Biden administration drug czar says it’s time to treat drug addiction like a chronic disease

By Nadia Kounang, CNN

The White House on Wednesday announced a new push to encourage harm reduction measures that make illicit drug use safer. Its supplying $30 million in grants for services such syringe exchanges and naloxone, the opioid overdose antidote.

The announcement is part of the Biden administration’s strategy to focus on harm reduction efforts, a priority announced in the spring. This administration is the first to so openly embrace this approach. But it comes as the country’s overdose crisis has already become dire.

Between April 2020 and May 2021, more than 100,000 people in the United States died from drug overdoses — the highest number ever recorded in a 12-month period.

“That’s the equivalent of an American dying every five minutes,” Dr. Rahul Gupta, director of the White House’s Office of National Drug Control Policy told CNN Chief Medical Correspondent Dr. Sanjay Gupta in an exclusive broadcast interview. The two doctors are not related.

“We have a number. And we have to look at this as an unacceptable number. It’s unprecedented. And we must have a response that matches that historic number,” Dr. Rahul Gupta said.

Fentanyl is the biggest driver of drug overdoses; it’s 50 times more powerful than heroin and is extremely cheap to produce. It’s used as a cutting agent that can stretch a supply of heroin or juice up fake prescription pills. The most recent data find nearly 70% of all overdose deaths involve synthetic opioids such as fentanyl.

“What that means is that a good majority of these (overdoses) are preventable in nature,” Gupta said.

Like his predecessors, Gupta has made a visit to the border to better understand how to stop the trafficking of fentanyl into the US.

“A lot of the fentanyl now, it’s easily transportable, it’s deadly in nature. And it’s across in all communities. And that’s what becomes the challenge,” he said.

But he also emphasized that it’s not just a matter of law enforcement: “This problem doesn’t start or end at the border,” he said. “It ends, unfortunately, in the emergency room.”

Gupta was previously the West Virginia health commissioner and state health officer. As the first physician to fill the position of drug czar, Gupta says it’s important to look at harm reduction: the idea of preventing overdoses by making drug use safer instead of focusing on abstinence alone.

Gupta said the Biden administration is prioritizing efforts including expanding the use of the opioid reversal drug naloxone, establishing syringe exchanges, and increasing the use of fentanyl test strips to test for the presence of the deadly drug.

But harm reduction has had a history mired in controversy, with critics saying it could potentially encourage drug use.

“As an evidence-based physician that has spent his career dealing with science and moving data around, we just do not have that evidence,” said Gupta.

Gupta said the approach to reducing overdoses has to ignore politics.

“When somebody’s suffering from substance use disorder or going through an overdose, whether fatal or nonfatal, they’re not Republicans, they’re not Democrats. They’re not living in red states or blue states, or rich or poor, or black or white … they’re human beings that we need to help support.”

And that support means approaching addiction and substance use not as a moral decision, but as a chronic relapsing brain disease.

“It’s no different than many of the other chronic diseases in so many aspects like diabetes and hypertension,” said the drug czar.

In addition to expanding funding for harm reduction efforts, the Biden administration also announced on Wednesday a framework for states to create syringe exchange-friendly laws. According to the US Centers for Disease Control and Prevention, people who use syringe exchanges are five times more likely to enter drug treatment and three times more likely to stop using drugs than those who don’t use the programs.

Advocates for harm reduction say these efforts work. Studies have found that people who check and test their drugs using fentanyl test strips are more likely to modify their drug use by using less, using slower, or making sure naloxone is available.

It’s a shift in how the country has long approached drug use, Gupta said.

“If you’re looking to save lives and you’ve reached a historic unprecedented level of deaths, then you cannot avoid looking at any and every option in order to save those lives,” he said.

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