Indian American Dr. Rahul Gupta made history as the first medical doctor to head the White House Office of National Drug Control Policy (ONDCP). Born in India to an Indian diplomat and raised in the Washington, D.C. suburbs, Dr. Gupta’s journey is remarkable. At 21, he completed medical school at the University of Delhi and went on to specialize in pulmonary medicine. He also earned a master’s in public health from the University of Alabama-Birmingham and a Global MBA from London School of Business and Finance.

In an exclusive interview with South Asian Herald on January 19, 2025, Dr. Gupta discussed the key initiatives of the White House during his term. He highlighted the importance of Naloxone in reversing opioid overdoses, the ongoing efforts to combat fentanyl trafficking at the border, the push for greater accountability among individuals and entities, and the US-India Drug Policy Framework, among other crucial topics.

You are the first Physician, also an Indian American, confirmed by the U.S. Senate to serve in this role. Can you share your thoughts on this historic achievement and the initiatives you implemented during your term at the White House?

As the first physician and first immigrant to lead ONDCP, I have had the honor of overseeing the largest and most significant turnaround in drug overdose deaths in American history. Under President Joe Biden’s leadership, we have made remarkable strides in combating the opioid crisis. When President Biden took office, the country was facing an alarming 31 per cent annual increase in overdose deaths. Meanwhile, drug traffickers and producers were operating at the pace of business, while the government was lagging behind. The President tasked me with creating a clear plan to save lives. Today, we are witnessing a 22 per cent reduction in overdose deaths for the 12-month period ending in August 2024, marking a remarkable 53 per cent improvement under this administration.

Can you elaborate on important initiatives that led to this dramatic?

So let me explain the 3 important steps, in addition to an awareness campaign, that led to this unprecedented drop – which has saved over 500,000 Americans lives. First, stopping bleeding is the first priority in saving lives, whether in trauma or an opioid crisis. Naloxone (Narcan) is essential in reversing opioid overdoses, which have devastated public health and the economy for nearly a decade. To save lives, efforts were made to make naloxone more accessible and affordable, including over-the-counter availability and free distribution in many communities. The White House Challenge to Save Lives from Overdose, engaged companies like United Airlines and MLB, along with local businesses, to stock naloxone. States and communities can now access it at historically low prices, ensuring life-saving support is widely available.

Secondly, access to opioid addiction treatment has significantly improved by addressing key barriers. Previously, doctors needed a special DEA license (the X-waiver) to treat opioid addiction, while they could prescribe opioids more easily. The removal of the X-waiver under the President’s initiative has expanded access, increasing the number of qualified prescribers 15-fold. Treatment is now more accessible in underserved areas, rural communities, and even jails and prisons. Advances in telehealth have also enabled 24/7 support for Americans nationwide, ensuring treatment is easier to obtain than drugs.

Thirdly, for years, drug traffickers profited while we counted the lives lost, and it was time to change that. Drug trafficking is a global issue that needed a global approach. We had to target the core of their operations, not just individual dealers. While taking down cartel leaders is important, it’s not enough—once one is arrested, another quickly takes their place. Today, we’ve made drug production more expensive, challenging, and time-consuming. Simply seizing drugs isn’t enough; we must disrupt the entire production and supply chain to prevent drugs from being made at all.

Please outline your efforts to combat fentanyl trafficking at the border?

We are continuing to make record fentanyl seizures at the border, preventing it from reaching American communities. In addition to these efforts, we’re taking a broader approach to tackling drug trafficking—targeting the financial networks and illicit profits of traffickers. We’re holding more people accountable, including not just drug dealers, but also the lawyers, accountants, brokers, and real estate agents who help facilitate drug trafficking and money laundering.

What are the steps undertaken on holding accountability for individuals and entities involved in drug production?

Under President Biden’s executive order, we have imposed sanctions on more than 300 individuals and entities linked to drug production and trafficking, severing their access to the U.S. financial system. This includes leaders of drug cartels, their supporters, facilitators, and chemical companies, especially those based in China. Through the President’s leadership, we are uniting the international community to tackle the global threat of synthetic drugs like fentanyl. Our efforts include working with China to stop the production of precursor chemicals, collaborating with India to prevent traffickers from exploiting their pharmaceutical industry, and uniting around 160 countries to combat the growing threat of synthetic drugs worldwide.

What were some of the significant initiatives you led in collaboration with the Government of India?

During my tenure, on June 22, 2023, we announced the “U.S. and India 21st Century Drug Policy Framework,” the most forward-thinking and comprehensive agreement on this issue ever signed between the two nations. Both President Biden and Prime Minister Narendra Modi expressed their commitment to developing a broader bilateral drug policy framework for the 21st century. The framework is built on three key pillars:

• Demonstrating global leadership in combating the illicit production and trafficking of drugs, including their precursor chemicals and related diversions.
• Advancing a sustainable, holistic public health partnership focused on evidence-based drug prevention, treatment, and rehabilitation for drug users.
• Establishing a secure and expanding pharmaceutical supply chain in the 21st century as a model for the world.

Indian Ambassador to the United States, Vinay Kwatra, and I signed the agreement on behalf of our respective countries, which was celebrated during the Biden-Modi meeting in September 2024.

How has the partnership with India played a crucial role in addressing the epidemic?

Partnership with India will continue to remain crucial as we see progress in our work with China. The world’s two largest democracies must lead with example to fight against the global synthetic drug threat.

Do you feel the Biden-administration’s initiatives will support the incoming administration in terms of handling the crisis?

This is a bipartisan issue and one that affects all Americans. We cannot afford to go back – Americans lives depend on the incoming administration doing all it can to continue saving lives. We are hopeful that will be the case. We need to double down on policies that are working and resource them. Now, we still have a long way to go to beat the opioid crisis once and for all. However, today, there are fewer families facing an empty seat at the dinner table each night, including during this holiday season. And we’re headed back in the right direction.

(This interview has been edited for length, brevity and clarity.)

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