Biden’s top man on the opioid epidemic has created a ‘toxic’ office environment

The White House office tasked with helping the nation manage a debilitating opioid epidemic has been beset by significant staff turnover and large-scale discontent with its director, Dr. Rahul Gupta, according to nine people familiar with its operations.

Seven former and current officials, as well two other people with knowledge of the office dynamics, described the White House Office of National Drug Control Policy as a “toxic” work environment. And they put the blame for that on Gupta, who they described as egocentric and a “prima donna” preoccupied with his public profile.

At least eight top officials and a number of other aides have resigned in recent months in large part because of Gupta’s leadership, according to the same officials. The departures have created a significant leadership vacuum in the office of roughly 75 people, leading to dysfunction across the team that has caused important deadlines to be missed, the people familiar with the office’s operations said.

“When everybody leaves, it can’t be ‘everybody is the problem,’” said one of the former officials who, like the others, was granted anonymity to speak candidly and without fear of retribution. “On some level, you might be the problem.”

An ONDCP official, in response to a request for comment, said the office’s “critical mission to address the overdose epidemic is deeply personal to Dr. Gupta: from his decades of work as a physician treating patients with substance use disorder, to leading the public health response efforts in ground zero of the opioid crisis in West Virginia.”

“Dr. Gupta remains laser-focused on the office’s work to strengthen life-saving public health services, prevent illicit drugs from reaching our communities, and meeting with Americans across the country to strengthen our whole-of-society response,” the official said.

Gupta, a practicing physician of more than 25 years, most recently served as the chief medical and health officer, interim chief science officer and senior vice president at the nonprofit March of Dimes before being appointed by President Joe Biden to his current post in 2021. He also served under two West Virginia governors as the state’s health commissioner and was a professor of medicine at several universities.

The White House praised Gupta’s nomination in 2021 as a “historic step in the Administration’s efforts to turn the tide of our nation’s addiction and overdose epidemic.” It noted his background as a physician made him uniquely qualified to oversee an office tasked with preventing drug overdoses through expanding access to prevention and recovery support services, as well reducing the supply of illicit drugs.

But the seven current and former officials told POLITICO that Gupta has not lived up to that billing. They say he put unrealistic pressure on his small team to raise his public profile, such as becoming frustrated when staff were unable to land meetings with a high-ranking official during his travels. In the public-facing role, Gupta travels domestically and abroad frequently, and staff often felt he had unrealistic demands about his travel accommodations.

The trips, the former and current officials said, often centered around Gupta rather than the work ONDCP was doing. He expected Cabinet-level treatment when traveling and would blow up plans when staff couldn’t deliver. He canceled one trip last year, after months of planning, because he didn’t want to fly Southwest Airlines, the officials said. He also once calculated the square-footage of a hotel room, and then requested staff book him a larger room. And he liked to roll up to events — including weekend embassy parties — in a black government SUV with staff, even though that sort of service is not typically used by ONDCP directors for events unrelated to the office’s direct work.

The current and former staffers said they believe his approach to the job is directly at odds with the president’s early insistence that he would not tolerate demeaning behavior by his team.

“The way he’s been treating people is like, completely the opposite of what Biden said he expects from his staff,” said a person with direct knowledge of the office dynamic. “I think everybody is afraid because they’re afraid of retribution.”

The current and former officials believe that Gupta has been harmed by not taking time to build key relationships with the White House, particularly with the Domestic Policy Council which coordinates the president’s domestic agenda and advises the president on policy. Staff say they fear that their issue was falling to the wayside as the West Wing juggles a number of weighty priorities.

“I think he likes the perks of the job. I think he likes the title, the ability to travel,” the first former official said. “But I don’t know that he likes the work that’s required to make it a very relevant place.”

As part of the Biden administration’s commitment to diversity in backgrounds, the White House has emphasized the importance of appointing people in recovery from substance use disorders to ONDCP. But some of those appointees said they felt like Gupta rarely listened to their input and at times felt like he stigmatized people in recovery.

“The director makes the culture and it was not supportive of my recovery,” said a second former official.

The tension flowing through the office has been a major distraction, the current and former officials said. Perhaps most frustrating, they said, is that internal dysfunction has taken attention away from the important issues the office is tasked with addressing, particularly combatting the historic overdose crisis.

Concerns around Gupta, an ally of Sen. Joe Manchin (D-W.Va.), surfaced even before the White House announced his appointment. As it became clear that he was the leading candidate for the role in early 2021, harm reduction activists and health experts criticized Gupta for not doing enough to prevent the shutdown of a controversial syringe exchange program in West Virginia, warning the White House at the time that they felt he placed politics above preserving the policy. People who worked with Gupta in West Virginia also reached out to Biden officials with warnings about how Gupta mismanaged the office during his tenure leading the state’s Bureau for Public Health, according to a person with direct knowledge of the private conversations.

Manchin’s office did not respond to a POLITICO request for comment. But in a 2021 statement on Gupta’s confirmation, Manchin celebrated Gupta as an “extraordinary West Virginian” and said he had “no doubt” he would be “a dedicated Director of the ONDCP.”

“His work to combat the drug epidemic in a state with the worst overdose rate in the nation, where we lost 1,386 West Virginians to fatal drug-related overdoses last year, makes him well-prepared to lead similar efforts on a national scale,” Manchin said in the statement.

Four of the former ONDCP officials acknowledged that leading the office is a challenging job. The office attracts a mix of career and political staffers who often come at drug policy from competing points of view on how to balance public safety priorities with public health goals. “You can’t put a bow on some of this,” said a third former staffer.

Still, they said Gupta was to blame for the recent departures. And few had any hope that the office could turn things around under his leadership.

“We were hired to do a very specific job that is important to the American people, important to the Biden administration, especially with the Hunter Biden stuff,” said a fourth former official, noting the younger Biden’s struggle with addiction.

“No matter what we did to try to push the real administration agenda, we would get side barred by the political aspirations of the director.”

Like this content? Consider signing up for POLITICO’s West Wing Playbook newsletter.