Biden Picks Dr. Rahul Gupta to Lead Federal Drug Policy During Historic Overdose Crisis 

    Former West Virginia health commissioner Dr. Rahul Gupta will lead President Joe Biden’s response to the deadliest overdose crisis in recorded history.

    The Biden administration is officially tapping Dr. Rahul Gupta as director of the Office of National Drug Control Policy, a White House spokesperson confirmed to Filter. Gupta became a nationally recognized health policy expert during his role as West Virginia’s public health commissioner from 2015 to 2018, where he led the state’s response to its own surging overdose crisis.

    Gupta will replace Regina LaBelle, the ONDCP’s current acting director, if confirmed by the Senate. He directed Filter’s request for comment to an ONDCP spokesperson.

    “President Biden’s nomination of Dr. Rahul Gupta to be the first physician ever to lead the White House Office of National Drug Control Policy is another historic step in the Administration’s efforts to turn the tide of our nation’s addiction and overdose epidemic,” the spokesperson told Filter. “Dr. Gupta brings firsthand experience as a medical doctor and public health official using evidence-based strategies to address the overdose epidemic in West Virginia. We hope he will be confirmed by the Senate soon.”

    It remains to be seen whether as “drug czar” Gupta will take more pro-harm reduction positions than he did in West Virginia.

    Filter broke the news in March that Gupta was the leading candidate for the role, reporting that harm reduction experts and activists have been critical of his drug policy record. In 2018, he supported the closure of a low-barrier syringe service program. West Virginia is not only struggling to prevent soaring overdose deaths, but is now facing multiple outbreaks of HIV and hepatitis C, driven by a lack of harm reduction infrastructure and access to sterile syringes for people who use drugs. In February, the Centers for Disease Control and Prevention described Kanawha County’s HIV outbreak as “the most concerning in the United States.”

    It remains to be seen whether as “drug czar” Gupta will take more pro-harm reduction positions and support local harm reduction organizations that are facing political backlash across the country.

    “The Biden Administration has made enhancing evidence-based harm reduction efforts one of ONDCP’s top priorities,” Robin Pollini, associate professor at West Virginia University’s Department of Behavioral Medicine & Psychiatry, told Filter. “I sincerely hope Dr. Gupta will embrace the opportunity to lead on that issue. And I would ask that he bring that leadership without delay back to West Virginia, where anti-harm reduction laws at both the state and local levels are literally killing our loved ones, friends, and neighbors.”

    Gupta is set to take on the federal government’s top drug policy job during a historic year of record-breaking overdose deaths, driven primarily by the presence of illicitly manufactured fentanyl in the unregulated drug supply, as well as stimulants like methamphetamine. However, President Barack Obama  previously downgraded the role of director of the drug policy office from a Cabinet-level position, diminishing its power and influence.

    “Hopefully, Dr. Gupta will take advantage of the growing political support of harm reduction strategies.”

    “It is my hope that the full power of federal resources and influence will be directed at addressing these crises through full implementation of evidence-based harm reduction strategies including syringe service programs, naloxone distribution, integration of medication treatments (i.e., buprenorphine & methadone) with syringe programs, safe consumption sites and safe supply interventions,” Ricky Bluthenthal, associate dean for social justice and a professor in the Department of Population and Public Health Sciences at University of Southern California, told Filter.

    “Dr. Gupta, if appointed, would have an excellent opportunity to lead such an effort. The well-being of hundreds of thousand individuals, their family members and communities depends on a comprehensive federal response to these multiple, preventable ailments. Hopefully, Dr. Gupta will take advantage of the growing political support of harm reduction strategies.”

    Earlier this year, the Biden administration laid out the federal government’s drug policy priorities, which for the first time in the 33-year history of the office included harm reduction interventions and racial equity, in addition to status quo supply reduction and interdiction strategies. President Biden’s American Rescue Plan also included a historic $30 million investment for syringe service programs and community-based harm reduction organizations, funding that experts say is desperately needed while overdoses surge during the COVID-19 pandemic.

    “Supply reduction was a very emphasized, some might say, over-emphasized, part of US drug policy for generations,” Dan Ciccarone, a physician-researcher at the University of California San Francisco School of Medicine, told Filter. “Now they’re bringing a more balanced approach to prevention, which includes harm reduction as well as treatment. This is where we need to go.”

    For decades, US drug policy has prioritized brute-force drug war tactics, leading to the mass incarceration of Black and Brown communities while achieving little by way of reducing the harms of drug use. Despite robust investment in drug interdiction at the US-Mexico border and criminalization at home, drugs are cheaper, more potent, and more accessible than ever. One analysis by Pew Charitable Trusts found that drug imprisonment rates do not correlate with reductions in drug use, drug sales or overdose deaths, highlighting the urgent need for a radical new approach.

    “We are grateful that President Biden has chosen someone with a public health background to lead ONDCP and look forward to working with him to implement critical harm reduction interventions—including safe consumption sites, syringe services programs and more—that have the power to save countless lives,” Kassandra Frederique, the executive director of the Drug Policy Alliance, told Filter.

    “As an X-waivered [buprenorphine] provider himself, Dr. Gupta understands the barriers people face in being able to access lifesaving medications for opioid use disorder and why more must be done, especially for Black, Latinx and Indigenous communities that have disproportionately borne the brunt of this crisis. With over 90,000 lives lost last year alone, it’s disappointing it took this long to lock in the position, but all the more reason why we have no time to waste—and must get to work now.”

    “If you look at Gupta as a complete package, there’s far more upside than downside.”

    As West Virginia’s health commissioner, Gupta implemented the state’s medical marijuana program and, according to Marijuana Moment, touted the medical and health benefits of cannabis. On the other hand, he was lukewarm at best about the harm reduction potential of vaping, emphasizing the idea that manufacturers were trying to get kids “hooked.”

    “The bottom line on Gupta,” Ciccarone said, “is that people in public office do a variety of things as public servants. It’s easy to say, ‘Oh, you messed up over here and you messed up over there.’ But if you look at Gupta as a complete package, the pros and cons of all the things he did while in West Virginia, there’s far more upside than downside. He talks openly about mistakes he’s made and what he’ll do differently in national office, which to me was very moving.”

    Gupta’s nomination happens to coincide with the CDC’s much anticipated release of 2020 overdose mortality data, which is expected to show that 2020 was the worst year on record for drug overdose deaths. According to preliminary CDC data, an estimated 91,000 people died from a drug overdose in the 12 months leading up to November, a 30 percent jump from the previous year.

    “We can hold Gupta to the fact that he has said he will ‘champion’ harm reduction,” Ciccarone said.



    Photograph of the White House by David Mark from Pixabay

    DPA previously provided a restricted grant to The Influence Foundation, which operates Filter, to support a Drug War Journalism Diversity Fellowship.

    • Zachary is a journalist focusing on drugs, justice and health. His work has appeared in publications including the New York Times Magazine, The Appeal, Slate and New York magazine. He is a fellow of the Health in Justice Action Lab at Northeastern University School of Law.

    • Show Comments