A harm reduction worker speaks to a person on the streets of San Francisco

Paul Harkin of HealthRIGHT 360 distributes naloxone and fentanyl detection packets to people on February 3, 2020 in San Francisco. (Photo: Nick Otto for The Washington Post)

Amid Overdose Crisis, 260+ Public Health Groups Urge Congress to Pass Life-Saving Bills

"If our leaders fail to act, another year of devastating and historic overdose deaths is inevitable," said one drug policy expert.

Two weeks after the Centers for Disease Control and Prevention released sobering statistics showing a record-breaking number of drug overdoses in the U.S. in the first year of the coronavirus pandemic, more than 260 advocacy groups called on lawmakers Tuesday to urgently pass public health proposals to mitigate the crisis.

"It is absolutely imperative that policymakers change course immediately and prioritize evidence-based public health alternatives that are proven to actually save lives."

Led by the Drug Policy Alliance, People's Action, the National Harm Reduction Coalition, and VOCAL-NY, the organizations said the unprecedented number of overdoses in the 12-month period ending in April 2021 was "grim, but not unexpected" considering the criminalization of drug use in the United States and lack of resources for people with drug use disorders.

"Criminalization has perpetuated stigma against people who use drugs, creating an environment where individuals have a more difficult time accessing the health services and support they need," wrote the groups in a letter to House and Senate leaders. "These approaches have also fueled overdose numbers by pushing people into risky situations, making the drug supply unregulated and unsafe, and wasting resources on punishment instead of harm reduction and other health services proven to save lives."

The overdose crisis could be curbed with the passage of three pieces of legislation, the organizations said, including:

  • The Mainstreaming Addiction Treatment (MAT) Act (H.R. 1384/S. 445), which would eliminate the requirement that practitioners apply for a separate waiver through the Drug Enforcement Administration (DEA) to prescribe buprenorphine for treatment of substance use disorder;
  • The Support, Treatment, and Overdose Prevention (STOP) of Fentanyl Act (H.R. 2366/S.1457), which would improve surveillance and detection of fentanyl and enhance evidence-based public health approaches to opioid overdose and substance use disorders; and
  • The Medicaid Reentry Act (H.R. 955/S. 285), which would allow Medicaid to cover health services during the last 30 days of incarceration and connect people with overdose prevention and substance use disorder treatment after their release--legislation that's currently included in the Build Back Better reconciliation package.

The groups also called for $69.5 million in funding to increase access to overdose prevention, harm reduction, and syringe service programs through the CDC's Infectious Diseases and Opioid Epidemic program.

"Congress must heed the calls for urgent action, and pass legislation rooted in science, harm reduction, and care before the new year," said Jasmine Budnella, director of drug policy at VOCAL-NY. "If our leaders fail to act, another year of devastating and historic overdose deaths is inevitable."

The overdose deaths recorded between April 2020 and April 2021 represent an increase of nearly 30% from the same period in the previous year, according to the National Center of Health Statistics.

The groups' call came as New York City officials announced the opening of two supervised injection sites--as early as Tuesday--making the city the first in the U.S. to authorize the operation of facilities where public health workers will administer naloxone in case of overdoses; provide clean needles and a clean, safe space for people to use substances that they bring; and offer addiction counseling to those who want it. The sites will be run by two nonprofit groups that receive funding from the city.

The use of supervised injection sites has been shown to decrease drug overdoses, without having a negative effect on crime or the prevalence of drug use, according to numerous studies. A study published in 2018 of Insite, a supervised injection site in Vancouver, British Columbia, found the fatal overdose rate decreased significantly in the area surrounding the facility after it was opened. No drug user has died at Insite since it opened in 2003.

Defense attorney and social justice activist David Menschel applauded New York City's "historic" decision and expressed hope that the Biden administration will allow the sites to operate despite federal laws that ban the operation of facilities for the purpose of using illegal drugs--under which the Trump administration shut down a supervised injection site in Philadelphia in 2019.

Supervised injection sites have not been explicitly endorsed by the Biden administration, though the White House has called for harm reduction measures like those the groups demanded in Tuesday's letter, including needle exchanges and the distribution of fentanyl test strips and naloxone.

The passage of evidence-based public health legislation "is not only more urgent than ever before--it's literally a matter of life and death for so many people," said Maritza Perez, director of the office of national affairs at the Drug Policy Alliance.

"We are far past the point of waiting for a politically convenient time to take the necessary steps to curb this crisis and save lives," said Perez. "The U.S. government has targeted and criminalized our communities for drugs over the last 50 years as a political ploy which has only fueled the overdose crisis. With countless more lives at stake, it's time to stop playing politics and continuing down this ill-fated path."

"It is absolutely imperative that policymakers change course immediately and prioritize evidence-based public health alternatives that are proven to actually save lives," she added.

Correction: In an earlier version of this story, Paul Harkin was identified as an employee of GLIDE in the photo caption. He works for HealthRIGHT 360.

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