President Obama’s Opioid Plan Released Today Promotes Major Harm Reduction Policies

President Obama delivered remarks at an addiction summit in Atlanta today that detailed a set of actions his Administration is taking to address the opioid and heroin crisis. Although the actions outlined in this White House fact sheet are largely consistent with previous announcements in recent months by the Administration on the opioid crisis, advocates praise the White House for clearly prioritizing evidence-based harm reduction and treatment interventions in their latest plan. At the same time, advocates are disappointed that the Administration’s plan continues to promote law enforcement as an appropriate response to the opioid and heroin crisis.

“It has taken President Obama’s entire tenure in office, but his Administration has managed to pivot much of the White House’s drug policy towards a more health-centered approach to drug use,” said Grant Smith, deputy director of national affairs with the Drug Policy Alliance. “However, the Administration still lags behind in its unwillingness to step away from the criminalization of people who use drugs. They fail to acknowledge that we must fundamentally change the role of law enforcement and end criminal penalties, if we are to truly address this crisis as a health issue,” said Smith.

The Administration’s plan proactively outlines steps it is taking to facilitate federal funding for syringe access programs. This step follows last year’s decision by Congress to enable states and localities to spend federal funds on syringe access programs, effectively lifting a decades-long ban on federal funding for such life-saving programs. Republicans have been forced to rethink their opposition to syringe access programs as rising heroin and opioid use in places like Kentucky and West Virginia has exacerbated drug use harms that can be mitigated by syringe access. Clear evidence shows that syringe access prevents the transmission of HIV, hepatitis C, and other blood-borne diseases, without contributing to increased drug use, drug injection, crime or unsafe discard of syringes.

The Administration’s plan also includes $11 million in new funding for states to purchase and distribute the opioid overdose reversal drug, naloxone, and to train first responders and others on its use. This step follows approval last year by Congress for $12 million in new federal funding to expand naloxone access. The Administration also details numerous steps taken to increase pharmacy-based naloxone access across the country. Advocates praise steps by the Administration to expand naloxone access beyond medical settings as essential to saving lives.

Advocates also applaud the Administration for increasing funding for medication-assisted treatment and taking clear steps to remove barriers to medication-assisted treatment for high risk populations, including buprenorphine patients, underserved populations and military personnel.

“The Obama Administration’s plans to expand access to medication-assisted treatment, syringe services and naloxone will help a great deal to save lives and reduce harms associated with heroin and opioid use,” said Grant Smith, deputy director of national affairs with the Drug Policy Alliance. “Although they could be going much further, the Administration is finally recognizing the very evidence-based treatment that harm reduction advocates and experts have been promoting for years,” said Smith. “It was also remarkable to hear President Obama’s remarks acknowledging that communities of color have been criminalized for their drug use for decades, and it is only now that the heroin and opioid crisis is affecting predominantly white and affluent communities that the political will to treat drug use as a health issue has emerged,” said Smith. 

The Administration’s plan also includes $7 million through the COPS program to increase the use of drug task forces aimed at the heroin and illicit opioid markets. Advocates disapprove of this funding increase, warning that federally funded drug task forces have an abysmal record of civil rights abuses and making large numbers of low level drug arrests, and the same outcomes may result from this latest initiative.

Advocates have similar views about the Administration’s plan to expand its “heroin initiative” among HIDTAs. The initiative, announced in August, pairs drug intelligence officers and health policy analysts to work within High Intensity Drug Trafficking Area (HIDTA) programs.  The drug intelligence officers are expected to gather information on trafficking patterns and trends for street-level law enforcement. Congress established the HIDTA program in 1988 to disrupt major drug trafficking networks. However, advocates have long observed that HIDTA programs lack congressional oversight and generally waste resources pursuing individuals engaged in low-level drug crimes.

“The continued push for law enforcement driven responses to the opioid and heroin crisis will likely lead to more low-level drug arrests and racial disparities in the criminal justice system, which doesn’t quite fit the narrative of the Administration’s new compassionate tone on drug policy,” said Grant Smith, deputy director of national affairs with the Drug Policy Alliance. “President Obama has made notable strides at shifting federal resources away from harmful law enforcement and incarceration and toward more effective measures like treatment and prevention, but these efforts will not fully succeed until we sincerely address the harms of drug criminalization,” said Smith.

Over the course of President Obama’s two terms in office, the Drug Policy Alliance has urged his Administration to shift federal resources from law enforcement and incarceration toward treatment and public health initiatives in ways that would treat drug use as a health issue and not as a criminal justice issue. The Drug Policy Alliance has specifically called on the Administration to commit more federal investments for medication-assisted treatment, naloxone access and overdose prevention, and make these resources more available to populations at elevated risk of overdose including military veterans and justice-involved populations. The Drug Policy Alliance has also called on the Administration to eliminate federal legal barriers to  research trials for supervised injection facilities and heroin assisted treatment.