A deadly plague continues to rage across America, and neither vaccines, face masks nor herd immunity can stop it. The drug overdose death epidemic has claimed more lives than COVID-19 and is more intractable. But the Biden administration is showing a welcome openness to a new strategy.
This approach is widely known as “harm reduction”. The idea is that drug addiction should be viewed as a public health problem, not a crime or a sin. Banning and punishing drug use does not work. A better option is to help illicit users change their behavior to reduce their risk.
“I think this administration is the first to use the term ‘harm reduction’ in its drug strategy,” said Maritza Perez, director of the National Affairs Office of the Drug Policy Alliance.
The risks associated with the use of opioids in particular are serious and increasing. In 2019, the number of drug overdose deaths was 70,630, the highest on record and most implicated in opioids. But in 2020, the total was 93,331, an increase of 32%. Since 1999, more than 900,000 Americans have died of drug overdoses.
The epidemic has its roots in the 1990s, when pharmaceutical companies released new opioids such as OxyContin, which were marketed as safe for the treatment of chronic pain. But many patients have become addicted and some have died of overdoses.
You might think that the federal crackdown on pain prescriptions and successful lawsuits against drug companies would make a big difference, and you’d be right: the number of OTC opioid-related deaths has skyrocketed.
For the past half century, presidents of both parties have viewed drug addiction as a job for police and prosecutors, relying on stiff penalties to deter buyers and sellers. But mass incarceration failed – and President Joe Biden, who helped make it happen as a US senator, now admits it was “a big mistake.”
Today he embraces something different: trying to keep addicts alive while also making it easier for them to access ways to overcome addiction and avoid death. The COVID-19 relief law enacted this year includes $ 30 million for harm reduction programs.
These include syringe services, which allow people who inject drugs to obtain free sterile needles without fear of arrest. This is a proven method for fighting deadly diseases, including HIV and hepatitis C, but they have long been excluded from federal funding. President Barack Obama lifted the ban, but when Republicans regained control of Congress in 2011, they reinstated it.
Even former Vice President Mike Pence, however, was ready to authorize syringe services when the situation got serious enough. As governor of Indiana in 2015, he approved a program in one county to fight a severe HIV epidemic. “I will tell you that I do not support needle exchange as a drug policy,” he said at the time. “But this is a public health emergency.” The program has been a phenomenal success.
The White House has issued a lengthy statement of its drug policy priorities, with the aim of reducing fatal overdoses. It promises to improve access to drugs used to treat and overcome opioid addiction. He supports efforts to promote the use of naloxone, which can reverse overdoses, and test strips to detect fentanyl, a very potent opioid that suppliers often mix with heroin and cocaine – with drugs. sometimes tragic results.
It’s not just about saving drug addicts from sudden death, but also paving the way for addiction. Harm reduction organizations, according to the White House statement, “can build trust over time with patients and are in a unique position to encourage (addicts) to seek treatment, recovery services and health care “. This year’s expansion of the Affordable Care Act has also enabled more people to seek treatment for mental health and addiction.
But the addiction to law enforcement is hard to break. Biden has proposed to make permanent the Trump administration’s policy of classifying all fentanyl-related substances as Schedule I drugs, exposing users to heavy criminal penalties.
It’s the opposite of harm reduction – adding the risk of imprisonment to the risk of overdose. Not to mention that, as we have learned in decades of efforts to eradicate cocaine, heroin, and methamphetamines, locking up people for drug use does not stop people from using drugs.
Biden has taken a big step towards a better future. But he still has one foot stuck in the past.