President’s Update, Jun. ’21: FORE’s Strategy Aligns with Federal Priorities for Ending Drug Overdose and Addiction CrisisJune 02, 2021
In April, the Biden-Harris administration announced its priorities for ending our country’s drug overdose and addiction crisis. I welcome the administration’s sense of urgency and strong public health approach; drug overdoses, mostly involving opioids, appear to have cost a record 90,000 lives in the 12 months ending in September 2020, in part due to worse access to treatment and recovery services during the pandemic and increased stressors such as economic and isolation. I also appreciate the administration’s commitment to reduce racial inequities in our health care, drug policy, and criminal justice systems. For too long, we have criminalized drug use in communities of color while treating addiction as a medical problem for white Americans.
The priorities put forth by the White House align with FORE’s approach, and the work of our grantees offers lessons and models for the nation.
Expanding access to evidence-based treatment
Noting that “addiction treatment and mainstream health care have existed in two separate systems,” the administration proposed several tacks to make it easier for people to find treatment. FORE is funding 20 projects, committing more than $10 million, to expand access to treatment for underserved populations, including people of color, those in rural and tribal communities, and those involved with the criminal justice system.
For example, we are funding efforts to ensure pregnant and parenting people have uninterrupted access to treatment for opioid use disorder (OUD) as well as support to sustain their recovery and build healthy families. One North Dakota program offers mentoring to physicians, nurse practitioners, and others to help them prescribe buprenorphine, the gold standard for medication for OUD. The Don’t Quit the Quit program is also reaching women during the postpartum period — when many lose touch with their providers — by recruiting community members to work as postpartum doulas and by training staff at Women, Infants, and Children offices to help women find OUD treatment. These and other promising programs could be spread through a provision in the American Rescue Plan enabling states to extend Medicaid coverage to women for 12 months after childbirth.
The administration is also exploring whether some of the emergency provisions made during the pandemic — such as giving patients take-home doses of methadone or enabling providers to initiate buprenorphine treatment through virtual visits — should stay. Twelve FORE-supported projects have been tracking the impacts of these provisions and their findings can inform future policymaking.
Advancing racial equity in our approach to drug policy
The administration recognized that Black, Latinx, indigenous, and other people of color with substance use disorders often have worse access to health care, receive differential treatment, and have worse outcomes than white people. It has called for promoting racial equity in the nation’s drug policy at a time when overdose rates have been increasing in some minority communities.
We recognize that we cannot hope to end the opioid crisis without also advancing racial equity. Twelve of our grantees are working to expand access to treatment and recovery services for Black, Latinx, and/or indigenous populations. One grantee in Miami is deploying peer recovery workers in two Black neighborhoods to encourage people to try MOUD — making it as easy as possible by offering virtual visits in a mobile van or via an iPad in people’s homes and deploying peers and medical students to help people navigate treatment.
Expanding access to recovery services and building the addiction treatment workforce
Recognizing the chronic nature of substance use disorders, the administration called for services to help people manage and sustain their recovery. At FORE, we made rapid response grants to nine organizations that sought to provide uninterrupted access to recovery supports during the pandemic. These include two groups that focus on young people: the Association of Recovery in Higher Education supports collegiate recovery programs and Young People in Recovery offers virtual recovery support meetings, social activities, and peer supports. A current grant with RTI International is evaluating these and other projects to glean lessons for future recovery programs.
Additionally, FORE is conducting a national survey of peer recovery specialists, who play a critical role in enlisting and keeping people in treatment and recovery. The findings, to be released this summer, will be helpful to federal and state policymakers who want to strengthen this workforce.
As we begin our second full year of grantmaking, we are excited to expand our reach. In May, we opened an RFP, Opioid Crisis Innovation Challenge 2021, that calls for innovative approaches to longstanding challenges: training professionals to reduce stigma; gathering timely and actionable data; and supporting transitions from treatment to recovery.
The pandemic has shown us we need to think creatively and work together to make progress. As vaccines make it possible to envision a post-pandemic world, we must find new ways to support people with OUD and their families. Through our grantmaking and our roles as a convener and developer of resources, FORE will continue to find ways to add value and make a difference.