The Drug War, like the other cultural wars, often seems intractable and divisive. However, there has been greater accord between the GOP and Democrats in recent years on support for overdose prevention and drug treatment services. Both the Biden and Trump administrations increased investment in drug treatment, with an appropriate focus on medically-assisted therapy including methadone and buprenorphine.
Also, bipartisan agreement led to greater availability of the opioid-antidote naloxone, which if administered in time, can restore respiration and prevent death. Research has proven that laypeople with relationships to opioid users, especially drug users themselves, can effectively administer the lifesaving antidote.
There is however a practical next step that would reduce death, disease and suffering, that is in danger of being treated like a political football.
Overdose Prevention Centers (OPC) are programs that allow drug users to use pre-obtained drugs under supervision of staff trained to treat drug overdose episodes. Typically, a person checks in, they are given sterile equipment, and a clean hygienic surface to sit at, and they use in an unhurried manner. Then, they are offered a place to rest and recover, while staff maintains a watchful eye. If a person experiences an overdose or other adverse reactions, the staff can intervene and treat them. Staff also uses this time to counsel participants on other services, including drug treatment.
These programs have existed for more than 30 years in Europe, Australia and Canada, and careful research has proven that they prevent drug overdose deaths and assist people in entering drug treatment. Research also shows that they reduce public drug use, reduce syringe litter, and have no negative impact on crime. Where there has been an observed change in crime, it was a reduction in property crimes, such as car break-ins.
Mayor Eric Adams of New York City embraced OPC public health and public safety benefits. In November of last year, two OPCs opened in Manhattan. Since that time, they have supervised almost 30,000 separate uses of drugs and intervened in 390 potentially deadly overdoses. Earlier this month, Mayor Adams, the former-NYPD Police Captain said, “Overdose prevention centers keep neighborhoods and people struggling with substance use safe. Now is the time to expand access to OPCs and do so in an equitable way across New York City.”
Former Pennsylvania Governor Ed Rendell gets it, as well. He and his nonprofit foundation backed the opening of a program in Philadelphia. However, the Trump Department of Justice sued to stop it from opening, saying that it violated federal drug laws.
Former Attorney General of California Xavier Becerra and seven other state Attorneys General pushed back on Trump’s action, joining an amicus brief saying that these programs are designed to prevent death and disease, and do not contribute to crime. Becerra is now the Secretary of Health and Human Services under President Biden.
The American Medical Association and other health policy organizations filed their own amicus in support of the Philadelphia program, which remains in legal limbo. All the while people die needlessly.
The lawmakers in Rhode Island voted to authorize OPCs, and Governor Daniel McKee signed a bill in 2021 to pilot and evaluate programs there. They are taking applications from community health programs now.
Gov. Gavin Newsom of California has the chance to sign or veto a bill supported by most California lawmakers. It’s narrowly crafted and will allow local governments a five-year window to pilot and evaluate programs in Los Angeles, Oakland and San Francisco. The elected leadership in those jurisdictions support the bill, as does the leading drug treatment associations in the state.
The bill was opposed however by the Republicans, and former Democratic Gov. Jerry Brown vetoed a similar bill sponsored by the treatment associations in 2018. The spotlight is now on Gov. Newsom, who stalwartly took hits from conservatives for his insistence on following the science on vaccination and his early stay-at-home orders to stop the spread of COVID-19.
Science has become politicized in the US, but facts are still facts. The number one cause of accidental death in the United States is drug overdose, and it doesn’t care if you are in a red state or a blue state, or who your parents voted for. Of the ten states with the highest rates of death from overdose, five are ‘red’ and five are ‘blue.’
Overdose prevention centers are proven to save lives and improve the overall safety of communities they serve. We hope that Gov. Newsom, like Mayor Adams and scores of other elected leaders in the country, will take the small, lifesaving step of testing this approach here in the United States.
Glenn Backes is a public policy consultant based in Sacramento, with Masters Degrees in Public Health and Social Work. He got his start in harm reduction in the late 1980s are part of ACT-UP New York, delivering syringes to homeless encampments in violation of state laws. The laws on syringe access eventually caught up to the science of disease prevention.
