WASHINGTON — The Biden administration announced several new actions aimed at tackling the opioid overdose crisis, including more funding for states and territories and new guidance designed to increase access to naloxone (Narcan).
“Our nation is facing 108,000 overdose deaths in just 12 months,” said Rahul Gupta, MD, director of the White House Office of National Drug Control Policy (ONDCP), on a phone call with reporters Thursday evening. “That’s one life lost every 5 minutes around the clock … Our North Star is to save lives and connect more Americans to treatment and recovery support services. We have already seen our efforts take effect. After a more than 35% increase in overdose deaths during the first 18 months of the pandemic, more recent 12-month rolling total overdose death counts have remained largely unchanged.”
Actions announced by the administration on Friday include:
$1.5 billion in funding to states and territories to address addiction and the opioid crisis. The funding, which is being given through the Substance Abuse and Mental Health Services Administration, will be used to increase access to treatment for substance use disorder, remove barriers to public health interventions like naloxone, and expand access to recovery support services such as 24/7 opioid treatment programs, according to a White House fact sheet. States can also use the funds to increase their investments in overdose education and to hire peer support specialists for emergency departments.$104 million in funds to expand substance use treatment and prevention in rural areas. This funding, which will come through the Health Resources and Services Administration, will go to public, profit, and nonprofit organizations as part of the multi-year Rural Communities Opioid Response Program. The money will be spent to open new medication-assisted treatment sites, help with workforce mentorship and training, and allow communities to invest in education and outreach to prevent and treat substance use disorder, the White House said.New guidance to increase access to naloxone. The FDA issued guidance Friday to ease distribution of FDA-approved naloxone products. The guidance, which is effective immediately, makes naloxone exempt from certain laws related to drug purchase and distribution under the Drug Supply Chain Security Act. Making these exemptions “helps to address some of the obstacles that have existed in obtaining access to naloxone, and may help eligible community-based programs acquire FDA-approved drugs directly from manufacturers and distributors,” the White House noted.More funding for law enforcement. In April, the ONDCP announced $275 million in funding for the High Intensity Drug Trafficking Areas Program to support law enforcement officials working against drug traffickers. The agency is now adding another $12 million to that funding, which also includes money for efforts to prevent gun crimes associated with drug trafficking.
Asked during a question-and-answer session about why the opioid crisis continued to escalate during the pandemic, Gupta said that “we know that the increase in drug overdose and poisoning deaths was beginning to rise even prior to the pandemic, and it has been very clear that the pandemic has clearly exacerbated the suffering to Americans, both in terms of isolation and of early shutdown of treatment facilities.” That’s why the administration has implemented “a number of things, including telehealth provisions, that allowed some significantly increased access to care, both for rural populations but also other marginalized and underserved communities, and populations such as [prison inmates],” he added.
MedPage Today asked officials whether any thought had been given to continuing the newly loosened restrictions on buprenorphine prescribing; as part of the COVID-19 public health emergency, the administration lifted the training requirement for a buprenorphine prescribing “X-waiver” in April 2021, although doctors still have a limit of 30 patients for whom they can prescribe the drug at any given time.
“We certainly have heard from communities” that the loosened restrictions “have been so helpful,” said Miriam Delphin-Rittmon, PhD, HHS Assistant Secretary for Mental Health and Substance Use. In addition, “for individuals who are on either methadone or accessing buprenorphine, it has been helpful to be able to receive those medications through telehealth, or to receive take-home doses. We are currently looking to continue those flexibilities for 1 year beyond the end of the public health emergency,” and also considering extending them even beyond that date, she said. “That is all in process and under discussion. But currently, for at least 1 year beyond the public health emergency, those flexibilities will be continued.”
Gupta added that as an X-waivered physician himself, he knows that “it is very difficult for providers and clinicians all over the country to be able to provide that access on par with the ability to write [prescriptions for] other Schedule II drugs … We want to make sure that these flexibilities that Dr. Delphin-Rittmon’s talking about — the telehealth provision and access to methadone to take home, as well as the mobile vans for methadone that significantly increased access to people, especially in rural communities — [continues because] it is critical, and we know treatment saves lives.”
However, he added, “we also need to make sure that the clinician community steps up and is providing those prescriptions, addressing the stigma that goes along [with addiction], including in healthcare, and providing people the help.”
Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy. Follow
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