Commentary: The Public Health Approach to a Balanced Drug Policy

Since I was sworn in as Deputy Director of the Office of National Drug Control Policy (ONDCP) last November, my days have been a whirlwind of new names, new faces and new ideas. Although I have spent two decades in the field of substance abuse prevention, treatment and support, the past two months have shown me that the field is thriving, and more exciting work lies ahead—not just for me, but for all of us.

Before joining ONDCP, I served as Director of the Bureau of Substance Abuse Services in the Massachusetts Department of Health. There, I was proud of the work we did to integrate substance abuse treatment and prevention into primary care. Doing so not only improved services, but increased efficiency and lowered costs. We also established a treatment system and recovery support for adolescents, a group that—as we all know—can be at high risk for substance abuse and deserves our steadfast support. Before the Affordable Care Act (ACA) became Federal law, the Commonwealth of Massachusetts implemented similar, statewide healthcare legislation that established coverage for substance abuse treatment. During the implementation process, I learned many valuable lessons that I plan to draw upon as we move forward with national implementation of the ACA and its far-reaching implications for the treatment of substance use and mental health issues.

Over the past year, we heard a lot from Director Kerlikowske about the importance of a balanced, public health-driven approach to substance use disorders in America. During President Obama’s first term, we saw the creation of the first-ever Recovery Branch in ONDCP and an emphasis on brief medical interventions to identify risky substance use and prevent disorders from developing. This historic support for recovery services at the national level, along with support for integrating primary care and substance abuse prevention and treatment, truly represents the way forward for America’s drug policy.

As the excitement of the New Year and the Inauguration recedes, we look forward to the changes the next four years will bring. The challenges we face in the field will require strong collaboration between the public health and law enforcement communities. In Massachusetts, we saw the benefit of that kind of collaboration first-hand. The police department in Quincy began carrying naloxone kits after confronting one of the highest overdose rates in the state. Over the past two years, officers in Quincy have used these kits to reverse 112 overdoses, turning the tide on a deadly trend, and building a model for future collaborations between public health and public safety.

Success like this gives me hope that those of us in prevention will continue to develop new ways to reduce drug use and its harmful consequences. I look forward to everything the New Year and the new Presidential term have to offer.

Michael Botticelli, Deputy Director of the Office of National Drug Control Policy