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Overdose deaths are so high that the Biden team is embracing ideas once seen as taboo

Secretary of Health and Human Services Xavier Becerra said the overdose epidemic has grown so severe, new measures are needed to keep people with addiction alive. He is seen here on Capitol Hill in September.
Secretary of Health and Human Services Xavier Becerra said the overdose epidemic has grown so severe, new measures are needed to keep people with addiction alive. He is seen here on Capitol Hill in September.

Updated October 27, 2021 at 5:56 PM ET

The Biden administration is rolling out a new coordinated strategy it hopes will slow the menacing rise in drug overdose deaths.

Many of the core ideas are still viewed as controversial in many parts of the U.S., including efforts to provide active drug users with clean syringes.

"We are willing to go places where our opinions and our tendencies have not allowed us to go [before]," Becerra said in an interview with NPR.

Becerra says the pandemic and the spread of the deadly opioid fentanyl made drug use far more dangerous. According to the latest preliminary data from the Centers for Disease Control and Prevention, roughly 100,000 people in the U.S. died from overdoses over a 12-month period, a massive surge from a year earlier.

Becerra said the federal government will now directly support ideas known broadly as harm reduction. That means providing direct support and care to people actively using illegal drugs.

HHS will back clean needle exchange programs designed to slow the spread of diseases such as HIV/AIDS and hepatitis among drug users.

The federal government will also provide fentanyl test strips to help active drug users identify contaminated street drugs.

"We are literally trying to give users a lifeline," Becerra said.

HHS doesn't take position on safe consumption sites

In an interview with NPR, Becerra initially suggested his agency might be open to one of the most controversial harm reduction strategies: creation of safe consumption sites.

Those are locations, proposed in New York City, Philadelphia and other communities, where people would use illegal drugs under some kind of supervision to minimize the risk of overdose.

"We're not going to say 'but you can't do these other type of supervised consumption programs that you think work or that evidence shows work,'" Becerra said.

But in a statement sent to NPR, an HHS spokesperson walked back the comment.

"HHS does not have a position on supervised consumption sites," the statement read. "The issue is a matter of ongoing litigation. The Secretary was simply stressing that HHS supports various forms of harm reduction for people who use drugs."

Drug consumption sites are still banned in the U.S. The Justice Department has previously fought to prevent their creation.

Harm reduction programs still face opposition

Many of the other harm reduction strategies outlined Wednesday have been in place on a small scale around the country for years. They're often operated by grassroots groups or local governments.

Data suggests they work, lowering death rates and transmission of disease.

"If you can't prevent someone from becoming a user, then at least prevent them from harming themselves to the point of death," Becerra told NPR.

But the programs still face pushback from law enforcement and local leaders.

In states like North Carolina, Pennsylvania and West Virginia there's pressure to close down or restrict the very harm reduction programs Becerra is now advocating for.

Becerra said important strategies for keeping active drug users alive have been "left on the table that people have been too afraid to try" because of political opposition.

Part of the Biden administration's new approach will be to help overcome that resistance.

"It's going to be tough. We need to get [drug user] buy-in. We need to get state and local partner buy-in," Becerra said. "If we want to keep people alive we've got to try everything the evidence says might work."

Praise from drug policy experts and calls for more sweeping change

Drug policy experts say this set of ideas could begin to change the federal government's role tackling the addiction crisis — treating active drug users less like criminals, more like patients needing care.

Ryan Hampton, who's been in recovery from opioid addiction for seven years, says programs like these might have kept him safer.

"I entered recovery with all sorts of health care problems including hepatitis because I didn't have access to clean needles," he said.

Hampton says harm reduction is needed even more now because of the spread of fentanyl.

New federal research shows that more people in the U.S. have been using drugs during the pandemic, putting them at high risk of overdose and death.

More than 9 million Americans misused pain pills last year, despite the fact that many opioid medications sold on the street are counterfeit and come laced with fentanyl.

Becerra wasn't willing to predict how quickly these new policies could shift the trajectory of the overdose crisis.

The administration plan, which comes with an $11.2 billion request for funding from Congress, also includes:

  • Greater access to drug treatment
  • A program to reduce racial and regional inequities in how people with addiction are treated
  • An effort to reduce stigma for Americans suffering addiction
  • Drug policy experts and advocacy groups praised the new overdose response initiative as an important step, but some said it doesn't go far enough.

    "Their logic is the right logic," said Keith Humphreys, an addiction researcher at Stanford University.

    "It's what you do when you have an epidemic of addiction. You try to keep people from becoming addicted, you try to keep alive the people you can't treat, and you try to get them into recovery."

    Humphreys said the impact of the plan would depend in large part on Congress' willingness to provide adequate funding. "There have to be dollars behind it," he said.

    Kassandra Frederique, head of the Drug Policy Alliance, also described the plan as "encouraging," but she said the Biden administration needs to decriminalize drug use so that more people can get health care without fear of punishment.

    Frederique also said the overdose crisis has become so severe that this plan's harm reduction steps may be too little, too late.

    "When we've hit over 100,000 people dying of overdoses ... the floor has changed," she said.

    Copyright 2021 NPR. To see more, visit https://www.npr.org.