National drug chief says overdose positives are declining, but more needs to be done

Early data from the Centers for Disease Control (CDC) show a dramatic 12 percent drop in drug overdose deaths in the U.S. over the past year. During the same period, West Virginia’s drug overdose rate dropped nearly 11 percent, nearly matching the national rate.

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

The transcript below has been lightly edited for clarity.

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

Say: I think we need to look at this the same way we’ve always looked at this type of data. When President Biden and Vice President Harris came into office in January of 2021, this comparable data showed that overdose deaths were up 31 percent year over year, 31 percent. And this is why President Biden and Vice President Harris made it a top priority from day one and have made historic public health and public safety efforts over the last four years to reduce our overdose deaths across the country. So now you look at this data and we can see the latest version of the data showing a 10 percent reduction in overdose deaths. This is, again, in the opposite direction of what we saw with this comparable type of data of a 31 percent increase year over year. Now, having said that, these are not just numbers. These are lives, and we did not go from overdoses increasing 30 percent year over year to decreasing by chance. It was not an accident. That’s because President Joe Biden and Vice President Kamala Harris made this a top priority from day one and committed to transforming the way our country approaches this epidemic through a whole-of-society response. So over the past year, the Biden/Harris administration has taken more historic actions and made more unprecedented investments that I want to talk about than ever before, ever before in the history of this country to directly address this crisis.

You know, if you look at the president’s 2022 strategy, it was very clearly laid out that if we have a clear strategy for policy and we invest in it, we will see this kind of progress. And so the president has really looked at this and the vice president has looked at how we can best address two major factors: one is untreated addiction. The other is the profits from drug trafficking. On the untreated addiction side, we have now, under the leadership of President Biden and Vice President Harris, broken down decades of barriers to substance abuse treatment. We have invested over 40 percent more than the previous administration in funding for treatment in communities across the country, particularly in West Virginia. And we have expanded access to life-saving overdose medications, overdose medications like Naloxone, which are not only available without a prescription, but at the lowest price it has ever been in history. And on the public safety side, we have seized more fentanyl at the border in the last two years than we have in the last five years combined. We’ve also deployed more drug detection machines at the border to stop the flow of fentanyl, and we’ve convicted hundreds of targets involved in drug trafficking, from the illegal Chinese chemical companies to the drug cartels to their lawyers and cronies. And then finally, we’re also working to strengthen international efforts to disrupt the entire global illicit drug trade. So this progress that we’re seeing is important to achieving this milestone. But also remember, we still have so much work to do, but at this point in time and history, we seem to understand what policies work and why we should invest in them. And that’s exactly why the President and Vice President are not going to stop. They have the backs of Americans, and they’re going to keep fighting, both in Congress and with anyone who doesn’t believe in the unity agenda, as Biden would say this is not a red state issue or a blue state issue. This is an American issue, and we have to make sure that we’re in this together as a country.

Rice: What do you think is the most effective measure to reduce 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 that can be attributed to the ready availability of Narcan and Naloxone that are FDA approved, over the counter, etc.?

Say: Well, I certainly think there have been a number of aspects, both in terms of public health and public safety, including approving, as you mentioned, the over-the-counter medications for over-the-counter purchase and making sure that they are affordable. So a historic investment in delivering those life-saving medications to the community, wherever you are. For example, the State Opioid Response (SOR) and Tribal Opioid Response (TOR) programs have delivered almost 10 million kits, 10 million kits of these overdose medications to communities. We’ve convened the U.S. drug manufacturers that have FDA approval for overdose medications through various means and how they can be accessed and affordable to save more lives. We also, in addition to expanding access to treatment, we now have 15 times more providers across the country than we did in the previous administration. We’ve also made sure that long-term telehealth is available for methadone and the barriers to methadone have been removed.

When you look at prevention, early intervention, and harm reduction, for the first time in the history of the United States, it’s at the federal level, not just as policy, but as funding. Then you look at the historic expansion of treatment, and then finally the recovery that we’ve been working on to develop a recovery-ready country through recovery-ready businesses. All of this combined with the historic fentanyl seizures at the border and the destruction of the border, are separate but combined and integrated actions that have worked, exactly as a strategy said, by addressing those two primary causes of untreated addiction, as well as the process of drug trafficking.

Rice: Speaking of your home state, one of the states hit hardest, if not the hardest, by the opioid epidemic, what steps can West Virginians involved in substance abuse prevention and treatment take to ensure that overdose rates continue to decline?

Say: Well, thank you for asking. I was back home a few months ago and we were meeting with the One Box Initiative… this goes back to the holistic approach. I mean, when they reminded me that when I was commissioner, we had funded $120,000 for this program and now we see the graduates of this program, the work of the program, and there are peer recovery support specialists available. It’s that kind 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 student representatives and other agencies, as well as law enforcement, schools, community and health and partnerships. So, you know, it’s heartening for me to see that we’re making progress in my home state, but at the same time, it’s really important to understand and learn from those that we’ve lost, and leave no stone unturned to make sure that we save the next life that we can save. So it’s important to put all the tools in the toolbox to save as many lives as possible through this evidence-based, data-driven policy. It’s now clearly demonstrated that Vice President Harris’ and President Biden’s agenda is having a positive impact on the state. But we still have so much work to do.

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