Stimulant Summit: ONDCP leader not satisfied with current progress

A decline in the growth rate of drug overdose deaths in 2017 certainly doesn't offer enough cause for celebration, says the deputy director of the Office of National Drug Control Policy (ONDCP).

Addressing attendees of the National Cocaine, Meth & Stimulant Summit in Florida on Tuesday, James Carroll said stepped-up efforts in prevention, interdiction and treatment all will be needed for what he referred to as an addiction crisis at its core.

“What's going on is not working,” Carroll said. With an ever-present treatment gap, “Folks are still missing out,” he said.

Carroll's talk, in which he largely shed his prepared notes, addressed both some accomplishments that he has considered pivotal to recent progress (availability of peer support, activity of community anti-drug coalitions) and those that need even more of a boost going forward (faith-based initiatives, broader access to life-saving naloxone).

He said of any naysayers who might see naloxone's presence as giving individuals license to use dangerous drugs, “They clearly have never met someone who has an addiction.”

Carroll, currently serving as ONDCP's acting director and nominated by President Trump in April to be permanent director of the office, described the transformation in his own thinking about the drug issue since serving as a prosecutor of drug cases. “I don't think I would have been an early adopter of drug courts,” he said, but now he sees the benefits of these programs as indisputable.

Questions and answers

Carroll fielded a number of questions from a summit audience made up primarily of treatment professionals. Some of the topics highlighted what the treatment community sees as some of the ongoing challenges in maximizing communities' responses to the addiction crisis:

• Asked about how naloxone could be made less costly, Carroll talked of his ability to use the “bully pulpit” to put pressure on manufacturers.

• An attendee from West Virginia asked for guidance on what she called a “broken” system of medication-assisted treatment in her state, where she said there are no meaningful therapeutic services. Carroll said it was important to fund more fellowships to get more physicians to participate in treatment efforts.

• An attendee from Nevada lamented that community coalitions that have received federal Drug-Free Communities funding for a full cycle cannot apply for additional funding even when they have expanded into new regions. Carroll said he did not have an answer, but his staff immediately reached out to the attendee.

• Another attendee brought up stigmatizing language that he thinks hurts the progress of recovering people. Carroll didn't disagree, but focused more on his desire to change the language in Hollywood that often glorifies drug use.