Biden Administration Embraces Once Taboo Strategies To Stem Alarming Opioid Overdose Crisis

As the opioid crisis in the U.S. reaches alarming numbers, resulting in roughly 100,000 overdose deaths in the past 12-month period, a massive surge from a year earlier – federal health officials are willing to try new approaches to stem the tragedy. This week, Secretary of Health and Human Services (HHS) Xavier Becerra revealed the Biden administration’s strategy to deal with the epidemic, which could include allowing supervised consumption sites, reported The Washington Post.

"We are willing to go places where our opinions and our tendencies have not allowed us to go [before]," Becerra said in an interview with NPR, adding that the pandemic and spread of the deadly opioid fentanyl has made drug use far more dangerous. Becerra said the federal government will now directly support ideas known broadly as harm reduction.

Strategy Details 

The four-part strategy would consist of:

• Measures to prevent drug addiction like reducing the inappropriate prescribing of opioids;
• Offering more harm reduction techniques like providing clean needles and test strips to detect fentanyl in street drugs;
• Advancing medication-based treatments, which, according to research is the most effective approach;

Improving support for those recovering from substance use disorder. 

“We’re changing the way we do this,“ Becerra said, “we know what works. We’ve had years of evidence now.”

According to a recent HHS report, some 840,000 people died from drug overdose between 1999 to 2019, though some estimates speculate there have been 20 to 30 times as many non-fatal overdoses.

Officials and experts often disagree on the best approach, with many of the latter claiming that harm reduction is a more efficient strategy than prosecution of drug users or attempts to stop drugs coming to the U.S.

Becerra also revealed that the federal government plans to allocate more funds to expand the distribution of naloxone, the antidote to opioid overdoses, support needle exchange 

programs and to provide test strips to detect the presence of fentanyl in other drugs.

Signaling Possible Policy Changes 

As for the supervised consumption sites, Becerra said: “When it comes to harm reduction, we are looking for every way to do that. … We probably will support the efforts of states that are using evidence-based practices and therapies.”

Becerra told NPR that the government is "literally trying to give users a lifeline” and will not hinder state attempts to establish safe injection sites. “We’re not going to say ‘but you can’t do these other type of supervised consumption programs that you think work or that evidence shows work.'

“We are willing to go places where our opinions and our tendencies have not allowed us to go [before],” Becerra said. “If you can’t prevent someone from becoming a user, then at least prevent them from harming themselves to the point of death.”

Becerra noted that the decision is outside his lane, but during his time as

California’s attorney general (2017-2021), he supported safe injection sites where a professional staff was equipped with naloxone and oxygen in case of overdose.

An HHS spokesperson, referring to Becerra’s comments, said in a statement that “HHS does not have a position on supervised consumption sites. The issue is a matter of ongoing litigation. The secretary was simply stressing that HHS supports various forms of harm reduction for people who use drugs.”

Nevertheless, Becerra’s comments signaled a possible shift in U.S. policy.

These sites already exist in Canada and Europe and are often considered a helpful tool in saving many thousands of lives of people who would otherwise have accidentally overdosed. Those who oppose them claim the facilities encourage drug use.

Drug policy experts and advocacy groups praised the new overdose response initiative. 

"Their logic is the right logic," said Keith Humphreys, an addiction researcher at Stanford University.

"It's what you do when you have an epidemic of addiction. You try to keep people from becoming addicted, you try to keep alive the people you can't treat, and you try to get them into recovery."

Photo: Courtesy of Michael Longmire on Unsplash