How removing barriers to addiction treatment can save lives
Reducing harm and quantity are some ways to reduce overdose deaths, said Rahul Gupta, director of the Office of National Drug Policy Control, during a fireside chat on the campus of Northeastern University in Charlotte.
While working in rural Alabama, Dr. Rahul Gupta treated a patient who had become addicted to painkillers. Gupta did not have a special license to prescribe him a drug to combat his addiction, so he referred him to a doctor 80 miles away.
A few weeks later, Gupta was working in the emergency room when the same patient was admitted and died of an overdose. The patient never sought the treatment Gupta recommended because, he said, he did not have the time or means to go to the doctor.
Gupta, now director of the Office of National Drug Control Policy, said his inability to prescribe drugs to combat addiction is an artificial barrier. Removing those barriers is one of the keys to helping millions of Americans with opioid addiction, he said during a recent fireside chat on the campus of Northeastern University in Charlotte.
The chat was moderated by Gibbie Harris, a visiting professor of clinical medicine at Northeastern University and former health director for Mecklenburg County, North Carolina.
“It’s important that we work to remove these artificial barriers like the special license,” Gupta said. “The number of patients who used to have a special license has increased from 129,000 to almost 2 million. Every county here in North Carolina now has a provider who can prescribe substance abuse medications, and that’s important.”
It is also important that providers screen patients for addiction disorders and then treat or refer them accordingly, Gupta said.
“It takes time, but removing the stigma and making it easier to get treatment than to get illicit drugs is a core element of our mission,” he said.
Drug overdoses are a leading cause of death in the U.S., and opioids are responsible for most of those cases, according to the Centers for Disease Control and Prevention. This costs the U.S. trillions of dollars and millions of lives, Gupta said.
More stories
Lost letters from Mary Stuart reveal their secrets after 450 years – thanks to a historian from the North East
Lost letters from Mary Stuart reveal their secrets after 450 years – thanks to a historian from the North East
How AshaPops, founded by a Northeastern University graduate and his mother, is revolutionizing snacks with popped lily seeds
How AshaPops, founded by a Northeastern University graduate and his mother, is revolutionizing snacks with popped lily seeds
Everything you need to know about moving to Northeastern University’s Oakland campus
Everything you need to know about moving to Northeastern University’s Oakland campus
Removing barriers to addiction treatment can save lives, White House drug envoy tells Northeast audience
Removing barriers to addiction treatment can save lives, White House drug envoy tells Northeast audience
But Gupta said fatal overdoses nationwide fell in 2023 for the first time since 2018.
“I don’t know when we last had a reduction,” Gupta added. “But I’m telling you, now is the time to double down on things that are working. I firmly believe we can end this (epidemic). We do that by taking a compassionate but evidence-based approach that includes prevention, harm reduction and treatment re-entry, while on the other hand also taking smart approaches to reducing supply.”
For Gupta, that means not only increasing the number of providers licensed to prescribe addiction treatment, but also providing more money for harm reduction programs and treatment options. This is especially true for people being released from prison. Gupta said they are at a higher risk of suffering from a substance use disorder and overdosing after they are released. Providing funds to people being released from prison so they can get treatment and a job after their sentence can save lives, he added.
As for supply reduction, Gupta said much of the fentanyl entering the country comes through legal ports of entry. The use of drug detection scanners can help reduce that, he said.
Gupta also spoke about the importance of increasing the availability of treatment in rural areas, saying something like telehealth appointments or a mobile clinic could have helped his patient, who died of an overdose.
“That’s a silver lining of the pandemic, that we now have permanent telehealth capabilities,” Gupta added. “We have the opportunity to continue to expand treatment. I also think we should focus on primary prevention, particularly in schools. If that’s not possible, we should think about how we can invest money in one of the best returns on investment that is often not talked about, which is primary prevention. You have to invest in the next generation as well.”
Another important part of this effort is also increasing the availability of naloxone, a drug used to treat overdoses, nationwide. Naloxone is available over the counter for as little as $24 per pack, Gupta said, and carrying this medication can and has saved lives.
The company behind the drug is ramping up production, he added, to make it more widely available. Airlines and schools in Los Angeles have already started carrying the drug. According to Gupta, this development has already saved 50 lives.
“I would like to see naloxone as readily available as a defibrillator or a fire extinguisher, whether in private offices, shopping malls, schools, family restaurants or other private establishments,” Gupta said. “That way we can save people from dying. We need to treat people, but you can’t treat the dead. We need to keep people alive to get them the help they need.”
