Policy & Advocacy

Biden's SOTU change of heart:

Why it matters that the President mentioned harm reduction

Did you hear addiction recovery advocates cheering on Tuesday night? Because something extraordinary happened during the State of the Union: President Biden became the first US President to reference harm reduction in federal policy.

“There is so much we can do. Increase funding for prevention, treatment, harm reduction, and recovery. Get rid of outdated rules that stop doctors from prescribing treatments.” 

It felt like a potential watershed moment to hear Biden discuss evidence-based public health solutions in clear terms.

We know the damage it can do when a President stays silent on a national health crisis: look at what it cost for President Reagan to wait years to acknowledge the AIDS epidemic. Regan’s silence made the crisis worse; finally speaking the words aloud made way for investment in treatment, research, and education that lessened stigma and saved lives. 

Although Biden isn’t the first to say that an “opioid crisis” exists, he is the first to name solutions that actually relate to evidence-based medicine and overdose prevention — as opposed to emphasizing harsher penalties on the supply-side while only vaguely calling for “more treatment.”

Now that prescribed medications for addiction and harm reduction have been defined as clear priorities, more doors will open. 

Addressing the “opioid epidemic” is now the #1 issue on Biden’s bipartisan Unity Agenda: Americans from both sides of the aisle are ready to support sensible, scientific, and evidence-based reforms to national drug policy. 

Evidence-based priorities 

The Biden Administration laid out a vision for treating addiction and preventing the overdose “opioid crisis” that offers hope for meaningful change, including:

  • Targeting universal access to medications for opioid use disorder (MOUD) by 2025
  • Funding harm reduction interventions, like safe syringe programs, fentanyl testing strips, and overdose-reversing naloxone (Narcan)
  • Supporting treatment initiation in important care settings like the Emergency Department, the justice system, and remotely through telemedicine
  • Making permanent COVID-19 flexibilities for MOUD, including buprenorphine initiation via telehealth and mobile methadone

At last, the federal policy agenda prioritizes a subset of health-based, supportive approaches backed by science.

Eliminating barriers to medication treatment

The President emphasized the important role of medications like buprenorphine and methadone for treating opioid use disorder – committing to “remove unnecessary barriers that prevent medical providers from prescribing FDA-approved medications,” with plans to “increase awareness and understanding” of MOUD.

This is a particularly meaningful statement from Biden, who was responsible for co-authoring the legislation that restricted MOUD access more than two decades ago.

The Drug Addiction Treatment Act of 2000 (DATA 2000) imposed specific regulations for prescribing buprenorphine to treat substance use disorder – rules that do not exist for any other medication or medical condition. 

DATA established arbitrary limits on the number of patients a clinician can treat with MOUD and erected numerous administrative burdens – further constraining the scarce supply of medical providers treating addiction – all while the need for services has exponentially grown.

Changing course 

We applaud the President’s acknowledgment that outdated policies have failed us. His continued willingness to follow the evidence could help us finally change our country’s trajectory. Perhaps Biden’s change of heart was also shaped by his own perspective as a father to a son in recovery. Like so many of us, Biden has experienced the complex struggle of addiction and the fragility of a loved one struggling to overcome it. He grieves the loss of one son, and recognizes with gratitude the presence of another who could have suffered the same fate. This is what harm reduction promises to do for thousands of families and American citizens: keep children, parents, friends and neighbors alive. 

President Biden believes that people can recover, and so do we. Policy and funding can enable these incredible success stories. 

What goals could be more important? Now, it’s time to see them through.​​

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