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The National Opioid Epidemic and Its Impact on U.S. National Security and Economic Prosperity

September 28, 2022

As a physician, Dr. Rahul Gupta has seen up close the human cost of the opioid and overdose epidemic doing major damage across the United States. “I’ve done shifts where I’ve had to reverse an overdose every single shift for months at a time,” he stated during a Dean’s Speaker Series event held at Johns Hopkins SAIS on September 28, 2022. “I’ve had people who have been treated successfully; I’ve also had people who, unfortunately, succumbed to their disease.”

Dr. Gupta is director of the White House Office of National Drug Control Policy (ONDCP)—the first medical doctor to lead ONDCP. SAIS Dean James Steinberg moderated the discussion, in which Gupta spoke about the opioid and overdose epidemic and its impact on U.S. national security and economic prosperity. Gupta noted that, over time, there has been a shift from plant-based drugs to more potent and lethal synthetics such as fentanyl. This has led to a significant increase in overdose deaths.There has also been a shift in the mode of drug transactions over the past seven years. In addition to the old mainstay of face-to-face cash transactions on street corners, drug traffickers are increasingly plying their trade online. “What we began to see was advertisements on the dark web, hundreds of online websites where you have an inventory and people can go through your products and pick what they want,” Gupta said. “And now you’re being paid with cryptocurrency and shipping directly to the buyer by mail… as simple as ordering something on Amazon.”

This has created new problems and complicated old ones, with implications for the U.S. economy and national security. For instance, hundreds of billions of dollars in proceeds from drug trafficking flow back into Latin America and destabilize the fragile democracies in the region through increased corruption, crime and violence. In turn, increases in crime and violence help to drive the migrant crisis at the southern border. Drug proceeds have also been used to fund violent extremism, terrorism, and a host of other transnational criminal endeavors.

Watch SAIS Dean James B. Steinberg in a conversation with Dr. Rahul Gupta, Director of the White House Office of National Drug Control Policy (ONDCP), about the national opioid and overdose epidemic, its impact on U.S. national security and economic prosperity, and the Executive Branch’s strategic approach in implementing a process to commercially disrupt the international business of drug trafficking.

The economic costs of the opioid and overdose crisis are also substantial. “There will be a report coming out from Congress just today which will show that, in 2020, this country lost $1.5 trillion because of the opioid crisis,” Gupta said. “That’s equal to the GDP of Russia, the 11th largest economy in the world. Think about that.”On top of that, a majority of Americans dying from opioid overdose are between ages 25 and 54—people who should be at the most productive stage of their lives, contributing the most to their communities and the national economy. He noted strong U.S. leadership is needed to confront what is also an international problem. Since less than 10 percent of Americans in need of drug treatment are getting it right now, Gupta said the Biden Administration’s strategy calls for 100 percent access to treatment by 2025. “We want to get people the help they need right now while working to disrupt and dismantle the trade,” he stated.Before President Biden appointed him director of ONDCP, Gupta was the chief medical and health officer, interim chief science officer and senior vice president at March of Dimes, providing strategic oversight for March of Dimes’ domestic and global medical and public health efforts.A practicing primary care physician of 25 years, Gupta began his career in private practice in an underserved community of fewer than 2,000 residents. He has since served under two Governors as the Health Commissioner of West Virginia. As the state’s Chief Health Officer, he led its opioid crisis response efforts and launched several pioneering public health initiatives.