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Drug Treatment is Infrastructure

Edmontonian with a sign that reads "harm reduction saves lives," photos of loved ones and crosses with purple ribbons and hearts gather for International Overdose Awareness Day at Capital Plaza outside the Federal Building.
States and localities should use this moment to tackle the overdose epidemic.
Edmontonian with a sign that reads "harm reduction saves lives," photos of loved ones and crosses with purple ribbons and hearts gather for International Overdose Awareness Day at Capital Plaza outside the Federal Building.
Joseph Longley,
Equal Justice Works Fellow,
ACLU's National Prison Project
Jay Diaz,
General Counsel, ACLU of Vermont,
American Civil Liberties Union
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September 10, 2021

COVID-19 was not the only deadly public health crisis of the past year and a half. The overdose epidemic killed a record 93,000 Americans in 2020, ravaging communities across the country, and may be on track to be worse in 2021. While the nation has combated COVID-19 by prioritizing medical research, vaccine production, treatment development, and implementation of common-sense public health measures, our response to the overdose epidemic has been tragically meager. In this moment of investment in our nation’s infrastructure, it is time for federal, state, and local governments to change course and invest in proven, life-saving public health tools to finally stem the tide of overdoses across the country.

It is no mystery what prevents overdose deaths. Studies consistently show that medical treatment and prevention, not punishment, saves lives. Yet, the most effective support for our family members, friends, and neighbors who use drugs are largely underfunded, and in some cases, outlawed.

Safe consumption sites, like the ones Rhode Island recently legalized, are a prime example of where investment needs to be made and barriers lifted. These medical facilities provide an individual who uses drugs with sterilized equipment and access to health care services and overdose reversal medications as needed, free from fear of criminal prosecution. Already operational in Canada, Australia, and Europe, these facilities are proven to save lives because they bring people out of the shadows to use drugs more safely, access substance use disorder (SUD) treatment information and referrals, and receive immediate medical intervention. In addition to preventing overdoses, safe consumption sites are proven to reduce the incidence of HIV and hepatitis C, among other diseases, benefiting everyone.

Yet despite all of the benefits, the implementation of common-sense programs like these has been stymied by years of stigma-based messaging, fearmongering, and moral panic about drug use. The Trump administration fought tooth and nail to shut down a proposed safe consumption facility in Philadelphia. It is crucial that the Biden administration allow safe consumption sites to operate and save lives in communities across the nation.

The nation also needs an all-hands-on-deck approach to harm reduction, ensuring ubiquitous access to fentanyl test strips, syringe service programs, and naloxone, the overdose-reversing medication. Emergency departments across the country should be ready to provide patients with appropriate screening, SUD medication, and direct referrals for long-term SUD treatment. Additional investments should be made in transportation to drug treatment clinics and more mobile clinics, for which the Biden administration recently loosened restrictions, to reach individuals in rural communities. And jails and prisons should ensure access to medications for opioid use disorder for everyone who needs it.

Not only do harm reduction policies like these save lives, but they also often save money. One study shows that $1 spent on new syringes decreased the cost of HIV treatment by $7. A study in California estimated that enrolling someone in a program that uses medication for opioid use disorder would save an average of over $17,000 per year versus detoxification, savings realized in decreased crime. States and localities can save more money by cutting spending on unnecessary and counterproductive criminal justice system expenditures — no longer arresting, prosecuting, convicting, incarcerating, and punishing people for drug possession. That money is better invested in our people’s health, housing, and education, counteracting the despair at the root of the overdose epidemic.

It is time to follow the evidence and make meaningful investments in prevention and treatment programs that will curb the horrific number of needless deaths. During the COVID-19 pandemic, we have seen how smart investments in public health can save countless lives. We must make smart investments in our prevention and treatment infrastructure to ensure people at risk of overdose can receive the care and support they need.

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