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During the campaign, Biden presented a comprehensive plan to address the opioid epidemic, but its public advocacy on the issue has fallen sharply as it focuses its presidency on its legislative agenda and coronavirus pandemic. Now, in addition to half of Biden’s first year in office, as the National Recovery Month ends, his administration faces calls to do more to avert the crisis.
But experts say more needs to be done to address the impact of the pandemic on addiction.
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, making it the deadliest last year for drug overdoses. Alcohol consumption by American adults appears to have also increased during the pandemic, and nearly 1 in 4 adults reported drinking more to cope with 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 CNN that overdose deaths “were already on the rise before the pandemic and worsened during the pandemic.” “.
Covid-19 has caused general complications, including 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 were moved to Zoom. Isolated individuals in their home. Capacity at addiction treatment facilities decreased.
The pandemic also sparked a mental health crisis that may have led more people to self-medicate with drugs and alcohol, experts say. People changed the way they treated illness and death to prevent the spread of Covid-19, sometimes preventing them from being able to sleep in the hospital of family members or could not personally mourn at funerals. . And many struggled with job insecurity or faced the possibility of health risks in the workplace.
Dr. Stephen Taylor, an Alabama-based doctor who acts as chief physician at Pathway Healthcare, which has outpatient addiction treatment offices across the South, said he sees people responding to the stress of pandemic with an increase in substance use. He also noted that across the country “people who do not even have a substance use disorder have increased their alcohol consumption.”
“What we’re experiencing more in Alabama than perhaps in other parts of the country is just the stress of the pandemic: the anguish of so many people getting sick and being hospitalized and dying hospitalized,” Taylor noted. “A lot of people respond to that with an increase in substance use.”
More work to do
Across the spectrum, experts also say the Biden administration is doing a lot more work, especially in the fight against 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 on the southern border, comparing the drug with a “weapon of mass destruction.”
“I think that’s one of the ways we have to address this issue,” he said.
“The aspect of prevention is so key, 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 key to what ONDCP wants to achieve … reducing the drugs that are on our streets.”
The administration also continues to face the challenge of an influx of illicitly manufactured fentanyl throughout the drug supply, LaBelle said.
“And that’s why we’re seeing rising rates of methamphetamine and cocaine-related overdose deaths. It’s because fentanyl is everywhere. When someone uses illegal drugs, there’s likely to be fentanyl in that drug,” LaBelle said. .
For example, deaths from methamphetamine overdose nearly tripled between 2015 and 2019 in people ages 18 to 64, and many of these involved the use of an opioid at the same time, according to a study by the National Institute on Drug Abuse.
There are areas where observers say the Biden administration is below what the president discussed on the campaign trail.
Maritza Pérez, director of the Office of National Affairs of the Drug Policy Alliance, a non-profit organization that states that it aims to advance policies that best reduce the harms of drug use and drug prohibition, argue that while candidate Biden raised “clemency, the need to re-review our drug laws, that no one should devote time to drug activity, (and) that it would prioritize racial justice” on track of the campaign, his administration has done little to address these concerns.
Some groups have also disagreed with the administration’s proposal to permanently program fentanyl-related substances, known as fentanyl analogs. The substances have been temporarily designated according to Annex I, the same level of drugs that includes heroin and ecstasy, since 2018.
Proponents of permanent fentanyl analogue programming say the ban helps law enforcement build cases against producers and deters individuals from making these potentially harmful substances.
But Perez said the Biden administration’s proposal to definitively schedule analogues, which would not apply mandatory minimum sentences except in cases of death or bodily harm related to substance trafficking, “is not enough.”
“Not all fentanyl analogs have the same effect,” Perez said. “Some are really useful, especially when we talk about opioid addiction and opioid overdoses. So that’s really problematic. It sets … a new standard for drug programming, but also a new standard for opioids. criminalization “.
The American Society of Addiction Medicine, where Taylor is on the board, urges the White House to support various measures in its 2022 National Drug Control Strategy, scheduled for Congress early next year. . Taylor stressed the importance of the proposed funding in the House’s $ 3.5 trillion spending bill. Democrats had originally settled on that front-line figure, but some party Senate moderates have indicated they will not support such a high number.
“We recognize that it would be the most significant legislation for people with substance use disorder, literally since the passage of the (Affordable Care Act),” Taylor said, adding that it is “also an opportunity to really move forward. in equity “.
The spending bill includes a provision to provide Medicaid inmates before they are released from prison, an important step that advocates argue will help an extremely vulnerable population gain access to mental health treatment and consumption. substances, possibly preventing recidivism. The spending proposal would also extend the child tax credit, but its inclusion could be placed on the blog.
LaBelle said, “Poverty puts people at risk for 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 reducing conditions that can lead to trauma (and) homelessness “.
Address the addiction epidemic at the federal level
Some aspects of the Biden administration’s approach to the issue of overdose encourage experts from across the political spectrum.
Perez said he credits the Biden administration for using the term “harm reduction” in public statements and said the federal government supports those measures.
“This has never happened before. So the fact that they say we have to support people, get to know them where they are, make sure people use drugs safely. They didn’t say that. But that it’s essentially what hurts the reduction is: it’s making sure people have the tools they need to use drugs safely. And, you know, that’s historic. We haven’t seen anything like it, “Perez said.
Experts praised 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 in opioid treatment programs, making it easier to care for more isolated communities. And the experts stressed the importance of the nearly $ 4 billion in funding available through the American Rescue Plan to expand access to mental health services and substance use disorders, which include $ 30 million for mental health services. damage reduction.
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 take on the role of drug tsar if confirmed.
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Source: https://www.cnn.com/2021/09/30/politics/biden-administration-drug-epidemic/index.html
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