Biden administration working to reduce overdose deaths
The overdose death rate in Delaware has risen 1.566% from 447 overdose deaths in 2020 – to 454 overdose deaths in the twelve-month period from May of 2020 to May of 2021, according to the CDC. Although it may seem that Delaware’s approach to the overdose crisis is trying our best, Delaware must and can do better if we work together through harm reduction – as President Biden pointed out in the State of the Union Address:
“So tonight I’m offering a Unity Agenda for the Nation. Four big things we can do together.”
“First, beat the opioid epidemic.”
“There is so much we can do. Increase funding for prevention, treatment, harm reduction, and recovery.”
“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 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.
In an era when overdose deaths are soaring, how should the law balance letting physicians exercise their best judgment with stopping egregious outliers?
Get rid of outdated rules that stop doctors from prescribing treatments.
Medicine is that which is made and created by law. Hence, if the court system has failed and created the overdose crisis – medicine by proxy has and will continue to fail the overdose crisis if the court system is not reevaluated along with medicine. To reevaluate medicine, we should consider the intersection of “medicine” and “law:”
The United States and the world should be watching how the Department of Justice and the State of Pennsylvania rectify the missing lives, lives, and afterlives of the overdose crisis in the case of UNITED STATES OF AMERICA, Plaintiff, v. THE UNIFIED JUDICIAL SYSTEM OF PENNSYLVANIA, Defendant. This case doesn’t matter just for this region, but precisely for the entirety of this country watching if harm reduction will be embraced or further suppressed from the state, national, and global level. Hence, if we continue to uphold court systems where Americans with disabilities are not given access to healthcare, the people, their belief in the system, and the system will not only die, but we as a country will die in their afterlives.
Today, the Justice Department filed suit against the Unified Judicial System of Pennsylvania (UJS) for violating the Americans with Disabilities Act (ADA). The department previously notified the UJS that its courts had engaged in discrimination by prohibiting or limiting the use of lawfully prescribed medication to treat Opioid Use Disorder (OUD) by individuals under court supervision. That letter of findings demanded that the UJS address the civil rights violations identified by the Justice Department’s Civil Rights Division and the U.S. Attorney’s Offices for the Eastern, Middle and Western Districts of Pennsylvania.
After getting out of rehab for the second time after graduation, before the summer even started, when I graduated from Delaware State University in 2017: I was not given medication for OUD when leaving Dover Behavioral Health in Dover, Delaware for my heroin addiction. Instead, I was strung out on suboxone the entire time I was there until I left and was forced upon release, with the weighted decision of getting sick and being sober – or getting high. In other words, when I was in rehab, I was given enough drugs to keep up with the suboxone and speedballs I shot to tolerate my nightmarish stints in rehab; furthermore, when I was told I was released, I was not given help besides an outpatient program that would not allow me any medication like suboxone to taper off of – even from my dose in rehab. Therefore, when I went to outpatient, I was shooting up even more and eventually overdosed – which could have and should have been prevented had I been given a clean supply – that the state clearly was in realms to do, since it did that very thing while I was in rehab at Dover Behavioral Health in the summer of 2017.
The Justice Department identified three individuals with OUD who were discriminated against by UJS Courts — specifically, the Northumberland and Jefferson County Courts of Common Pleas. Two individuals alleged that the Jefferson County Court ordered all probationers to stop using their prescribed medication for OUD. A third individual alleged that the Northumberland County Court required her to stop using her prescribed OUD medication to graduate from drug court. The department’s investigation corroborated these allegations and additionally found evidence that other UJS Courts have policies that discriminate against individuals with OUD.
Now is the time to take action across this country and stop discriminating against those with opioid use disorder – but to make things a more even playing field for all, this lawsuit will determine more than anything the effectiveness of the state’s rhetoric and its red herrings of pills and overprescribing being the self-chasing problem and solution – the DEA and all forms of law enforcement and power in the United States throw to the forefront: as the problem and solution to the overdose crisis – because they create it under the guise of solving it. In that pursuit: the state and its agents of law enforcement believe they have solved the overdose crisis because they are state actors physically acting.
