ONDCP Blog

In Recognition of World Hepatitis Day

• Enhanced access to HCV testing based on the availability of rapid point-of-care tests and US Preventive Services Task Force recommendations for HCV screening among individuals at high risk for infection; 
• Improved access to health coverage based on provisions of the Affordable Care Act and Federal parity protections; and,
• New HCV therapies that are effective in curing HCV in the majority of people who complete treatment.  

Drug Policy Reform at Home and Abroad

Today is the International Day Against Drug Abuse and Illicit Drug Trafficking, an annual observation established in 1987 by the United Nations General Assembly. It is an important day to reflect on the progress the world has made against drugs and the many challenges still to be addressed. 

One notable example of progress is the increasingly widespread support for a public health-focused approach to the drug problem. Just a few years ago, a focus on prevention, early intervention, behavioral and medication-assisted treatment, overdose prevention, and recovery support services was controversial in many areas of the world. In fact, there was a time when the word “recovery” was not even accepted in U.N. documents. But in 2014, a U.S. resolution on recovery at the annual U.N. global drug meeting (the Commission on Narcotic Drugs) easily won approval.  These discussions at the U.N. and elsewhere have led to a greater appreciation of the urgent need to reduce the stigma associated with substance use disorders – both out of genuine compassion and as a means to encourage those who need help to seek treatment.

Implementing public health policies requires a lot of hard work and an investment in building treatment capacity, including training medical professionals on how to address substance use disorders through screening and early intervention. Once medical professionals are trained to screen patients for substance use, they can identify and address problems earlier. This type of assessment can result in huge long-term savings in future criminal justice and other public costs.

Also critical to improving public health is the use of medications to treat addiction and the implementation of medication-assisted treatment (MAT) protocols. Although cultural and social stigmas regarding medications used to treat opioid use disorders persist in some places, clinical research has shown it is highly effective, reducing relapse rates and improving health outcomes significantly.

Another encouraging development is the emerging global consensus in favor of alternatives to incarceration for people with substance use disorders.

There are now over 2,900 drug treatment courts in the United States and dozens more internationally. Over the years, these specialized courts have continued to refine and improve their operations. This intervention has repeatedly demonstrated success in decreasing recidivism, driving drug use down, and reducing criminal justice costs.  In addition, DTCs break down the walls that too often divide justice and health agencies, allowing them to work together toward the same goal.  It is no surprise that international partners are studying these models and adapting them to the challenges they face in their countries.

In just over a decade, Hawaii's Opportunity Probation with Enforcement (HOPE) and similar initiatives operating in about 40 jurisdictions have helped to inspire probation reforms across the United States.  The Swift, Certain, Fair approach reduces drug use, recidivism, and crime by employing brief, consistently applied sanctions for every probation violation.  Treatment is provided to those who request it.  An independent evaluation of the HOPE program found that participants – primarily methamphetamine users – were 55 percent less likely to be arrested for a new crime; 72 percent less likely to use drugs; 61 percent less likely to skip appointments with their supervisory officer; and 53 percent less likely to have their probation revoked.[1]

As the international community prepares for the U.N. General Assembly Special Session on drugs in April 2016, the United States will advocate wider adoptions of vital reforms such as these around the world.

More information about medication-assisted treatment and alternatives to incarceration is available at http://www.dpt.samhsa.gov, the National Association of Drug Court Professionals, and the SwiftCertainFair Resource Center.

 

Community Policing and Drug Overdose: Where You Live Doesn't Have to Determine Whether You Survive an Overdose

The odds of surviving a drug overdose, much like the odds of surviving a heart attack, depend on how quickly the victim receives treatment. But access to naloxone—which can reverse heroin and prescription drug overdoses--varies greatly across the country, even though all drug poisoning deaths have surpassed traffic crashes as the most lethal cause of preventable injury. Because police are often the first on the scene of an overdose, the Obama Administration has strongly encouraged local law enforcement agencies to train and equip their personnel with naloxone.

Yesterday, the President traveled to Camden, New Jersey, a city that’s taken steps to create economic opportunity, help police do their jobs more safely, and reduce crime in the process. Yet another area where the Camden County Police Department is taking the right steps is with its creation of an overdose prevention program.  This program has reversed 68 overdoses since it started a year ago. Across New Jersey, law enforcement officers have used naloxone to respond to overdoses 888 times since 2014.

By engaging with law enforcement in naloxone administration, we are truly pursuing a 21st century approach to drug policy and community policing--one that combines public health with public safety.

Recently I met Corporal Nicholas Tackett, a police officer from Anne Arundel County in Maryland. Corporal Tackett has witnessed about 50 drug-related overdoses in his law enforcement career.

He knows the signs of overdose, the looks on their faces. Now, with naloxone, he has a tool that enables him to save lives. Corporal Tackett brought me to the locations where his use of naloxone reversed the life-threatening overdoses of two people. Naloxone works, and it is an incredibly important tool.

In October 2014, the Department of Justice released a Naloxone Toolkit for law enforcement. This toolkit is an online clearinghouse of more than 80 resources, such as sample policies and training materials designed to support law enforcement agencies in establishing a naloxone program. 

In the past year, we have witnessed an exponential expansion in the number of police departments that are training and equipping their police officers with naloxone.  They now number in the hundreds and they are saving lives.

The Police Department in Quincy, Massachusetts, has partnered with the State health department to train and equip police officers to resuscitate overdose victims using naloxone. The Department reports that since October 2010, officers in Quincy have administered naloxone in more than 382 overdose events, resulting in 360 successful overdose reversals.

The Vermont Department of Health has been distributing Overdose Rescue Kits with naloxone to State police as well as to individuals through community-based partners. To date, naloxone has been deployed 146 times across the State.

There is also collaboration taking place in rural and suburban communities. In Illinois, the Lake County State’s Attorney has partnered with various county agencies, including the Lake County Health Department; drug courts; police and fire departments; health, advocacy and prevention organizations; and local pharmacies to develop and implement an opioid overdose prevention plan.  As of February 2015, the Lake County Health Department had trained 828 police officers and 200 sheriff’s deputies to carry and administer naloxone, and more departments have requested this training.

To build on these efforts, the President’s FY 2016 Budget directs the Department of Health and Human Services to permit the use of block grant funds for naloxone purchases. It also provides funding specifically for law enforcement to purchase naloxone.

Where you live shouldn’t determine whether or not you survive an overdose. So our goal is to get naloxone in every community where overdose deaths are prevalent. Combined with evidence-based prevention programs and access to effective treatment, this approach will save the lives of many Americans.

Michael Botticelli is Director of National Drug Control Policy. 

The Indianapolis Star: "Work to prevent opiate drug abuse"