Emily Rice Published

National Drug Czar Says Overdose Decreases Positive, But More To Do

A photo of Rahul Gupta standing outside the White House.
FILE - Dr. Rahul Gupta, the director of the White House Office of National Drug Control Policy, is shown at the White House, Thursday, Nov. 18, 2021, in Washington.
Alex Brandon/AP
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Early Center for Disease Control (CDC) data shows a dramatic fall of 12 percent in overdose death rates across the U.S. in the last year. During the same period, West Virginia’s drug overdose rate fell almost 11 percent, nearly keeping pace with the nation.

To gain insight into this encouraging development, Appalachia Health News Reporter, Emily Rice, spoke with West Virginia’s own Dr. Rahul Gupta, the nation’s director of the Office of National Drug Control Policy (ONDPC). Here is that conversation.

The transcript below has been lightly edited for clarity. 

Rice: At the end of your statement, you say the decline in overdose deaths is both a beacon of hope and an urgent call to action. The advocates that I’ve spoken with here on the ground in West Virginia also see it as a call to action but are hesitant to celebrate these numbers because they are provisional and because they say one overdose death is still too many. So in speaking about the drug epidemic, how should we interpret this provisional data from the CDC?

Gupta: I think we should look at this in the same way we have always looked at this type of data. When President Biden and Vice President Harris took office in January of 2021 this similar type of data showed that drug overdose deaths were increasing at 31 percent year over year, 31 percent. And this is the reason that from day one, President Biden and Vice President Harris made it a top priority, and made historic public health and public safety efforts over those last four years to reduce our drug overdose deaths across the country. So now you look at this data, and we can see the latest version of data showing that 10 percent reduction in overdose deaths. This is, again, in the reverse direction of what we were seeing with this similar type of data of a 31 percent year-over-year increase. Now, having said that these aren’t just numbers. These are lives, and we didn’t get from the number of drug overdoses increasing by more than 30 percent year after year, to decreasing by accident. It has not been an accident. It is because President Joe Biden and Vice President Kamala Harris made this issue a top priority on day one, and set out to transform the way our nation approaches this epidemic through a whole of society response. So over the past year, the Biden/Harris administration has taken more historic action and made more unprecedented investments that I want to talk about than ever before, ever before in the history of this country to address this crisis head-on. 

You know, if you see the President’s 2022 strategy, it was very clearly outlined that if we have a clear strategy on policy, and we invest in those, we will see this type of progress. So this is why the president really looked at this and the vice president as how to best address two key drivers: One is untreated addiction. The other is the trafficking profits. On the untreated addiction side, under the leadership of President Biden and Vice President Harris, now we have removed decades-long barriers to treatment for substance use disorder. We’ve invested more than 40 percent more than the previous administration in funding for treatment in communities all across the country, especially in West Virginia. And we’ve expanded access to life-saving overdose medications, overdose medications like Naloxone, which is not only available over the counter but at the lowest price cost it has ever been in history. Now on the public safety side, we’ve seized more fentanyl at the port of entry in the last two years than in the past five years combined. We’ve also added more drug detection machines at the border to stop the flow of fentanyl, and sentenced hundreds of targets involved in drug trafficking, from the illicit Chinese chemical companies to drug cartels to their lawyers and enablers. And then we finally also work to strengthen the international efforts to disrupt the entire global illicit drug trade. So this progress that we’re seeing is important to take this milestone. But also remember, we have so much more work ahead, but at this point in time and history, we seem to understand what policies do work and why they have to be invested in. And this is exactly why the President and the Vice President are not going to stop. They have American’s backs, and they will continue to fight, both in Congress and with anyone that does not believe in the unity agenda, as Biden would say that this is not a red state or blue state issue. This is America’s issue, and we need to make sure that we are addressing this as a country together.

Rice: What do you think has been the most effective measure in decreasing overdose deaths that the Biden-Harris administration has implemented since January 2021? While I know it will take time more data and research to determine which substance use disorder initiatives were most effective, do you think some of those can be attributed to the ready availability of Narcan and Naloxone approved by the FDA, over the counter, etc?

Gupta: Well, certainly, I think there’s been a number of aspects, both on the public health and public safety side, that includes approving, as you mentioned, the overdose medications for over the counter purchase and making sure that they are affordable. So an historic investment in getting those life saving medications to the community no matter where you are. For instance, the State Opioid Response (SOR) and Tribal Opioid Response (TOR) programs have delivered nearly 10 million kits, 10 million kits of these overdose reversal medications to communities. We’ve convened the U.S. drug manufacturers who have FDA approval of overdose reversal medication through different ways and how they access and have the affordability to save more lives. We’ve also, in addition to expanding treatment access, we now have 15 times more providers across the country than we did before in the prior administration. We have also made sure that there is telehealth available for methadone in the long term, and the barriers to methadone is lifted. 

When you look at the prevention, the early intervention, and harm reduction approach that’s been the first time in the history of the United States that it has been federally, not only policy, but also been funded, then you look at treatment expansion in historic ways, and finally, the recovery we have been working to develop a recovery ready nation, through recovery ready businesses, all of these combined with historic seizures of fentanyl at the border and destroy the border having are separate but combined and integrated action that has worked, just as a strategy has mentioned, addressing those two key drivers of untreated addiction, as well as the drug trafficking process.

Rice: Speaking to your home state, one of the hardest, if not the hardest, hit by the opioid epidemic, what are some steps that can be taken by West Virginians working in prevention and treatment of substance use disorder to ensure overdose rates continue to fall?

Gupta: Well, thank you for asking that. I was just back home a couple of months ago, and we met with the One Box initiative….this goes back to the holistic approach. I mean, when they reminded me that when I was a commissioner, we had funded $120,000 for this program and now we’re seeing the graduates of this program, the work of the program, and have peer recovery support specialists become available. It is this type of work. And then we saw 13 new commitments to the White House challenge to save lives from overdoses from colleges and universities working across West Virginia. Then we also had meetings with local officials and representatives from the students and other bodies, as well as including police, schools, community and health and partnerships. So you know, it’s heartwarming for me to see that we are making progress in my home state, but at the same time, it is really important to understand those we have lost and learned from them, as well as leave no stone unturned to make sure that we’re saving the next life that we can save. So it’s important to put all tools in the toolbox in order to, you know, save every life possible that we can through these evidence based, data driven policies that have now demonstrated, there’s clear demonstration that you know what the agenda that Vice President Harris and President Biden set out to do is having a positive impacts for the state, but we have so much more work to do.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Marshall Health.