President Obama and #DrugPolicyReform: A Leap in the Right Direction

On April 24, the Obama Administration released its 2013 National Drug Control Strategy—and it contains some huge gains for harm reduction advocates.

An annual document that outlines the vision for the Administration’s drug policy, this year’s strategy has replaced emotional “war on drugs” rhetoric with appeals to “evidence,” “science,” and “public health.” The strategy includes unequivocal support for access to methadone and buprenorphine for the treatment of addiction to heroin and other opioids, layperson access to the lifesaving medication naloxone, and a recommendation—complete with call to action—about lifting the federal ban on funding for syringe exchange services.

These three key elements—treatment, overdose prevention, and the benefits of needle/syringe programs—are reinforced throughout the document.

The preface to the strategy, written by Office of National Drug Control Policy Director, Gil Kerlikowske, highlights the story of Project Lazarus, an overdose prevention program in North Carolina that offers community and physician training and naloxone distribution to help prevent fatal overdoses. The strategy goes on to declare overdose prevention a priority for the Administration. It not only recommends that police, firefighters, and other “first responders” carry naloxone, but also recognizes the trained layperson’s essential role in responding to overdoses in the community. The Administration also highlights the potential for Good Samaritan Laws that protect bystanders who use naloxone or call emergency services to save lives in the event of an overdose. 

In addition, this official federal document has language that clearly states the Administration’s support for one of the core harm reduction services: needle and syringe programs. Multiple studies, including a notice from the Surgeon General commissioned by the Obama administration, show that syringe services programs can prevent HIV and provide a bridge to addiction treatment. The strategy notes that such programs should be supported with funds for Substance Abuse Prevention and Treatment. Congress, unfortunately, still imposes the federal funding ban on needle exchange.

Support for medication-assisted addiction treatment—and crucially, the need for reimbursement—is highlighted throughout the document. The document also highlights the expectation that the Department of Defense will reverse the long-standing ban on methadone and buprenorphine maintenance treatment. This is good news for America’s military, and sends the right message for those who’ve served the country, but haven’t yet been well served if they have drug dependence problems.

My organization, the Harm Reduction Coalition, believes that harm reduction is about much more than just a series of interventions such as naloxone distribution and syringe services. It is also about promoting social justice by eliminating disparities in health access for drug users, and ensuring that active drug users aren’t deprived of rights or social participation. It would be an overstatement to declare that this strategy accomplishes that goal, but it is a leap in the right direction.

The harm reduction community has come a long way in the past few years in terms of our work with elected representatives and local officials. The Office of National Drug Control Policy has come a long way, too. This year, we have a national drug strategy that proves it.

6 Comments

Here is a question we all should ask Mr. Kerlikowske: «what criteria/metrics should be met before you recommend ending the Prohibition regime and its criminalisation policies. Is there a tipping point?»

It seems to me that for US Drug Tsar, Gil Kerlikowske, as it is for UNODC director, Yury Fedotov, and for that matter for all staunch supporters of Prohibition , criminalisation of drug consumption is a moral, ideological imperative, i.e. drugs are bad and their consumption ought to be prevented come what may, whatever the costs. No matter how hard he has tried to sanitise the ONDCP language, in the eyes of Mr Kerlikowske and the like, discouraging consumption and criminalisation go hand in hand.

Gart Valenc
Twitter: @gartvalenc

Here is another question for US Drug Czar, Mr Kerlikowske,

How do you reconcile your claim that drugs policies are based on scientific evidence with the fact that the ONDCP

a) is prohibited from funding any study or contract relating to the legalisation (for a medical use or any other use) of a substance listed in schedule I of section 202 of the Controlled Substances Act (21 U.S.C. 812) and

b) is obliged to take any action to oppose any attempt to legalise the use of a substance listed in schedule I of section 202 of the Controlled Substances Act (21 U.S.C. 812)

Gart Valenc
Twitter: @gartvalenc

Gart, you are an old legalizer that never gets tired of asking the same irrelevant questions. The metrics are clearly laid out in the Strategy. Just because to you harm reduction doesn't mean legalization to them you throw a tizzy.

Kellogg, would you mind explaining to me why you think my questions are irrelevant?

As for not getting tired of asking the same questions, I'm afraid I'll keep asking until I get a satisfactory answer.

Here's a thought: since you seem to know the answer, would you kindly enlighten me, please!

Gart Valenc
Twitter: @gartvalenc

I think we all recognize resourcing as a major shortcoming for harm reduction. If the new strategy includes a scaling up of investment, an increase in coverage and a deeper commitment to life-saving interventions, then we can all applaud.

We should separate the rhetoric from the reality. The criminalization of people who use drugs is still a horror show, mass incarceration is a national shame and discriminatory enforcement remains a major problem. So we know there needs to be a better supportive policy environment for harm reduction to thrive.

But a greater commitment to evidence, science and support for people who use drugs will save lives. It's probably a bit rash to say this reflects the "end of the drug war." But as an incremental step, it appears to be in the right direction.

Let's hope there are many more to follow.

I thought this was an organization to stop torture in health care. I'm a chronic pain patient with back pain that is untreatable with injections and a broken knee following 2 failed surgeries and no option for a 3rd. My pain was managed with fentanyl and Percocet for breakthrough pain. I was still in pain but the drugs helped me out of bed in the morning. Not much more. Now Florida is taking away my pain treatment plan and wants to send me to drug addiction rehab clinic. I am not a drug addict. I've been on these drugs for 11 years and rarely have had to raise the dosage. I have never felt "high" from these medications. I know I need to suffer with the lowest possible dosage because this pain will never go away and I don't want to run out of options for pain relief. Chronic pain patients are going to be left with no option other than suicide. How do you think this will play out with millions of baby boomers aging into pain from arthritis, RA, broken bones from osteoporosis, Fibromyalgia and other painful conditions? Obama doesn't have a clue. Truth is: unless you have suffered from chronic, agonizing, never-goes-away pain, you cannot understand the situation or formulate a solution. You may do good work in some fields but we need help here in the USA!

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