Biden-Harris Administration Enhances HHS Overdose Prevention Strategy, Expands Addiction Treatment

The U.S. Department of Health and Human Services (HHS) celebrated two years of its Overdose Prevention Strategy (Strategy) by announcing bold new actions to combat overdoses. These actions include finalizing a rule to dramatically expand access to life-saving medications for opioid use disorder, allowing certain grant funds to purchase XYL test strips (XTS), and releasing the Substance Abuse and Mental Health Services Administration’s (SAMHSA) updated Overdose Prevention and Response Toolkit. These initiatives build on President Biden’s National Drug Control Strategy and his Unity Agenda's call-to-action to address the overdose epidemic and save lives.

“Drug overdoses reach every corner of our society, taking lives and causing immeasurable pain to families and communities. That’s exactly why President Biden made it a key priority of his Unity Agenda. We have made important progress, but there is still a lot of work to do. But we have the tools, evidence-based strategies, and shared commitment across our nation to take on the overdose epidemic,” said HHS Secretary Xavier Becerra.

Since the launch of HHS’ Overdose Prevention Strategy in 2021, the Biden-Harris Administration has continued to dramatically increase the nation’s treatment and harm reduction capacity. An average of 37,000 new patients per month are now seeking buprenorphine treatment, resulting in a total of approximately 862,000 people receiving treatment each month. Access to naloxone has increased, as evidenced by an almost 40% rise in naloxone units sold between October 2022 and September 2023 compared to the corresponding period in 2020–2021. This progress is driven by the administration’s historic investments in all four of the strategy’s pillars: primary prevention, evidence-based treatment, harm reduction, and recovery support services. Last year, President Biden invested nearly $8 billion to support the HHS programs implementing the strategy and bolstering the nation’s behavioral health infrastructure.

“At HHS, we believe there should be no wrong door for people who are seeking support and care to manage their behavioral health challenges, including when it comes to getting treatment for substance use disorder. The easier we make it for people to access the treatments they need, the more lives we can save,” said HHS Deputy Secretary Andrea Palm.

Additional details about each of the announcements are below:

HHS Updates Opioid Treatment Program Regulations for First Time in 20 Years
HHS, through SAMHSA, published a final rule to comprehensively update the regulations governing Opioid Treatment Programs (OTPs), the only programs where people can access methadone treatment for opioid use disorder. The final rule seeks to dramatically expand access to life-saving medications for opioid use disorder (MOUD) and to reduce stigma. Today’s updates are the first substantial changes to these regulations in more than two decades.

“This final rule represents a historic modernization of OTP regulations to help connect more Americans with effective treatment for opioid use disorders,” said Miriam E. Delphin-Rittmon, Ph.D., the HHS Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA.

The final rule incorporates critical feedback submitted by treatment providers, advocates, and patients. Major provisions of the final rule that will expand access to medications for opioid use disorder while ensuring high-quality care include:

Making permanent COVID-19-era flexibilities that expand eligibility for patients to receive take-home doses of methadone. This will help reduce the burden of transportation for frequent clinic visits.
Allowing the initiation of treatment via telehealth, including methadone via audio-visual telehealth technology and buprenorphine via audio-only technology, will remove transportation barriers.

Expanding provider eligibility to allow nurse practitioners and physician assistants to order medications in OTPs, where state law allows, will reduce the burden on OTP operations and increase patient access to medications.
Breaking down barriers to entry for treatment by removing the stringent admission criteria that had previously required patients to have a history of addiction for a full year before being eligible for treatment. This will help open more doors to treatment for more people when they need it and ensure that everyone can get the care they need.

Expanding access to interim treatment, allowing patients to initiate medication treatment while awaiting further services, will ensure people have access to care as soon as they are ready and reduce the barriers of treatment waitlists.
Promoting patient-centered models of care that are aligned with management approaches for other chronic conditions.

In addition to reducing barriers to medication, the updated rule also removes stigmatizing and outdated language and updates definitions to reflect current medical usage. While finalizing more flexible regulations for OTPs, SAMHSA will continue to maintain robust quality standards through accreditation requirements for all programs. The final OTP regulations will be published in the Federal Register on February 2, 2024. Following a 60-day period from the publication date, the new rules will take full effect within six months, providing OTPs with the opportunity to prepare for implementation.

Source: US HHS