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Biden's speech comes with opioid epidemic having become a deadly public health crisis


One of President Biden's guests at tonight's State of the Union address will be a father from New Hampshire who lost his daughter to a fentanyl overdose. Biden addresses the nation as the opioid epidemic has evolved into a far more deadly public health crisis. NPR addiction correspondent Brian Mann looks at how we got here and what might come next.

BRIAN MANN, BYLINE: One thing everyone agrees on - the soaring death toll from the opioid fentanyl crisis is shattering families, scarring whole communities. Brandon Dunn from Texas lost his 15-year-old son, Noah, to a fentanyl overdose last summer.


BRANDON DUNN: He was murdered by a drug dealer selling counterfeit Percocet pills. Noah was the third victim in less than two months in Hays County from illicit fentanyl.

MANN: Dunn testified before the House Judiciary Committee last week. The U.S. has really been navigating two public health crises at the same time - the COVID pandemic and an explosion of drug deaths linked to fentanyl. Dr. Rahul Gupta heads the White House Office of National Drug Control Policy.

RAHUL GUPTA: Our nation is facing 108,000 overdose deaths in just 12 months. That's one life lost every five minutes around the clock. We're living in historic times. Our North Star is to save lives.

MANN: The Biden administration has focused its response on health care, trying to get more addiction treatment to more people, while also scrambling to make a medication that reverses opioid overdoses, called Naloxone or Narcan, more widely available. Gupta says these strategies are helping.

GUPTA: After more than 35% increase in overdose deaths during the first 18 months of the pandemic, the more recent total overdose death counts have remained largely unchanged.

MANN: So the overdose epidemic may be slowing just a bit, but researchers still say the U.S. is on track to lose another 1.2 million lives to opioid overdoses by the end of this decade. The fentanyl that's killing so many people is flowing into the U.S. from Mexico. The Drug Enforcement Administration says the leaders of drug cartels have decided fentanyl is a moneymaker - cheap to make, easy to smuggle through official ports of entry. And the cartels simply don't care if it kills a lot of Americans.

DAVID TRONE: We're not winning. We're losing the battle.

MANN: Congressman David Trone, a Democrat from Maryland, says fentanyl smuggling can't be seriously curtailed with anything short of a large U.S. military presence inside Mexico, which he says is unrealistic.

TRONE: My belief is there's absolutely no way to stop it. If we could, you know, do major raids in Mexico with our military, it's not our country. It's their country. They've chosen not to go after the drug traffickers.

MANN: This is why the Biden administration is focusing mostly on health care. There's a growing conviction among Democrats and many drug policy experts that illicit fentanyl is now a permanent fixture on American streets. But many Republicans are pushing back, arguing more can be done to secure the border and often falsely linking fentanyl with undocumented migrants. Congressman Chip Roy from Texas spoke at last week's judiciary hearing.


CHIP ROY: The overwhelming flood at our borders distracting Border Patrol from being able to carry out their duty to stop the flow between the ports of entry or do inspections at the ports of entry is resulting in more fentanyl pouring into our communities.

MANN: But Republicans haven't suggested specific policy ideas or strategies that might seriously slow fentanyl trafficking. So as President Biden speaks tonight, fentanyl has joined the COVID pandemic as a public health crisis that's also a fault line in America's political divide. Brian Mann, NPR News. Transcript provided by NPR, Copyright NPR.

Brian Mann is NPR's first national addiction correspondent. He also covers breaking news in the U.S. and around the world.
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