Strategy highlights plans of action to address untreated addiction, overdose epidemic.

In response to recent reports that 106,854 individuals have lost their lives due to overdose over the past 12 months, the Biden Administration released the National Drug Control Strategy to address addiction and the overdose epidemic. The strategy focuses primarily on untreated addiction and drug trafficking and outlines a plan of action for each effort.1

Shortly thereafter, the American Medical Association (AMA) announced that it endorses the strategy’s plan of action for addressing untreated addiction, especially for individuals at highest risk of an overdose.2 Specifically, the strategy calls for the expansion of high-impact harm-reduction interventions such as naloxone; greater access to evidence-based treatment for those at the highest risk of an overdose; and the improvement of research and data systems to guide the development of drug policy.1

The strategy also outlines a targeted approach to reducing access to illicit drugs by reducing drug trafficking. It calls for collaboration and coordination on the domestic and international levels to reduce the supply of illicit drugs that are smuggled into the United States, and for the disruption of the financial activities of transnational criminal organizations that manufacture these drugs and traffic them into the United States.1

“This sober, clear-eyed report sees the nation’s drug overdose and death epidemic as a public health emergency that requires increased access to a wide variety of harm reduction efforts. Such approaches as increased access to naloxone, drug test strips and syringe services are evidence based, and, if enacted, would save thousands of lives,” said Bobby Mukkamala, MD, chair of the AMA Substance Use and Pain Care Task Force and chair of the AMA Board of Trustees, in a press release. “We also agree with the need to remove all barriers to medications to treat opioid use disorder, including barriers from health insurers as well as those encountered by incarcerated patients and those in recovery homes.”

“The AMA urges all health insurers and state legislatures to take steps to make this strategy a reality. The AMA is a willing partner,” Mukkamala concluded in a press release. “This epidemic has gone on too long and claimed too many lives. We need to make sure evidence-based overdose prevention and treatment is available for everyone.”

Although the strategy supports evidence-based harm reduction interventions and the removal of barriers to medications that can help treat opioid use disorder, some experts suggest that additional attention needs to be paid in the development of new treatments, particularly in regard to fentanyl, and to expansion of the related research beyond opioids.

“To fight the epidemic of lethal fentanyl related overdoses and, more recently, the surge in fentanyl mixed with stimulants like cocaine and methamphetamine, we also need to improve our interventions and develop new [US Food and Drug Administration] (FDA)-approved treatments,” Thomas R. Kosten, MD, told Psychiatric Times™. “Progress is being made in this medication development mission through the [National Institutes of Health] (NIH), and this mission requires expansion of the [Helping to End Addiction Long-Term] (HEAL) research initiative beyond just opioids,” he added.

Kosten is the Jay H. Waggoner Endowed Chair and co-founder at the Institute for Clinical and Translational Research, as well as a professor of psychiatry, neuroscience, pharmacology, and immunology at Baylor College of Medicine in Houston, Texas.

“The 2022 National Drug Control Strategy needs to recognize this fundamental scientific requirement for adequate control of the expanding lethal epidemic with effective novel interventions like anti-fentanyl vaccines and application of real-time monitoring devices that will deliver overdose reversal agents like naloxone to individuals at high risk of lethal overdoses at the time of those overdoses,” he said.

References

1. Fact sheet: White House releases 2022 National Drug Control Strategy that outlines comprehensive path forward to address addiction and the overdose epidemic. The White House. News release. April 21, 2022. Accessed April 25, 2022.

2. AMA welcomes public health approach to overdose epidemic. American Medical Association. News release. April 21, 2022. Accessed April 25, 2022.

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