are still unaware of the risk — and the government needs to educate them.

“We need to do educational campaigns about fentanyl exposure in every other drug,” says Ryan, who has seen many cases of non-drug addicts unwittingly exposed to fentanyl and dying. death.

“They weren’t looking for any drugs,” Ryan said. “There needs to be a publicity campaign to say, ‘hey, if you’re going to use drugs, understand that this compound could be in them’.”

The education efforts are largely focused on preventing teen drug use, said Lindsey Vuolo, vice president for health law and policy, Partnership to End Addiction. than adolescents — and younger children, who may be more susceptible.

“Substance use prevention has been too narrowly focused and focused on adolescents,” says Vuolo. “Substance use prevention needs to start much earlier in a child’s life and focus more broadly on healthy adolescent development by reducing risk factors, including social determinants of health and adverse childhood experiences, and enhance protective factors, such as resilience.”

Experts are the first to admit that in an area where understanding of addiction and substance use disorders is rapidly changing, there is no silver bullet for addressing the overdose crisis.

“A lot of what we did in the area that we thought was important, hasn’t changed our trajectory,” says Roy. “Actually, it got worse.”

But compared to other public health concerns, many of which are equally difficult to address, drug use is still being “shortened” by the federal government, Ryan said.

“If you compare substance use disorder with everything else — cardiovascular, diabetes, it doesn’t matter — we’re spending about 100 times less than we can,” Ryan said. . “And then there’s some degree of surprise that these reports continue to come out as bad as they are. Honestly, it’s embarrassing and frustrating when people say, “Well, I don’t know why we’re not going to make any progress.”