By Dunstan Prial

Fentanyl is the latest in a long line of weapons of self-destruction, which in recent decades have 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 politicians change their attitude towards addiction.

Unfortunately, federal lawmakers, distracted by an all-consuming presidential election and escalating global conflicts, have lost focus on arguably the most crucial domestic issue of the past decade.

October 1 marked the one-year anniversary of the expiration of the SUPPORT Act, which provided funding for opioid use prevention, recovery and treatment, and the failure of Congress reauthorizing the money has devastated grassroots programs in cities devastated by fentanyl, like Paterson, Newark and Camden.

The SUPPORT Act was a rare act of bipartisan cooperation, and its goal was to save lives by spreading $20 billion across a range of treatment programs and educational resources, many of them grounded in innovative harm reduction practices.

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 rates have only started to trend lower, thankfully. But in the six years between the passage of the SUPPORT Act in September 2018 and May 2024, overdose deaths in the US rose almost 40%according to the US Centers for Disease Control and Prevention.

Despite the alarming increase, the issue of addiction has been buried under more polarizing topics — like immigration — even though 100,000 Americans die from overdoses each year.

Aside from acknowledging the scourge of fentanyl and placing blame for the rise in overdose deaths, Kamala Harris and Donald Trump have been mostly silent on the subject of addiction as a stand-alone issue.

Instead, both candidates have framed the topic through a criminal justice lens, preferring to outline their plans to reduce illegal 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 is needed is a new approach that acknowledges the reality of drug use while removing 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 at a drug treatment center in Paterson. Few American cities have been hit harder 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 alleviate the terrible 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 were taking Suboxone, a prescription drug that helps reduce cravings and ease withdrawal symptoms. The catch is that Suboxone is opiate-based, meaning it can be addictive if abused.

The Biden administration was instrumental in improving access to Suboxone prescriptions via telehealth, but the medication remains hard to get in many areas of the United States

I met a crack addict who used opiates to come down from his cocaine trials. He said he always shot up to one safe injection sitewhere opiate users consume their drugs under the supervision of trained staff armed with naloxone, a nasal spray that reverses overdose effects.

There are two consumption locations in New York City – in Harlem and Washington Heights – the only two in the US, with a third planned to open in Providence in December. The New York facilities, known as OnPointused by 4,000 people in their first two years of operation. The results: There were 1,100 overdoses and zero deaths.

Europe, Australia and Canada have enjoyed the same 100 percent success rate across their combined 200-plus sites. For decades, they have provided spaces that keep 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 overturned by political pressure and scare tactics. But opponents argue that methods used to reduce harm enable – even encourage – abuse.

Chairman of the Health Board, Late. Joseph Vitale (D-Middlesex), agrees that it’s time to establish a pilot program with four injection sites in New Jersey, because “the data is undeniable that these sites save lives.”

But harm reduction measures will not be accepted and adopted until policy makers muster the courage to go beyond tired clichés which stigmatizes addicts 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.

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