"This lawsuit aims to safeguard the rights of people with Opioid Use Disorder who are too often subject to discrimination rooted in stereotypes and myths rather than in science,” said Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division. “Court-involved individuals with Opioid Use Disorder deserve access to medications needed to support their recovery and to break the cycles of addiction. We hope that this lawsuit against the Unified Judicial System of Pennsylvania sends a strong message about the need for courts to protect the rights of individuals with Opioid Use Disorder."
But let this be known, politicians and individuals are not to blame: everyone is trying their best on all fronts to fight this epidemic. Delaware and the rest of the United States need to have a national conversation on harm reduction – because without it, the current approach to drug overdoses is not only the cause of this overdose epidemic, but by continuing this old approach, we may never see the opportunities in recognizing that life is more important than condemning our neighbor for drug use.
A tentative settlement announced Thursday between nine attorneys general and the Sackler family – the owners of Purdue Pharma, which developed and manufactured the addictive opioid painkiller OxyContin – could mean nearly $50 million for Delaware opioid treatment and prevention programs.
The settlement, if approved by a bankruptcy court judge, would require the Sacklers to pay as much as $6 billion for their role in the opioid epidemic. The epidemic has killed hundreds of thousands of Americans over the last two decades – and thousands in Delaware alone.
“The agreement adds at least $1 billion to a prior bankruptcy settlement worth about $4.5 billion," Delaware Attorney General Kathy Jennings said Thursday. A federal judge vacated that deal in December, questioning whether the lifetime legal shield granted to the Sacklers as part of the plan was legal.
"‘The opioid epidemic has caused immeasurable damage to our state, much of which we can never repay,’ Jennings said. She added that in recent years, more than 400 people annually have died from overdoses in Delaware – the second-worst per capita rate in the nation.”
“‘The bottom line is that Delaware’s families deserve the best deal possible.’ Jennings said Thursday's settlement does just that, ‘not only through the additional millions of dollars secured for our state, but also through the acceptance of responsibility by the Sacklers, their permanent exile from the industry and the dismantling of a legacy bought with ill-gotten gains.’”
Still, it could be some time before Delaware and other states receive any of the nearly $6 billion.
The agreement must be approved by federal Judge Robert Drain, who presided over the previous bankruptcy hearings. It's also conditioned on several other factors.
If it does overcome these hurdles, Delaware could see up to $12 million in the first 18 months followed by yearly payments through 2039. The money received by the state must be put toward mitigating the effects of the opioid crisis and would be deposited into Delaware's Prescription Opioid Settlement Fund.
The overdose crisis is not a result of overprescribing or Big Pharma. It’s the class divide in the United States. My cousin couldn’t afford anything. The way the penal system in the United States renders drug users useless – made it so my cousin couldn’t provide for his family. He couldn’t provide for his kids. Take that away from any person, no matter how many times he got clean, and what’s the narrative? There isn’t. There is only the truth. And the truth of Delaware specifically being a macrocosm of the overdose crisis on a microcosmic level is that we are second in the United States in overdose mortality rates because all over Delaware, are people like my cousin used to be – before he OD’d, riding the line between life and death, hustling any way possible so he could pay child support, and diapers, food, and clothes, and shooting between his neck when the moment felt right. That’s real life in Delaware. That’s real life in Dover, Delaware. And until you do something personally, about it, it will stay that way. Drive past the person begging for their life on the street, it could have been you, it used to be me – but it will always be us, Delaware – until we take action, each of us – the D in OverDose will always stand for Delaware.
We must take this a step further. We must hold all systems of law and power accountable for the overdose crisis. We must hold all of ourselves accountable for the overdose crisis. This is a threat to human life – existence itself. The overdose crisis is existential. Who are we as a nation? What does it mean to exist as an American? What does it mean to be human as an American? Until we ask ourselves why someone would put a needle in their arm, we will never have the compassion to see courage and hope in this crisis. Only together, through harm reduction can we end the War on Drugs and the overdose crisis together. As President Biden said in the State of the Union Address:
If you’re suffering from addiction, know you are not alone. I believe in recovery, and I celebrate the 23 million Americans in recovery.
Jordan McClements is a resident of Felton.
This article originally appeared on Delaware News Journal: Biden administration working to reduce overdose deaths