CHARLESTON, West Virginia – Dr. Rahul Gupta, the first doctor to be named a drug czar in the United States, silently counted the number of Americans at risk of death during the 30 minutes he spent answering questions from a journalist. Of them. Four. Six.
As the deadliest drug epidemic in the country’s history continues to escalate, he knows an average of two victims die every 10 minutes.
“I always calculate the time spent everywhere in each meeting by the people killed during this period,” Gupta said.
“It’s that scary aspect that keeps me awake at night. It keeps me centered and focused on what we need to do, what I need to do.”
The immensity of the challenge he now faces as director of the Office of National Drug Control Policy hit him in his first week in office as he stood in a tunnel used for years by cartels to smuggle drugs from Mexico to the United States.
Gupta has made it a top priority to meet with officials in Mexico City, given that the bulk of the illegal drugs that killed more than 108,000 Americans in 2021 come from two world powers: the Sinaloa Cartel and the Jalisco Nueva Generación Cartel. , known as CJNG.
The US Senate confirmed Gupta as the country’s drug czar in October. He oversees a $449 million annual budget and leads task forces across the country that unite local and state police with special agents from various federal agencies, including the FBI and the U.S. Drug Enforcement Administration. .
The Biden administration, including Gupta, has mapped out a two-pillar approach with a goal of saving 165,000 lives by 2025. One focuses on drug interdiction. The other on harm reduction. This includes: increased availability of the opioid antidote naloxone; youth prevention programs; and expanded access to drug treatment.
A pioneer of “social autopsies”
A Courier Journal reporter and photographer accompanied Gupta on his August visit to his home state of West Virginia, an overdose epicenter. He met people in recovery and parents who lost their children to overdoses, including mother Cece Brown, who lost her son, Ryan, 27, to an overdose in 2014.
“He’s very willing to listen, very respectful,” Brown said, after she and Gupta and health and law enforcement officials brainstormed during a roundtable at the State Culture Center. in the Capitol complex in Charleston. She lobbied to include naloxone in first aid kits.
When her son died, he was on two waiting lists for drug treatment.
“When I hear their stories, it’s like a dagger in my heart,” Gupta said.
Less than one in 10 drug addicts who want drug treatment are able to get it, Gupta said.
“It’s a sad situation, and we have to build that infrastructure,” he said.
Brown has known Gupta for years, since serving as state health commissioner under two governors, a Democrat and then a Republican, from 2015 to 2018. He pioneered ‘social autopsies’ of all victims overdose cases in 2016, investigating causes of death, as well as marital and employment status, prison and hospital stays, and non-fatal overdoses in the year before their fatal overdoses.
“I wanted to learn from the dead to save the lives of the living,” Gupta said.
“We found that four out of five people, in the year before they died, came into contact with the health care system,” Gupta said. “We disappointed them.”
The results led to policy changes across the state, including expanded access to naloxone, telehealth and addiction treatment. Since then, the program has been replicated across the country.
“He’s innovative and involved,” said Dr. Angie Settle, director of West Virginia Health Right, the oldest and largest free clinic in the state, providing underinsured and uninsured residents with everything from medical care , dental and vision to mental health and addiction treatment.
She has known Gupta, a longtime clinic volunteer, for years.
“He was always genuine and dedicated to the mission,” Settle said.
During his recent visit, Gupta spent a few hours caring for patients while wearing his white doctor’s coat.
In a private room at the clinic, he used a soothing tone to urge Jeremiah Holstein, 33, to avail himself of resources to quit smoking and focus on his recovery.
“If you slip up, it’s fine,” Gupta told Holstein, who has been sober for a year and eight months. “Let us know and we’ll help you. If you think you’re going to, give us a call.”
During a Senate caucus on international narcotics control in June, Sen. Chuck Grassley, R-Iowa, pointed out that Gupta’s 2022 strategy focuses more on harm reduction than police efforts to intercept. counterfeit synthetic pills, which often contain fentanyl – the main drug culprit. US-related deaths
Three in four overdose deaths are now linked to opioids, mostly illicit fentanyl, Gupta said. And an amount as small as the tip of a pencil can kill.
Gupta explained the country’s plan of attack, which included the recent creation of a fentanyl task force in Mexico to target super labs, as well as continuing to work with Chinese authorities to limit the amount of precursors. illicit chemicals used to make fentanyl that are sent to Mexico.
In recent National Drug Threat Assessments, the DEA has warned of an increasing amount of fentanyl precursors coming from India. Gupta has started the first partnership with India, his native country, and plans to visit officials in New Delhi in November.
Gupta said the United States was helping train the Mexican Navy, SEMAR, to detect illegal drug shipments on the Mexican side of the border.
And he pledged to provide more resources and technology to U.S. Customs and Border Protection officers to help them detect fentanyl, which can be liquified and hidden in gas tanks and Windshield washer fluid. Gupta stood alongside officers at the El Paso port of entry last fall to see the challenges of intercepting drugs on pedestrians and hidden in vehicles.
Gupta has no experience in law enforcement, so he has traveled the country to see firsthand the challenges of preventing drugs from entering the country and intercepting them once they do. are in American communities. He traveled across the country to ride and meet with officials who oversee high-intensity drug-trafficking area task forces, called HIDTAs, which team up with local, state and federal law enforcement. – and in some cases tribal police forces – to target drug hot areas.
Appalachia HIDTA Chief Vic Brown traveled from his office in London, Ky., to Charleston to meet with Gupta and share challenges in his region.
“He really made an effort to engage with law enforcement and understand our perspectives,” said Brown, who oversees a $10 million annual budget for 48 drug task forces in Kentucky, Tennessee. , Virginia and West Virginia.
Brown said he was impressed that Gupta traveled across the country to ride with HITDA task forces to learn what they do and what resources they need.
“In the past, we didn’t have that level of commitment from previous directors,” Brown said.
More than half of Gupta’s budget, $296 million, is appropriated by Congress to fund 33 regional HIDTAs across the United States, the Virgin Islands and Puerto Rico. In 2021, the HIDTA seized $26.1 billion worth of drugs and arrested members of more than 3,100 drug trafficking and money laundering organizations across the country, Gupta said.
“Dr. Gupta brings a very unique perspective to the opioid epidemic as he was a physician who was in the epicenter of Charleston treating patients with addictions,” said Brown, an U.S. Forces veteran. order.
“In the past, law enforcement has not always understood this perspective.”
During Gupta’s trip to West Virginia, he also visited the town of Huntington and accompanied the state’s first Rapid Response Team, an outreach program that combines medical professionals, police and social workers to conduct walk-in home visits and connect recovering individuals to Resources. They have seen most of their clients within 72 hours of a near-fatal overdose and have helped guide 350 people into addiction treatment since 2017, nurse Connie Priddy, the team’s coordinator, said.
“There is absolutely no easy way out,” said team member Jason Smith, a 17-year veteran of the Huntington Police Department. “But I think it’s a better solution for us on the law enforcement side.
“I knew what we were doing, trying to get out of it, wasn’t working.”
While making stops to check on a few recovering clients, Gupta chatted privately with Smith to ask about law enforcement’s views and needs.
“He’s here trying to figure it out,” the police corporal said. “It’s better than someone sitting behind a desk dictating policy.”
Reporter Beth Warren: firstname.lastname@example.org; 502-582-7164; Twitter @BethWarrenCJ.