As the opioid epidemic has broadened into a substance use disorder epidemic in recent years, the Office of National Drug Control Policy has been working on multiple fronts to combat troubling trends. The COVID-19 pandemic has added an extra layer of challenge this year.
At this month’s virtual Cocaine, Meth & Stimulant Summit, Eric S. Talbot, MS, assistant director of ONDCP’s National Cocaine Coordination Group, will discuss what his office is seeing across the country, from overdose trends to treatment service utilization to data on seizures of illicit substances by law enforcement.
Ahead of the Stimulant Summit, he spoke with Addiction Professional about regional drug use trends, ONDCP’s top priorities and how they are executed on the ground level in communities, and how COVID-19 has impacted his office’s work in 2020.
Editor’s note: This interview has been edited for length and clarity.
What have been the most notable trends you’ve observed with regards to current drug use and overdoses in the U.S. within the past few years? Are we seeing more stimulant use? More polysubstance use? All of the above?
Unfortunately, we’re seeing more all of the above like you described. We’re seeing a continued rise in overdose deaths, and the situation is only getting more complicated where, of course, you see a rise in deaths involving opioids, in particular with the deadly synthetic fentanyl. You see rises related to cocaine and methamphetamine. That is, of course, in some ways the polysubstance use you described, mixing fentanyl and cocaine or fentanyl and methamphetamine. But also, if you strip out combinations of drugs, you see increases in just plain cocaine, for example. It’s a complicated issue, which is why we talk about how we’ve moved beyond an opioid crisis and we have a substance use disorder crisis where we need to help people and focus on reducing the number of people dying from overdose deaths.
Are any of the trends you’re seeing regional in nature, or are these things happening pretty uniformly across the country?
You definitely do see regional variance. For example, when we’re looking at cocaine, you see higher rates of overdose deaths in the East in particular. One thing that has been different over the past few years is with meth. Meth used to be a little more of a western United States issue, but it has become more widespread across the country. It depends on the drug type, but you see growing issues and some regional issues.
What would you say are our top drug-related priorities at the federal level, and how does what you’re working on play out at the local level in our communities? What’s happening on the ground?
At the federal level, we take our cue from the president’s national drug control strategy, which set forward that the focus of everything we’re working on is to save Americans’ lives. It set forth a three-point plan to work through that. The first issue we need to work on is preventing drug use before it starts. The administration has been doing an awful lot in that area, particularly reaching out to youth and doing prevention work, for example, through the Drug-Free Communities program my office sponsors. The second line we have is to provide treatment to folks and to make it available. That includes improving the quality we have and getting best practices out there, and increasing the number of people who are trained so that treatment is more readily available. Finally, we have to reduce the availability of drugs, which means securing our borders, working with law enforcement and working with our foreign partners to reduce drug production in the first place so that our public health systems have the space they need to respond to this crisis that is ongoing.
From what you’ve seen, how has the COVID-19 pandemic impacted drug use and how ONDCP has been able to respond? How has your work been impacted?
The COVID-19 pandemic brings with it all kinds of challenges for all of us. When you’re looking at the issue of substance use disorder and providing treatment, one of the biggest issues is that when people are isolated, it’s much harder for them to make progress and receive the treatment they need. This administration has done a lot of work to improve access to treatment by, for example, encouraging and creating new opportunities for telemedicine that people can get remote treatment through. It has also looked at more ways to provide access to naloxone and medication-assisted treatment, and provide waivers so that can be looked at and provided in a telemedicine context.
In the prison system, many folks have a substance use disorder, and when they depart the prison system, they are particularly vulnerable. In a COVID-19 environment, we are, for humanitarian reasons, releasing some folks from the prison system, and we want to make sure they have the support that they need in that transition, so we’ve worked to increase those supports as well.