EXCLUSIVE — Dr. Rahul Gupta, the director of the White House Office of National Drug Control Policy, believes the Biden administration is substantively changing the course of the nation’s fentanyl crisis but cautioned that more must be done to address international supply and domestic addiction before declaring victory over the epidemic.

Gupta, the first medical doctor to lead ONDCP since its creation in 1988, spent roughly a decade combating the opioid crisis in West Virginia, leading the Kanawha-Charleston Department of Health from 2009-2014 before serving as the director of the state’s Bureau for Public Health from 2015-2018.

He sat down for a lengthy interview with the Washington Examiner on the subject and explained why ending the crisis is a much more complicated problem than some lawmakers, and even other drug policy experts, have claimed for the better part of the past decade.

In short, Biden’s policies, specifically making lifesaving overdose treatments readily available, have flattened the exponential rate at which people are being killed by fentanyl. But he indicated that only a prolonged commitment to addressing the problem both internationally and domestically, which would require buy-in from Republicans to install new legislative fixes, will result in an overall decrease in yearly fentanyl overdoses.

Gupta did express some apprehension to the Washington Examiner about the current politicization of the fentanyl crisis, particularly as it relates to conversations surrounding border security or immigration reform. An overwhelming majority, roughly 90% in total, of all fentanyl flows into the country through legal ports of entry, not at illegal crossings where human smugglers are helping immigrants illicitly enter the country, and Gupta believes that some, but not all, Republicans are doing a “disservice” to the public by conflating immigration reform with the fentanyl crisis.

“The problem doesn’t begin or end at the border,” he stated simply.

At this point, a decade into an already widening epidemic that exponentially worsened during the COVID-19 pandemic, roughly 75,000 fentanyl overdose deaths occur in the United States each year, making up almost three-fourths of the country’s total overdose deaths. Gupta told the Washington Examiner that domestic addiction levels, coupled with a highly mutable, profit-driven global drug trade, make it impossible to drive those numbers down to zero in the short term. Still, Gupta counts every life saved from an overdose as a success story, and he’s confident that Biden’s policies will help the country continue down the path to recovery.

“To me, every life is precious and worth saving, and I akin this to, epidemiologically, a large ship going fast in the wrong direction,” he stated. “First, you’ve got to stop it, and you’ve got to turn it around. We’ve gotten to a point now where we have slowed it down, and we are stopping, and now we’ve got to turn this around.”

Recent data would appear to back up Gupta’s claims. Fentanyl overdose deaths have increased every year since 2014. When Biden came into office in January 2021, the overdose death rate was growing by more than 31% year over year, with the White House projecting that yearly fentanyl overdoses would exceed 165,000 by 2025.

Yet by the summer of 2023, the last period in which total overdose death statistics have been fully calculated, that yearly change had fallen back to 2.8%, the lowest rate increase in a decade. Gupta insists that doubling down on the president’s policies targeting the crisis has saved an estimated 30,000 lives over the past two years and could potentially halve the administration’s projected overdose deaths by 2025.

Gupta also says that the Biden administration is approaching fentanyl policy in a fundamentally different way than both the Trump and Obama administrations. Rather than simply trying to “catch drugs” being transported into the country, the administration is treating fentanyl as a global “illicit commerce” operation, requiring an international coalition that targets cartels, freelance producers, and a sprawling web of “enablers” — including financiers, shippers, lawyers, accountants, wealth managers, and even real estate agents — all connected to the transnational fentanyl supply chain.

Upon Gupta’s recommendation, Biden has also taken direct steps at home to prioritize recovery and treatment options for fentanyl users. That includes putting millions of doses of Naloxone, Narcan, and other emergency overdose treatments into circulation, which Gupta estimates has prevented around 26,500 overdose deaths. Furthermore, Biden eliminated the “X Waiver,” an impediment to the prescription of the opioid use disorder treatment buprenorphine, which Gupta says helps de-stigmatize the process and will help more rapidly transition recovering users back into society and the workforce. 

Since 2021, 144 countries have signed on to Biden’s global fentanyl initiative, known as the Global Coalition to Address Synthetic Drug Threats, and Gupta claims that Biden and top administration officials have effectively communicated to foreign leaders that “the world is divided up into three types of countries.”

“One, like the United States, where you’ve got a problem, and you know about it, like fentanyl and meth. Another set of countries who have a problem and just don’t know about it,” he explained. “And then the third group of countries, they are going to have a problem in the future.”

“These cartels, these criminal, transnational criminal organizations, and all these drug trafficking organizations, there’s money to be made, and they’re not stopping at America’s borders. They’re going to go everywhere. They want to co-op the remote networks there, and they’re going to expand the trade. It’s all for money,” Gupta continued.

