New reports are celebrating a nearly 15% decrease in overdose deaths in the U.S. between June 2023 and June 2024 compared to the same period the year before, according to preliminary data. But nearly 100,000 people still die of overdose every year. These are our loved ones: our families, our neighbors, and our friends.
Overdose deaths are preventable, but criminalization is standing in the way of saving lives. Criminalization creates instability, blocks access to jobs and housing, and increases overdose risk. Effective solutions center support, not punishment.
Our Executive Director Kassandra Frederique interviews Dr. Kim Sue, addiction medicine physician and Assistant Professor of Medicine at Yale School of Medicine.
The truth is that it’s too early to tell, and I don’t want to speculate. But what people must remember is that nearly 100,000 people dying from overdose is incredibly high and a higher rate than before COVID.
This is a public health emergency–we have enough evidence already to know that a public health approach to the overdose crisis is urgently needed.
To date, the United States has lost over one million lives to the devastating overdose crisis.
Although drug use rates are similar across racial lines, Black and Indigenous people, those involved in the criminal legal system, and those experiencing poverty are dying of overdose at much higher rates. This is due to limited access to effective treatment and overdose prevention services, mistreatment and stigma in healthcare, and racist enforcement of drug laws that target these communities.
As a doctor, I’ve seen firsthand how drug use and overdose affect all different walks of life. So many are dying because they don’t know what’s in the drug supply — from young people who are experimenting with drugs for the first time to those who have been struggling with substance use disorders for years.
I’ve also seen firsthand how the overdose crisis is fueled by punitive drug war policies that prioritize arrest and jail instead of lifesaving care and support. Although criminalizing people has been the default response to drugs for more than 50 years of the drug war, the overdose crisis has only gotten worse.
For starters, there are huge barriers to proven lifesaving health interventions. This includes insufficient access to overdose prevention and harm reduction services. Strict regulations and stigma mean that medications for opioid use disorder like methadone and buprenorphine are difficult to access even though they are the gold standard treatments that cut overdose risk in half.
Criminalization is also a major driver of the overdose crisis. Crackdowns and enforcement have made the illicit drug supply more unpredictable and unsafe. Fentanyl entered the market after the crackdowns on prescription opioids and heroin, and the overdose crisis intensified. This phenomenon, where harsh enforcement leads to more potent drugs, is known as the “iron law of prohibition”. That’s why fentanyl flooded the illicit market and drives the majority of overdose deaths today. Despite harsh penalties for all fentanyl-related substances since 2018, overdose rates have increased across the U.S.
And there are so many other ways that criminalization is making things worse. Drug and alcohol overdose deaths have more than doubled in jails and prisons. And people are 27 times more likely to die from overdose within two weeks of release from incarceration compared to the general population. Arrests make it harder for people struggling with substance use disorders to stabilize and get help. Fees, fines, and a criminal record can make it more difficult to find housing, get a job, or stay in treatment. Fear of arrest can deter people from asking for help during an overdose emergency.
I know from experience working at Rikers Island jail that prisons and jails aren’t equipped to support people who use drugs. My book, Getting Wrecked: Women, Incarceration, and the American Opioid Crisis, points out how poorly jails and prisons are at helping people recover their lives. We can’t just reengineer them into health facilities—they were never designed to be. Most jails don’t offer any medication to treat opioid withdrawal, and they rarely offer connections to addiction services. Criminalization does not address why people are struggling — treatment is currently expensive and inaccessible, housing and transportation are unavailable, and many people need an array of medical and social services and can’t even get their basic needs met.
Overdose deaths are preventable. Most Americans agree that drug use should be treated like a health issue, not a crime. Yet, our elected leaders refuse to address the underlying economic, housing, or mental health reasons people struggle with substance use. And they continue to call for more of the same punitive drug war policies that have failed to keep us safer or healthier.
Shifting to a health approach is what is needed to save lives. Organizations like the Drug Policy Alliance are leading the way to make that change possible. Instead of continuing the failed response of criminalizing and punishing people who use drugs, elected leaders need to enact real solutions that are proven to help people stay alive, address addiction, and thrive.
Open and fund overdose prevention centers, which reduce overdose risk and unwanted public use. They also connect people with addiction services and social supports, including treatment.
Expand access to evidence-based treatment. There are a variety of treatment options, including medications for opioid use disorder and contingency management.
Fund and expand access to harm reduction and overdose prevention. Increasing access to drug checking (like fentanyl and xylazine test strips), naloxone (a medication that can reverse an opioid overdose), drug education, and syringe service programs can help people stay safe.
Explore safer supply. Drug prohibition has created an unregulated drug supply that is adulterated and unpredictable. The opposite of this would be to offer a safer supply where people know exactly what’s in their drugs and its potency.
We know that people need stability to have a chance at recovery. As such, our elected leaders also need to meet people’s other basic needs, including ensuring more housing and humane shelter and increasing street outreach and community-led response teams to connect people to the services and supports that are proven to work.
Effective solutions center support, not criminalization. They focus on health, provide a full continuum of care, and centralize community responses. Studies show public health responses reduce overdose deaths and other harms associated with drug use more effectively than incarceration. The only way to curb the overdose crisis is by replacing the failed drug war with health approaches that save lives.
Learn more about why we need a health approach to overdose and how you can help save lives at drugpolicy.org/overdose.