WASHINGTON — At a House oversight hearing Thursday, the Biden administration’s top drug policy official emphasized the need to address both mental illness and drug addiction simultaneously to reduce fentanyl deaths.
According to a 2021 survey by the Substance Abuse and Mental Health Services Administration, over nine million adults in the U.S. have this co-occuring disorder.
“We’re talking about people who lack the resources they need to treat mental illness, who face stigma in obtaining treatment, and who may self-medicate with alcohol, fentanyl,” said the committee’s ranking member Jamie Raskin (D-Md.) in his opening statement. He called on Congress to address the prevalence of untreated mental illness fueling the illicit drug market.
Rahul Gupta, the director of the White House Office of National Drug Control Policy, testified that “mental illness and drug addiction go hand in glove,” emphasizing that “it’s really important that we address both mental health, social isolation as well as addiction.” He pointed to the President’s proposal on Tuesday to force health insurers to cover mental health and addiction care as comprehensively as they cover treatment for physical health conditions to signify the Biden administration’s commitment.
This intersection between mental illness and addiction also extends to accidental overdoses, Gupta suggested, with young people taking pills that they think are the anti-anxiety drug Xanax or stimulant Adderall but are actually laced with fentanyl. “Proper education in our schools, homes, and communities can be the difference between life and death,” said Rep. Jake LaTurner (R-Kan.) given that fentanyl “is often just one wrong Snapchat message away” to young people.
Tackling these dual crises is an ongoing effort in Congress, with the Bipartisan Mental Health and Substance Use Disorder Task Force passing seventeen bills co-led by a Democrat and Republican in the previous 117th Congress.
During the hearing, Republicans largely focused on securing the border from fentanyl and the threat from Mexican cartels and China, while Democrats largely focused on public health.
Other areas of bipartisan interest included addiction treatment in the criminal justice system, with both Rep. Anna Paulina Luna (R-Fla.) and Rep. Maxwell Frost (D-Fla.) inquiring about rehabilitation programs. Released inmates are 129 times more likely to die from overdose within two weeks after release as compared with other residents, Gupta pointed out.
Gupta noted that his office is committed to offering treatment to everyone in custody of the Federal Bureau of Prisons and that states can apply for CMS Section 1115 waivers to allow incarcerated individuals to get substance use treatment 90 days before release through Medicaid. California was the first to obtain this waiver in January, with Washington being the second last month; thirteen other states are currently in the application process.
During the hearing, there was also bipartisan interest from lawmakers about xylazine, the veterinary tranquilizer increasingly found in the illicit drug supply that is making overdoses harder to reverse. In a recent CDC study, the percentage of illicit fentanyl overdose deaths involving xylazine, also known as “tranq,” jumped by nearly 300% between January 2019 and June 2022, with xylazine now being detected in one in nine fentanyl overdose deaths. “Tranq dope is making fentanyl look like a walk in the park,” Gupta testified.
In April, the White House took the unprecedented step of designating xylazine as an emerging drug threat and, two weeks ago, announced a plan to address the crisis with better testing, research, and data collection, as well as disrupting the xylazine supply and developing evidence-based treatment and harm reduction practices.
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