On the campaign trail, Biden presented a comprehensive plan to address the opioid epidemic, but his public advocacy on the issue has largely fallen by the wayside as he focuses 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 comes to a close, his administration is facing calls to do more to stave off the crisis.
But experts say even more needs to be done to address the pandemic’s impact on addiction.
Regina LaBelle, the acting director of the White House Office of National Drug Control Policy, underscored in an interview with CNN that overdose deaths were “already increasing before the pandemic and it was exacerbated during the pandemic.”
The pandemic also sparked a mental health crisis that may have led more people to self-medicate with drugs and alcohol, experts say. People modified how they dealt with illness and death to prevent the spread of Covid-19, sometimes being barred from family members’ hospital bedsides or being left unable to grieve at funerals in person. And many struggled with job insecurity or confronted the possibility of health hazards on the job.
Dr. Stephen Taylor — an Alabama-based physician who serves as the chief medical officer of Pathway Healthcare, which has outpatient addiction treatment offices across the South — said he sees people responding to the stress of the pandemic with increased substance use. He also pointed out that across the country, “people who don’t even have a substance use disorder have increased their drinking.”
“What we’re experiencing more so in Alabama than perhaps in other parts of the country is just the stress of the pandemic — distress of so many people who are getting sick and who are being hospitalized and dying,” Taylor pointed out. “Many people respond to that with increased substance use.”
More work to do
Across the spectrum, experts also say there’s 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 the director of the White House Office of National Drug Control Policy during the Trump administration, expressed concern about the influx of fentanyl seizures at the southern border, comparing the drug to a “weapon of mass destruction.”
“I think that’s one of the ways we have to sort of approach this issue,” he said.
“The prevention side of this is so key, but we just need to know that drugs are not coming into our country. We cannot have a porous border for drugs,” he added. “That’s really key in order 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 throughout the drug supply, LaBelle said.
“And that is why we’re seeing increasing rates of overdose deaths involving methamphetamine and cocaine. It’s because fentanyl is everywhere. Where someone is using illegal drugs, it is likely that there is fentanyl in that drug,” LaBelle said.
There are areas where observers say the Biden administration is falling short of what the President discussed on the campaign trail.
Maritza Perez — the director of the Office of National Affairs at 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 while candidate Biden brought up “clemency, the need for revisiting our drug laws, that nobody should serve time for drug activity, (and) that he would prioritize racial justice” on the campaign trail, his administration has done little to address those concerns.
“We recognize that would be the most significant piece of legislation for people with substance use disorder, literally since the passage of the (Affordable Care Act),” Taylor said, adding that it’s “also an opportunity to really advance equity.”
LaBelle said, “Poverty puts people at greater risk for experiencing some of the conditions that may lead to early substance use,” arguing that the extension of the credit will “help prevent people from developing substance use disorders by reducing the conditions that may lead to trauma (and) homelessness.”
Addressing the addiction epidemic on a federal level
Experts across the political spectrum are encouraged by some aspects of the Biden administration’s approach to the overdose issue.
Perez said she credits the Biden administration for using the term “harm reduction” in public statements and saying the federal government supports such measures.
“That’s never happened before. So the fact that they’re saying that we need to support people, meet them where they’re at, make sure that people are consuming drugs safely. They didn’t say that. But that’s essentially what harm reduction is — it’s making sure that people have the tools they need to safely consume drugs. And, you know, that within itself is historic. We haven’t seen anything like that,” Perez said.
Experts lauded efforts to exempt health care 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 to opioid treatment programs, making it easier to get treatment to more isolated communities. And experts underscored the significance 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 toward harm reduction services.