“We can prevent overdoses and save lives by ensuring equitable access to essential health care and support services without stigma.”
(DHHS Overdose Prevention Strategy)
On October 27, 2021, Health and Human Services Secretary Xavier Becerra announced the release of the new HHS Overdose Prevention Strategy. With overdose deaths from opioids and heroin actually decreasing, many people think that the crisis is over. During the pandemic, however, the use of synthetic opioid such as illicitly produced fentanyl, the use of methamphetamine, cocaine and other stimulants, and poly drug use (the use of multiple drugs at a time) spurred a 30% increase in overdose deaths, or over 93,000 deaths. At the same time, social distancing and other pandemic restrictions have made it increasingly difficult to find treatment and recovery support and services despite the expansion of telehealth and virtual care, and despite removal of restrictions for medication assisted treatment.
The new strategy is intended to provide access to care and services for people who use any substance with the potential for overdose. Rather than follow previous efforts for individual drugs in addressing the problem, the new person-centered strategy targets multiple drugs with a variety of treatment approaches for both those who use the substances and their families.
What This Means For Providers
The new Overdose Prevention Strategy is not just about prevention; it includes four areas of focus that can be read in detail by following the link in the heading. Each of the pages lists current federal activities each of the four key focus areas.
Primary prevention – “Creating fair and just opportunities for everyone to be as healthy as possible.” Focusing on root causes and key predictors of substance use, primary prevention includes “tiered, multidisciplinary prevention activities, ranging from population-level strategies to targeted interventions aimed at high-risk individuals. These activities engage health and human services providers directly and facilitate cross-sector collaboration on prevention” (Assistant Secretary for Public Affairs (ASPA), 2021).
Harm reduction – Focusing on reduction of risks related to substance use, such as overdose and transmission of infectious diseases, harm reduction promotes the idea that “Individuals inherently deserve services that promote health, regardless of whether they use drugs. Evidence-based harm reduction strategies minimize negative consequences of drug use. These activities further expand access to harm reduction interventions and better integrate harm reduction into general medical care“ (Assistant Secretary for Public Affairs (ASPA), 2021).
Evidence-based treatment – When implemented without delay, stigma, or other barriers, “Evidence-based treatments for substance use disorder can reduce substance use, related health harms (for example, infectious disease transmission), and overdose deaths. High-quality treatment can also increase social functioning. The strategy therefore focuses on reducing barriers to accessing the most effective treatments, using motivational and cultural enhancements to encourage those who might be reluctant, advancing strategies to improve engagement and retention, and continuing to develop new therapeutic approaches” (Assistant Secretary for Public Affairs (ASPA), 2021).
Recovery support – By focusing on funding reimbursement, workforce training, and protocols for peer, employment, and housing supports, the recovery support strategy “recognizes that treatment alone may not be enough to support long-term recovery. Despite the demonstrated benefits of recovery support services — such as peer supports, employment and housing services — various challenges impede their availability and uptake. Enhancing coverage and integration of recovery support services is critical to promoting access to and use of these services. Strengthening the recovery support services workforce is also essential to promoting access and quality” (Assistant Secretary for Public Affairs (ASPA), 2021).
Who Will be Involved?
Implementation of the new strategy will include comprehensive, collaborative efforts by governments at the local, state, and federal level in partnership with health care professionals, law enforcement, policy makers, employers, advocacy groups, and communities to remove barriers to care, advance evidence-based public health and safety activities, promote equity for underserved populations and racial groups in accessing healthcare, treatment in the justice system, and drug policy, and us a wide range of interventions in harm reduction and recovery support services.
The new strategy will be funded by increases of 54 percent from FY 2021 funding that will be used to increase and improve services in all four areas of focus and strengthen the U.S. behavioral health infrastructure. Proposed funding includes:
- SAMHSA’s FY 2022 budget request includes $3.5 billion for the Substance Abuse Prevention and Treatment Block Grant. The FY 2022 request also included, for the first time, a 10 percent set-aside for recovery support services.
- HRSA’s FY 2022 budget request includes $1.1 billion in mandatory and discretionary funding to support the substance use disorder responses in community health centers, invest in the National Health Service Corps, develop the behavioral health workforce, and expand substance use disorder response in rural America.
Partners in this comprehensive $11.2 billion funding effort across all of HHS include:
- Administration for Community Living (ACL)
- Administration for Children & Families (ACF)
- Agency for Healthcare Research and Quality (AHRQ)
- Office of the Assistant Secretary for Planning and Evaluation (ASPE)
- Centers for Disease Control (CDC)
- Centers for Medicare & Medicaid Services (CMS)
- Food and Drug Administration (FDA)
- Health Resources & Services Administration (HRSA)
- Indian Health Service (HIS)
- National Institutes of health (NIH)
- Office of the Assistant Secretary for Health (OASH)
- Office of the National Coordinator for Health Information Technology (ONC)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
The effort represents a united and coordinated endeavor across the continuum of care to address the nation’s overdose crisis.
For more information about the nation’s opioid and overdose crisis, read the Catalyst related blog posts listed under Opioids. Just a few of the titles include:
Medications for Opioid Use Disorder: What’s New in the July 2021 Revision of TIP 63
NIH HEAL Initiative: The Healing Communities Study
Intensive Outpatient Treatment (IOT): A Treatment Modality That is More Relevant Than Ever
Integrated Opioid Treatment and Recovery Centers (IOTRCs) – No Wrong Door
Advances in the Field and Treatment Implications for Opioid Use Disorders in Sexual and Gender Minority Populations
Additional resources can be found in CASAT OnDemand Resources & Downloads. Visit CASAT Conversations to listen to podcasts exploring Behavioral health topics. For professional development visit CASAT Learning for in-person workshops, webinars and online-study materials to accommodate busy schedules.