The root of our overdose epidemic is not fentanyl. The problem is government myopia | Opinion

By Dunstan Prial
Fentanyl is the latest in a long line of weapons of self-destruction, which in recent decades included heroin, crack, crystal meth and OxyContin. In a few years, another drug will emerge to replace fentanyl, and the cycle will repeat itself.
Unless policymakers change their approach to addiction.
Unfortunately, federal lawmakers, distracted by an all-consuming presidential election and escalating global conflicts, have lost focus on arguably the defining domestic issue of the past decade.
October 1 marked one year since the expiration of the SUPPORT Act, which provided funding for opioid-use prevention, recovery, and treatment, and this failure of Congress to reauthorize the money has devastated grassroots programs in cities devastated by fentanyl, such as Paterson, Newark and Camden.
The SUPPORT Act was a rare act of bipartisan cooperation, and the goal was to save lives by spreading $20 billion across an array of treatment programs and educational resources, many of them rooted in innovative harm reduction methods.
That was before fentanyl, the powerful synthetic opioid, emerged as a cheaper alternative to heroin and OxyContin. Now fentanyl is in everything – cocaine, counterfeit benzodiazepine pills, even marijuana.
Overdose figures are just starting to trend lower, thankfully. But in the six years between the passage of the SUPPORT Act in Sept. 2018 to May 2024, overdose deaths in the U.S. rose nearly 40%, according to the U.S. Centers for Disease Control and Prevention.
Despite that alarming spike, the issue of addiction has been buried beneath topics more easily polarized — such as immigration — even though 100,000 Americans die of overdoses each year.
Other than acknowledging the scourge of fentanyl and casting blame for the rise in overdose deaths, Kamala Harris and Donald Trump have been mostly quiet on the topic of addiction as a stand-alone issue.
Instead, both candidates have framed the subject through a criminal justice lens, preferring to describe their plans to reduce illicit shipments of fentanyl across the U.S. border. This is the same approach that four decades ago led to the failed “War on Drugs.”
What’s needed is a new approach that acknowledges the reality of substance use while at the same removes harmful stigmas. Harm reduction measures accomplish both, and that’s where state lawmakers can have a profound impact.
I worked for three years as a counselor in a substance use treatment center in Paterson. Few American cities have been harder hit by the opioid crisis. Every day I saw how harm reduction can save lives.
I met opioid addicts who used medical marijuana to stave off cravings and ease the horrific withdrawal symptoms that derail many attempts to quit. Yet most treatment centers – including mine – require total abstinence, a policy that can discourage opioid users from seeking treatment.
I met many others who took Suboxone, a prescription medication that helps reduce cravings and ease withdrawal symptoms. The catch is that Suboxone is opiate-based, which means it can be addictive if abused.
The Biden administration was instrumental in improving access to Suboxone prescriptions via telehealth, but the medication remains difficult to obtain in many areas of the U.S.
I met a crack addict who used opiates to come down from his cocaine binges. He said he always shot up at a safe injection site, where opiate users consume their drugs under the supervision of a trained staff armed with naloxone, a nasal spray that reverses overdose effects.
There two New York City consumption sites – in Harlem and Washington Heights — are the only two in the US, with a third planning to open in Providence site in December. The New York facilities, known as OnPoint, were used by 4,000 people in their first two years of operation. The results: There were 1,100 overdoses prevented, and zero deaths.
Europe, Australia, and Canada have known the same 100% success rate in their combined 200-plus sites. For decades, they have provided spaces that keeps drug use out of the dark public spaces, saving countless lives just through routine fentanyl testing and the availability of naloxone.
Plans for safe injection sites in New Jersey and Philadelphia have been scuttled by political pressure and scare tactics. But opponents argue that methods used in harm reduction enable – even encourage – substance use.
The chairman of the Health Committee, Sen. Joseph Vitale (D-Middlesex), agrees that it is time to establish a pilot program with four injection sites in New Jersey, because “the data is undeniable that these places save lives.”
But harm reduction measures won’t be accepted and adopted until policy makers muster the courage to move beyond tired cliches that stigmatize substance users as criminals and/or moral deviants who must be punished and shamed. How many more deaths will it take?
Dunstan Prial is a substance abuse counselor in Caldwell.
To comment on this op-ed, send a letter to [email protected].
Our journalism needs your support. Please subscribe today to NJ.com.
Bookmark NJ.com/Opinion. Follow on Twitter @NJ_Opinion and find NJ.com Opinion on Facebook.