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Reduce Harms of Fentanyl

Fentanyl poses a significant overdose risk. The Drug Policy Alliance is advocating for health solutions to fentanyl to keep people safe.  

“ Our focus on fentanyl should be on expanding a public health approach, not more handcuffs. Our leaders must fully fund addiction services like treatment and overdose prevention services.”

Dr. David Goodman-Meza

addiction medicine specialist

Solutions

To Reduce Fentanyl’s Harms:

  • Invest in addiction services.

    A full range of addiction services—including counseling, medications, long-term treatment, and recovery housing—should be available to individuals. Personalized support reduces overdose risk and improves recovery chances.

  • Expand access to addiction medications.

    Medications like methadone and buprenorphine promote recovery and save lives by reducing opioid cravings and withdrawal symptoms, while cutting overdose risk in half. They should be widely available, including in jails and prisons.

  • Address demand (root causes of fentanyl use).

    Fentanyl offers pain relief— many people use it to cope with physical or emotional pain. Ensuring people have access to housing, community, mental health services, and jobs can help address why people are using.

  • Support increased community-based naloxone access and distribution. This medication saves lives by immediately reversing an active opioid overdose.
  • Authorize overdose prevention centers (OPC) on the state and local level. These centers provide connections to care and can respond to an active overdose at its earliest sign, preventing overdose deaths, saving lives, and promoting recovery in the process.
  • Ensure people have access to their basic needs, like housing. Offer retroactive record clearing and the removal of civil penalties for drug convictions so people have more access to jobs, housing, and benefits.
  • Allow medical research into fentanyl-related substances. Of the few fentanyl-related substances tested on a limited basis by the FDA, at least one showed properties similar to the overdose-reversing medication naloxone. Research can allow us to discover new treatments.
  • Prioritize a health approach to drugs, end criminal penalties. Shift drug policy from criminal penalties to public health, focusing on treatment, housing, jobs, healthcare, overdose prevention, and crisis-response teams to provide effective support and resources.
  • Improve drug checking and data collection. This will help us better understand the current drug supply, create warnings, and offer better solutions.

People can be kept alive and safe from fentanyl.

A person checks a fentanyl test strip.
Interior of OnPoint NYC overdose prevention center. The wall reads "This Site Saves Lives" in English and Spanish.

Fentanyl is a synthetic opioid that is often used for pain relief under medical supervision. But most people’s concerns are about street fentanyl, which carries a significant overdose risk. Our collective safety requires that we prioritize the health and economic solutions that reduce the harms of fentanyl and keep us safe.

U.S. criminalization policies brought fentanyl to the U.S.

Despite over 50 years of the drug war in the U.S., drugs are more available, cheaper, and more potent than ever.

Though it may seem counterintuitive, cracking down on the drug supply often leads to more dangerous drugs. After prescription opioid crackdowns, people dependent on opioids turned to the streets to find substitutes. Many were desperate to ease painful withdrawals. The illegal drug market responded by mixing fentanyl with heroin and counterfeit pills to meet the overwhelming demand. People with minor roles in the drug trade are most often criminalized, but the supply chain continues to thrive, as they’re easily replaced.

When the U.S. federal government criminalized all fentanyl-related substances in 2018, overdose deaths rose by 60% in four years—from 67,367 deaths in 2018, to 107,941 in 2022. The policy further opened the door for newer drugs to enter the market and our streets. Now, fentanyl is driving deaths across the country and concerning drugs like xylazine and nitazenes are more widespread. Nitazenes are synthetic opioids that can be up to 10 times stronger than fentanyl.

Fentanyl harm will persist so long as politicians focus on enforcement rather than addressing demand.

To save lives, invest in health solutions for fentanyl.

Leaders must invest in addiction services, treatment, and overdose prevention centers. This includes greater access to medications that reverse or reduce the risk of a fentanyl overdose, like naloxone, methadone, and buprenorphine. Offer retroactive record clearing and the removal of collateral consequences for convictions so people have more access to jobs, housing, and benefits.

The Drug Policy Alliance is committed to reducing the harms of fentanyl with health and economic solutions that make communities safer and healthier.

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