Drug overdose deaths have reached a historic high, devastating families and communities. More than 104,000 Americans died due to a drug overdose in the 12-month period ending in September 2021. We grieve these losses, and commit to continuing our work to save lives.
Tonight, President Biden outlined the decisive actions his Administration is taking to address addiction and the overdose epidemic and laid out a vision for how his Administration will continue to expand evidence-based prevention, harm reduction, treatment, recovery, and supply reduction approaches to save lives. These efforts are bringing together Republicans and Democrats across the country because every community has been affected.
Specifically, the President outlined his comprehensive approach, including:
Increasing Funding for Public Health and Supply Reduction
According to the 2020 National Survey on Drug Use and Health, 40.3 million people aged 12 or older had a past-year substance use disorder. Meanwhile, more than four out of five Americans who need treatment for illicit drug use do not receive it. Mental health and substance use disorder services have been under-resourced for far too long, and the COVID-19 pandemic has placed an even greater burden on the system. The American Rescue Plan, which delivered nearly $4 billion to these services, was a down payment to support life-saving interventions. The President’s FY2022 budget request includes a historic $41 billion for drug policy efforts that will further these efforts. Specifically, the President is calling for:
- A historic proposed investment of $10.7 billion in discretionary funding for the Department of Health and Human Services (HHS) to fund research, prevention, harm reduction, treatment, and recovery support services, with a focus on meeting the needs of populations at greatest risk for overdose and substance use disorder. The President’s FY2022 budget proposes a total of $23.5 billion for public health approaches to reduce drug use and its consequences.
- A proposed investment of $5.8 billion for interdiction efforts, which is an increase from the FY2021 enacted level. This funding would help reduce the availability of illicit drugs in the United States and abroad through air and maritime seizures; enhancement of drug source nations’ ability to interdict drugs; and efforts along the nation’s borders to stop the trafficking of illicit drugs, weapons, and bulk currency. The President’s FY2022 budget proposes a total of $17.5 billion for supply reduction efforts.
Removing Barriers to Treatment
Medication for opioid use disorder (MOUD), such as buprenorphine and methadone, is a safe and effective treatment. However, most Americans who need treatment for an opioid use disorder do not get it. That is why President Biden has called for universal access to MOUD by 2025. To reach this goal, the Administration has advanced actions that remove unnecessary barriers that prevent medical providers from prescribing FDA-approved medications to their patients; lifted the moratorium on mobile vans providing methadone; supported states funding the purchase of such vans; and begun work on meeting individual treatment needs at times when people at high risk for an overdose need care and support.
- To further reduce burdens in accessing MOUD, the President supports eliminating outdated rules that place unnecessary administrative burdens on providers, discouraging them from prescribing effective treatments for addiction. The Administration will increase awareness and understanding of these medications so that patients and providers can make informed choices. This builds on last year’s action by HHS to release new Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder, which exempted eligible health care providers from Federal certification requirements related to training, counseling and other ancillary services that are part of the process for obtaining a waiver to treat up to 30 patients with buprenorphine. This action resulted in more providers registering to prescribe buprenorphine, thereby expanding access to evidence-based treatment.
- The Administration has extended and will propose making permanent the emergency provisions implemented during the COVID-19 pandemic concerning MOUD authorizations. This includes ongoing work allowing providers to begin treating patients with MOUD via telehealth, including by audio only, as well as the Substance Abuse and Mental Health Services Administration (SAMHSA) announcement extending the methadone take-home flexibilities for one year, effective upon the eventual expiration of the COVID-19 Public Health Emergency.
- Over the next year, the Administration plans to establish a set of hospital recommendations for overdose care and care coordination and create a model state law. Individuals who have experienced a non-fatal overdose are at greater risk of a fatal opioid overdose. Hospital emergency departments (EDs) offer a unique setting to initiate treatment, provide naloxone, and connect patients with peer support services.
- The Administration is working to expand MOUD throughout Federal incarcerated settings, in order to set an example for state and local jurisdictions. In conjunction with this effort, educational efforts will take place to support state and local jurisdictions in understanding the evidence and benefits of MOUD and community care connections upon release from incarceration – a time when individuals are at the highest risk for overdose. Recognizing that the prohibition of the use of federal funds for services behind bars acts is a barrier to states and counties in implementing evidence-based practices, an examination of federal funds usage and opportunities will take place during the coming year.
