Biden administration launches harm reduction-based drug strategy in face of record deaths

US president Joe Biden has sent his administration’s first National drug control strategy to Congress, focusing on a whole-government approach to the country’s ‘overdose epidemic’. Almost 107,000 people in the US died a drug-related death in the 12-month period to November 2021.

The strategy is the first to ‘champion harm reduction to meet people where they are and engage them in care and services’, the White House states, as interventions like naloxone and NSP are often still restricted or underfunded at community level. Less than 7 per cent of the 41m people needing treatment for substance issues were able to access it, according to the 2020 national survey on drug use and health.

President Joe Biden: a whole-government approach to the ‘overdose epidemic’

The strategy calls for more access to harm reduction interventions like naloxone, NSP and fentanyl test strips, and directs federal agencies to integrate them into care systems. Naloxone, however, will remain prescription only and will not be available over the counter. The administration’s efforts to expand access to treatment will focus on high-risk populations like people experiencing homelessness and people in – or leaving – prison. ‘The Biden-Harris Administration is committed to deploying an evidence-based approach to policy making,’ the White House says, combined with a focus on addressing trafficking and supply. The administration has submitted budget requests for an extra $300m each for the Drug Enforcement Administration (DEA) and Customs and Border Protection (CBP).

Existing harm reduction policies were ‘failing people’ as a result of inconsistency and barriers to access, director of the White House Office of National Drug Control Policy, Dr Rahul Gupta, told CNN. ‘We’re failing to meet them where they are and every one of those overdoses – from an opioids perspective – is reversible. Your zip code defines whether you live or die and that should just not happen. President Biden has made sure that this is an urgent priority, and we need to act with a sense of urgency because this is not a matter of days, weeks or years. It’s a matter of every minute when we lose Americans.’

‘We applaud the Biden-Harris Administration for taking the historic step to support access and funding for harm reduction services and reduce barriers to life-saving medications,’ said Grant Smith of the Drug Policy Alliance NGO. ‘Despite over 1m lives lost to drug overdose over the last 20-plus years, this is the first time an administration has included harm reduction in the National drug control strategy. The administration should continue to focus on its promise of equity by decreasing racial disparities in drug policy and the overdose crisis. Criminalisation approaches only saddle mostly Black, Hispanic and Indigenous people with criminal legal records and often incarceration, which increases their risk for infectious diseases, overdose and death.’ 
Prioritising spending on public health rather than enforcement was the best path forward, he stated. With the overdose crisis ‘now costing the US economy over $1tn annually we must embrace the evidence-based public health approaches we know work and save lives. But it must be done outside of the harmful apparatus of the drug war to be effective and provide the kind of racial equity this administration has long promised.’

National drug control strategy at – read the strategy here


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