One country that notably has not signed onto the Global Coalition is China, yet Biden’s escalating sanctions against Chinese companies and individuals have brought Beijing back to the negotiating table. Since 2021, Biden has sanctioned 152 individuals and 112 entities over their connections to fentanyl production and trafficking, and in November 2023, Biden and Chinese President Xi Jinping entered into a new handshake agreement to target the synthetic drug. That framework includes increased information and intelligence sharing and a promise from Beijing to shut down companies supplying Mexican cartels with fentanyl precursors and production equipment.

Speaking of Mexico, Gupta is pleased with how President Andres Manuel Lopez Obrador has responded to overtures from the administration to address the drug trade despite historic roadblocks within that country, be they government corruption or the very presence of the cartels themselves.

“If he’s cooperating, it’s not out of fear. It’s out of protecting its own citizens; it’s out of making sure that law enforcement and rule of law prevails in Mexico to the extent he can and hold bad actors accountable,” he expressed. Gupta noted that cooperation and intelligence sharing between the United States and Mexico has led to the arrest of top members of the Sinaloa cartel and other drug trafficking organizations over the past two years. That list includes Ovidio Guzman Lopez, a son of former Sinaloa boss Joaquin “El Chapo” Guzman, Nestor Isidro Perez Salas, Alejandro Silva Delgado, Ismael Quintero Arellanes, Jose Guadalupe Tapia Quintero, and Rafael Caro Quintero.

When it comes to the fraught border security negotiations between the Biden administration and certain GOP lawmakers, Gupta did not discount calls to reform the immigration system but said, “Without going into names,” not all Republicans understand “the difference between the challenge of immigration and the challenge of drugs, which are two separate issues.”

He criticized calls from some Republicans, like former President Donald Trump and former U.N. Ambassador Nikki Haley, to take direct military action on Mexican soil in an effort to slow the flow of fentanyl into the country.

“Those threats of invasion do just the opposite. That’s how much more difficult it makes our work. It doesn’t make it easy; it makes it more difficult because today, we’re in a world where these types of talks just don’t work. They just don’t,” he told the Washington Examiner. “We’re pushing them every single day, don’t get me wrong about that, but the fact is that we need a cooperative, accountable Mexico government in order to keep Americans safe.”

“Look, I come from local and state [government]. I come from nonprofit, corporate academia,” Gupta concluded. “I look at this as you’ve got to at least tell the truth to the American people and let them decide for themselves.”

However, Republican lawmakers, by and large, do not appear to believe the Biden administration’s claims that their current policies are sufficiently addressing this national epidemic.

“Any government official denying the correlation between the security crisis at our southern border and the record-high influx of life-ending fentanyl into our country is divorced from reality,” Rep. August Pfluger (R-TX) told the Washington Examiner.” This administration could fix the fentanyl crisis and the immigration crisis with a secure border.”

Rep. Monica De La Cruz (R-TX) said Gupta must be honest with the public about the seriousness of the sitaution at the border.

“The Border Patrol reports recovering 480 pounds of fentanyl so far in fiscal year 2024, enough to kill more than 106 million people,” she said in a statement. “That amount seized is just a drop in the bucket. In no way is that ‘turning the tide.’ We have to be honest about the amount of fentanyl crossing our southern border and ending up in communities from Maine to Oregon and everywhere in between. Director Gupta may say we are turning the tide, but not being honest about the situation only hurts the American people.”

Staffers for Rep. Michael McCaul (R-TX), the chairman of the House Foreign Affairs Committee, explained to the Washington Examiner that their boss is “acutely aware” of the transnational nature of the fentanyl trade and pointed to legislation McCaul has sponsored that aims to disrupt the global supply chain. They also say McCaul does not support calls from other Republicans to conduct military actions targeting the cartels.

Still, they indicated that he believes that the Biden administration’s border policies, and even recently impeached Department of Homeland Security Secretary Alejandro Mayorkas himself, do bear some responsibility for fentanyl-related deaths in the U.S.

CLICK HERE TO READ MORE FROM THE WASHINGTON EXAMINER

“Secretary Mayorkas and President Biden would like the fentanyl and border crises discussed separately to improve their odds at partial credit as we approach election season. Americans know better: The Biden administration’s open border policies have empowered the cartels’ criminal enterprise along our porous southern border, where fentanyl, produced in China and shipped to Mexico, seeps into the U.S. and kills 200 Americans each day,” McCaul himself told the Washington Examiner.

And Anna Kelly, a spokeswoman for the Republican National Committee, told the Washington Examiner that “Joe Biden’s open border is enabling the fentanyl crisis that’s killing tens of thousands of Americans each year, and it’s made communities across the country less safe.”