Reducing Harm and Saving Lives
In reaction to the steep rise in overdose deaths and the increasingly lethal drug supply, the Biden-Harris Administration has prioritized engaging and building trust with people who use drugs in order to save lives and provide care. For the first time, harm reduction services – which include naloxone, fentanyl test strips, and syringe service programs – are a federal drug policy priority. These interventions are saving lives in red states and blue states, as years of research have demonstrated. People who use heroin and others who inject drugs who regularly utilize a Syringe Services Program (SSP) are five times more likely to initiate substance use disorder treatment, compared with those who have never used an SSP. Syringe services sites can be effective platforms to motivate people with opioid use disorder to enroll in substance use treatment and, over time, to reduce drug use and number of drug injections. Distribution of naloxone to reverse the effects of an opioid overdose saves lives and is cost-effective.
- The Administration has prioritized funds for harm reduction. The American Rescue Plan included $30 million in support for harm reduction services – a historic amount that will enhance interventions like syringe services programs. Additionally, CDC and the SAMHSA announced that federal funding may now be used to purchase fentanyl test strips in an effort to help curb the dramatic spike in drug overdose deaths.
- The Administration is including the input of people who use drugs in designing harm reduction interventions that will help save lives. In December, ONDCP, SAMHSA, and the CDC convened the first-ever Harm Reduction Summit. A steering committee made up entirely of people with lived experience is working to provide guidance and input on future Administration harm reduction efforts.
- The Administration plans to continue efforts to support syringe services programs through funding opportunities to provide these programs with needed supplies such as fentanyl test strips and sterile syringes, which have been proven to reduce diseases such as Hep-C and HIV. In addition, ensuring naloxone is easily and readily available to these programs will provide the overdose reversal medication to people who need it most.
- In order to deliver resources to local communities, the Administration is working with states and communities to elevate harm reduction best practices. Last year, ONDCP released model laws for states to help expand access to naloxone and SSPs. This year, ONDCP plans to elevate best practices for harm reduction organizations initiating low-threshold treatment through warm hand-offs to care or colocation of treatment. The Administration plans to work with states to expand this strategy in communities most in need.
- The overdose reversal medication naloxone is a critical tool for saving lives. However, equitable access to naloxone across the country is often defined by where you live. The Biden-Harris Administration is examining barriers to the acquisition and distribution of naloxone at the local level in order to increase access and availability where it is most needed.
Stopping the Trafficking of Illicit Drugs
Transnational organized crime is a multi-billion-dollar enterprise that transcends geographical boundaries and threatens global stability. Every year, millions of lives are affected by transnational criminal organizations, including through drug overdose and addiction, violence, firearm deaths, human trafficking, and smuggling. Drug trafficking and transnational organized crime threatens our partners as well, especially in Latin America. It fuels corruption, unbalances economies, preys on the most vulnerable, and calls into question the very foundations of legitimate governance, all of which lead to internal population displacement and migration. Additionally, domestic drug trafficking organizations often contribute to public health challenges and violence in American communities. Addressing the core causes and sources of transnational and domestic criminal activities is an urgent priority for the Administration.
- In October, President Biden announced two Executive Orders to counter transnational criminal organizations and illicit drug trafficking: first, by formally establishing the U.S. Council on Transnational Organized Crime; and second, by modernizing and expanding the U.S. Government’s ability to target drug trafficking organizations, their enablers, and financial facilitators through sanctions and other related actions. With these new tools, the Administration will disrupt the drug traffickers’ ability to fund their business and deny them the benefits of their illicit activities.
- Through its High Intensity Drug Trafficking Areas (HIDTA) Program, ONDCP is funding new initiatives to reduce the violence associated with drug trafficking, refine interdiction efforts through enhanced data sharing and targeting, and go after illicit finance using innovative approaches, including cryptocurrency investigation. HIDTA baseline funds supporting these initiatives will be issued within 45 days of enactment of FY2022 appropriations. These efforts will leverage strategic partnerships with Federal agencies, academics, and private industry. ONDCP is evaluating emerging drug threats in a variety of geographic regions and is poised to expand the HIDTA Program, as needed, by designating new areas as HIDTAs to better equip these regions to disrupt and dismantle drug trafficking organizations. ONDCP plans to announce HIDTA designations this summer in the Federal Register.
- The HIDTA Overdose Response Strategy, funded by ONDCP and CDC, brings together drug intelligence officers and public health analysts at the local and regional levels to share information and develop evidence-based intervention and support services that reduce overdoses. The Strategy is piloting a range of innovative investigative, overdose prevention, and harm reduction approaches in all 50 states, Puerto Rico, the U.S. Virgin Islands, and the District of Columbia.
These actions build upon the significant efforts the Administration has advanced through its first-year drug policy priorities and the American Rescue Plan. These efforts delivered critical attention and resources to the communities that are tackling this crisis on the front lines. More information about actions taken by the Biden-Harris Administration to address addiction and the overdose epidemic can be found HERE.