Photo Credit: Governor Tom Wolf
The prohibition of opioids in the United States has been raging for almost a century. The Anti-Heroin Act of 1924 began the criminalization of importing and possessing opioids. Now, after countless people have been imprisoned and an immeasurable amount of money and resources have spent, we are in the midst of an opioid epidemic. Each year, the number of fatal opioid overdoses rises, with the CDC’s estimates for 2017 reaching a record 72,000 deaths. Let us be very clear: these are preventable deaths. Through legislative change and the implementation of proven harm reduction strategies, we have the option to adopt a drug policy based on compassion and evidence-based results rather than on punishment and propaganda.
The presence of opioids has become common throughout the United States. Some come from the black market and have been produced illegally and without government regulation, while others are prescribed and produced by registered pharmaceutical companies. A common misconception is that overdoses only stem from illegally produced opioids. In reality, a full 40% of these overdoses are due to prescription opioids. Incredibly, more than a third of Americans used a legally prescribed opioid in 2015. This number does not include illegal opioid use. This brings us to our first recommendation in the fight against opioid overdoses: Narcan should be in every household across America.
What is Narcan? Also known as Naloxone, this drug blocks the absorption of opioids at the receptor-level. Opioids effect our respiration, which is why someone suffering from an overdose may stop breathing. By pausing the effects of the opioids in the body, Narcan saves lives by restoring the person’s breathing. It is FDA approved and can be administered easily via a nasal spray. Even a child can do it. It was intentionally developed for use by those without medical training who may arrive at the scene first, such as friends or family. Narcan is not a replacement for calling 911, but can save the person’s life while EMTs are on the way.
Just as we have a fire extinguisher in every building and house to protect us in the event of a fire, we should also have Narcan readily available at all times. Harm reduction centers will often provide free Narcan kits and training to those who want it, and an increasing amount of other institutions are doing the same. The New York City government has even started distributing Narcan through a range of channels as part of its HealingNYC initiative. St. Ann’s Corner of Harm Reduction (SACHR) also provides Narcan and relevant training to individuals and organizations interested in equipping themselves with this life saving tool at no cost to participants.
Raising the availability and awareness of Narcan in our society is a powerful anti-overdose strategy. But legislative change must also be brought about if we truly hope to disrupt the opioid epidemic. Prohibition is a primary driver of overdoses and actually exacerbates the harm that these drugs can cause. We know that banning opioids does not make them disappear. On the contrary, it drives their use and production underground which is far more dangerous. Users do not know the content, strength, or dosage of what they are ingesting. Imagine if every time you needed cough syrup – it came in an unmarked bottle and was always either stronger or weaker than the last time you bought it. Obviously, the chances of you accidentally taking too much would skyrocket. Alcohol is also a potentially dangerous drug, but we learned in the 1920s that prohibiting it only made things worse.
Clearly, some form of regulated access would be preferable to the current system. This has already been tried and proven to work in many other countries, particularly in Europe. Switzerland’s program has gained considerable attention as a success story. Starting in the 1990s, “Zurich became the first place in the world where therapy programs handed out heroin prescriptions to heavy and long-term opiate users for whom other substitutes wouldn’t work.” As a result, the rate of new users, new HIV infections, overdoses, and other problems associated with opioid use all plummeted.
It is up to us as voters and individuals to drive this change forward in the fight against opioid overdoses. The steps are relatively straightforward: Equip yourself with Narcan and learn how to administer it (it’s very simple). Vote for candidates who support harm reduction measures and non-prohibitionist approaches to our drug policy. Getting “tough on drugs” has only made things worse – it’s time for compassion and pragmatic change. Lastly, support your local harm reduction centers. By tackling overdose prevention, HIV and HCV testing, sex education, syringe access, and more – these facilities do wonders for the communities they serve.