Fentanyl and Public Drug Use: A Doctor Gives the Facts

DPA: How should we address fentanyl and public drug use?

Dr. Goodman-Meza: Public drug use has more to do with the lack of people’s ability to access housing and affordability than with increases in the number of people using drugs. Housing prices have escalated, and options have dwindled. Unfortunately, most cities just do not have enough housing options for the amount of people experiencing homelessness or at risk for homelessness. We lack a true safety net for people who are about to become homeless, and a system that makes it really hard for someone who’s homeless to get housing.

So how do we address public fentanyl use? We need more housing, and especially affordable housing. But for the housing units we have available, cities need to invest in Housing First models for people who use drugs. These models prioritize getting people into housing despite their use of substances. Once housing is secured, a multidisciplinary team of support workers and medical professionals can address their substance use disorder and mental health issues. Treatments such as methadone and buprenorphine work. But we know that people who are experiencing homelessness struggle more with relapse than people who have housing. Thus, making it easier for people experiencing homelessness to get housing while in treatment is essential for their success.

Another solution are overdose prevention centers. These are sites where people can use drugs in a monitored setting. These sites connect people with addiction services and social supports. There are over 100 of these sites worldwide, and where they have been placed, evidence suggests that public use of drugs, littering of drug paraphernalia and crime goes down.

Lastly, investing in community-based crisis response teams that prioritize peer health and social worker outreach to engage people in treatment services is key.

Return to the main question page for more facts on fentanyl.

About Dr. Goodman-Meza: Dr. David Goodman-Meza is a Mexican-American physician and scientist focused on the intersection of infectious diseases and addiction. He is board certified in Internal Medicine, Infectious Diseases, and Addiction Medicine. Over his career, he has authored over 60 peer-reviewed publications along topics related to substance use disorders and infectious diseases.