Overdose prevention centers reduce “overdose and unwanted public use” while connecting people “with addiction services and social supports including voluntary treatment,” according to the Drug Policy Alliance.Too often, this is the cycle: try to make systemic change, misinterpret early results based on what we see, get scared and angry, undo it or even kick the pendulum swinging in the opposite direction.
Kaia Sand is the executive director of Street Roots. This column represents her views.
That’s discouraging. It takes courage not to cave to dismal public polls, inflamed rhetoric and cash infusions for destructive policy by people who aren’t always well-informed or well-intentioned.
The visibility of people smoking fentanyl has sparked an enormous backlash toward Measure 110, the legalization of possession of small amounts of drugs in Oregon.
What gets lost, though, is the dramatic reduction in drug-related arrests for Black and Indigenous Oregonians at 77% and 70%, respectively, as Jeremiah Hayden reports in his coverage of Measure 110 in the Oct. 25 issue of Street Roots. Caving to the backlash likely means more disproportionate arrests of Black and Indigenous people, even though they don’t use drugs at higher rates than white people.
What gets lost is the patience to roll out a successful treatment infrastructure — and not redirect funds toward the expensive system of incarceration. Jail time alone costs $400 a night.
What also gets lost is the evidence, such as the recent New York University study finding no rise in overdoses due to the legalization of drug possession in Oregon.
Instead, rolling back Measure 110 will push people into hiding, so more people will die alone.
Miraculously, opiate overdoses can be reversed, but it takes someone to witness the overdose. Look, it’s magical thinking that people using fentanyl can just go away. The only way that someone can “go away” is to have another place to go.
There is a common sense response to this. Provide spaces where people can, in fact, go and where people have a greater chance at living and recovering.
This is a series of columns that explores bettering public-health responses to our overdose crisis rather than moving backward into criminalization two years after Oregon voters passed Measure 110, decriminalizing possession of small amounts of drugs.Illustration by Etta O'Donnell-King/Street Roots
As a baseline, people need a chance to stay alive. This means testing fentanyl at overdose prevention centers. A big reason people overdose is the dosage sold on the streets is highly variable. It’s the equivalent of not knowing if one is handed water or vodka or Everclear, as Haven Wheelock told me.
Overdose prevention centers are staffed with people to connect others to recovery service and administer naloxone.
Fentanyl entered Oregon later than many east coast states. It became a cause of death in the Domicile Unknown Report only in the last couple of years. Street Roots annually publishes the report with Multnomah County about deaths on the streets.
National trends show Oregon is behind the majority of states on fentanyl use, but because of the legalization, people don’t have to hide.
And so, Street Roots has shifted to meet the public health crisis by handing out naloxone. Street Roots staff and vendors reverse overdoses, which means that we see the miracle of people who were nearly dead come back to life.
I’ve read some ghoulish comments on social media wishing death upon people who overdose, claiming they will overdose again anyway. My god. I wish them health, and I’d like better systems to do it. I’d like to see centers where people can be clean, out of the glare of public disdain, under the supervision of trained providers, and able to connect to recovery services.
It’s pretty common sense, really, if you ignore the noise, and it’s something county health departments should provide.
That’s what is happening in Rhode Island as it gears up to pilot overdose prevention sites. The first one is slated to open in Providence later this year. Brown University will study the Rhode Island sites, as well as existing sites in New York City that are run by a nonprofit.
We are at a dramatic fork in the road. We’ve had to confront the drug use that exists by witnessing it firsthand on our streets. That actually leads to more knowledge. More of us have stepped into public health roles, checking in on people and, frankly, saving lives. But through this, we know it can be better.
Street Roots has covered drug use for the past 25 years, and it’s hard to imagine covering this topic responsibly and not coming to this conclusion, which our editorial board has over the years, again and again.
In the past overdose prevention centers were often described as “safe injection” sites, but currently, on the West Coast, fentanyl is mostly smoked, which is, fortunately, safer than the needles people are turning to in other parts of the country that can lead to hepatitis and endocarditis.
Despite the backlash, despite the uproar, despite the fear, now is the time to actually build a place for people to go. We are indeed at a fork in the road, but let’s keep turning toward better health, and not head down the easy, destructive path.
After all, it’s easy to misinterpret early results of system-change work based on what we see, and to get scared and angry. But then, we can pause, and instead respond by doing the work that actually leads to better outcomes for people suffering the most in society.•
Editor’s Note: The Street Roots newspaper maintains editorial independence from the organization’s advocacy work led by Kaia Sand. Sand’s commentary on Street Roots’ news content is a function of Street Roots’ advocacy and is not to be construed as involvement in editorial content.
Street Roots is an award-winning weekly investigative publication covering economic, environmental and social inequity. The newspaper is sold in Portland, Oregon, by people experiencing homelessness and/or extreme poverty as means of earning an income with dignity. Street Roots newspaper operates independently of Street Roots advocacy and is a part of the Street Roots organization. Learn more about Street Roots. Support your community newspaper by making a one-time or recurring gift today.
© 2023 Street Roots. All rights reserved. | To request permission to reuse content, email editor@streetroots.org or call 503-228-5657, ext. 404