On January 20, the Biden administration announced Regina LaBelle as acting director of the Office of National Drug Control Policy. LaBelle, who previously served as the ONDCP’s chief of staff during the Obama administration, appears to be more aligned with harm reduction than a typical candidate for the role.
“We are thrilled that a friend of the harm reduction community will serve as acting director of the White House Office of National Drug Control Policy,” AIDS United tweeted after the announcement.
LaBelle has been particularly interested in increasing access to medication for opioid use disorder (MOUD) for people in detention centers. She’s praised a MOUD program in New York’s Albany County jail, and helped to develop a model law for access to MOUD in correctional settings.
The administration hasn’t yet named a long-term “drug czar,” as the role is known, but that isn’t unusual. The position is usually filled after inauguration day, according to Grant Smith, deputy director of national affairs with the Drug Policy Alliance (DPA)*. Regardless, some advocates are excited by the prospect of pushing the yet-to-be-named drug czar to embrace harm reduction—and have already laid out the agenda items that they’d like to see the new administration pursue.
DPA was one of 212 organizations to sign a recent letter—addressed to Rahul Gupta, the Biden transition team’s ONDCP team lead—calling for sweeping changes to federal drug policy.
“I think all of us hope that [not yet picking a permanent drug czar] signals that they are vetting a director based off of what over 200 organizations, as well as many people who were not in that letter, like experts, are saying where we need to move at this moment,” said Jasmine Budnella, a drug policy campaign coordinator with VOCAL-NY, another organization behind the letter.
After sending the letter, which Smith described as a “roadmap for this new administration for its first 100 days, as well as looking long-term,” the writers asked the Biden administration if they could meet with the new ONDCP director once the decision is made. Budnella said the administration agreed to stay in contact.
Here’s a snapshot of the demands that harm reductionists are making of the Biden administration, both for the first 100 days and beyond.
Funding for Syringe Service Programs
The harm reduction community’s “most immediate request” to the Biden administration is the ask to increase federal funding to syringe service programs (SSP) in the next COVID relief package, according to Smith.
“We’re in a real dire situation where many providers of harm reduction services are struggling to remain afloat,” Smith told Filter. Some New York harm reductionists, faced with a statewide shortage of syringes and other supplies, are fronting the bill themselves. Harm reductionists in other states, like Minnesota, are also facing shortages .
Funding SSPs is an especially critical public health issue when many harm reductionists are uniquely able to foster relationships of trust with people who use drugs—and thereby help them reduce the spread of COVID.
Rollbacks of Restrictive Federal Regulations
Harm reductionists are also demanding curtailment of federal restrictions on the distribution of methadone and buprenorphine, and on the operation of safe consumption sites (SCS).
“We’re continually getting to a point where we’re butting up against federal policies that prevent us from being able to move in a significant way to achieve ending the overdose crisis and the drug war,” Budnella, who runs VOCAL-NY’s city and statewide campaigns, told Filter.
As the pandemic hit in spring 2020, the federal government relaxeed regulations on methadone and buprenorphine. Under the new and currently temporary accommodations, patients are no longer required to meet in-person with providers before being prescribed buprenorphine, and certain patients who were not previously permitted to do so can now take home more than 14 days’ worth of methadone.
The letter calls for those accommodations to be made permanent. But the issue is also that they “didn’t fully trickle down” when they were introduced, said Budnella.
Federal policy has also compounded state-level obstructions against opening SCS in New York, Budnella said. New York harm reductionists have not only had to fight against Gov. Andrew Cuomo’s reluctance to open the sites, but also had to keep in mind the Department of Justice’s lawsuit against the opening of Safehouse in Philadelphia. The letter’s signatories call for the Biden administration not to prosecute organizations or people who operate SCS, and for Biden’s DOJ to withdraw the litigation challenging Safehouse.
Ending the DEA’s Fentanyl Analogue Ban
The letter’s authors call for the federal government to allow the class-wide Drug Enforcement Administration ban on all fentanyl analogues to expire. The ban currently classifies all fentanyl-related substances as Schedule I drugs, which then allows prosecutors to seek fentanyl-related mandatory minimum sentences. The ban is scheduled to expire on May 6, 2021.
That expiration date was the result of a compromise brokered in January 2020 between the federal government—which wanted a permanent ban on fentanyl analogues—and drug policy reform advocates.
The Biden administration’s opportunity to let the ban expire “will be a first major test of this administration to honor its pledge not to exacerbate mass incarceration, not to perpetuate mandatory minimums,” Smith said. “Any effort by this administration to apply pressure on Congress to extend this [ban] again will be a betrayal of those pledges.”
* DPA previously provided a restricted grant to The Influence Foundation, which operates Filter, to support a Drug War Journalism Diversity Fellowship.