Posted on by Nathan Riley

Overdose Deaths Are Proof That the U.S. Fails To Provide Healthcare to Drug Users

With a drug overdose, a person gradually stops breathing and while it is not true for marijuana, opioid use can be dangerous.

Crossing the street is dangerous—vehicles kill. That is why we have traffic lights and look both ways before crossing. For the illegal drugs we also have “traffic lights:” Don’t do drugs alone. Be sure there is someone there who can help if the user becomes helpless and could die. Have naloxone nearby to interrupt an overdose.

In cities all over the world, drug users inject, inhale, and snort in facilities where a healthcare specialist is on duty and able to interrupt the overdose, or some other health crisis that threatens the user’s well-being.

But not in the United States.

Such facilities are rare and subject to legal sanction because U.S. law can’t distinguish between a crackhouse and a healthcare facility. It’s not just stupid; it’s cruel and all too often murderous.

New York City should have dozens of these programs. Almost every needle exchange program would like to become a healthcare facility where drug users ingest drugs while a healthcare specialist oversees, ready to protect the user if things go wrong. Even with severe limitation the two facilities in New York City have interrupted 1,000 overdoses.

Needle exchange programs set up to stop the spread of H.I.V. faced opposition. “This neighborhood already has too many programs.” Or providing sterile needles and stopping the spread of disease, “Encourages drug use. There is only one message, and that is ‘Just say no.’” Drug use is wrong, accepting the conclusion that illegal drugs must be demonized. Thanks to the public health community and ACT UP’s demonstrations that delivered pithy messages supporting them, needle exchange programs can be found in metropolitan areas all over the United States. Safer consumption facilities should also become widespread.

The neighborhoods survived needle exchange, and the lives of the general public stayed the same. By and large, only drug users and local officials paid attention to the programs. Adding Supervised Injection Facilities would also neighborhood health.

Drug users should have a place to inject drugs away from public view. Many members of the public are disgusted when users take their drugs on street corners or under bridges. A city with drug consumption rooms protects the neighborhood and the privacy of drug users.

The arguments in favor of safer injection facilities are overwhelming. All over Europe, cities have adopted these programs for decades. But not here. A federal judge in Philadelphia has actually found that U.S. law prohibits these programs. Laws intended to close drug dens also stopped health programs.

This situation is more than stupid. It’s deadly. In New York City, on the average, there are about eight deaths every day from overdoses. In 2014, the state comptroller’s researchers reported 2,300 deaths. In 2021, 5,841 New Yorkers died.

Unless something positive is done, 58,000 New Yorkers will die every ten years. The number of deaths in the United States is equally startling. In 2021, 106,719 died in the U.S. That’s a million deaths every ten years.

Nothing, it seems, will persuade U.S. officials to give drug users “traffic lights” to improve their safety. During this time, fentanyl use spread and increased the risk of an overdose.

Fentanyl is easier to smuggle because just a little bit provides a powerful high. If, as Freedom Democrats advocate, these drugs were manufactured by drug companies and prescribed by doctors, only rarely would the prescription authorize fentanyl. There would have been few, if any, overdose deaths from fentanyl-laced drugs.

But because the United States gives illegal operators a monopoly, they are able to add fentanyl. But facts are facts; in the United States people were using opioids when George Washington’s troops were fighting the British, when the Union was battling the Confederacy, and when the United States entered World War I. Opioid use has a long history and will not go away. Policy makers must recognize this reality.

Opioid use is here. And if Freedom Democrats get their way, it will be a safe drug to use. Obviously, some users will want the drug every day; that has always been true, but so what.

Anybody who knows drug users knows that there are depressed people who depend on it. Others want their high right after they’ve been released from prison, forcing them to go “cold turkey” didn’t stop the memories. Indeed, one group who suffer overdose deaths are recently released persons.

Some drug users live disorganized lives, but there are others who support positive change.

Recent news reports describe such a person. Cecilia Gentili founded Trans Equity Consulting, served as director of policy at GMHC, and was board co-chair of the New Pride Agenda. The details of her death are silent on whether she was by herself when the overdose occurred, or whether she was only an occasional user and unused to the potency of fentanyl-laced heroin.

She was in the news in late September 2024 because the two dealers who sold the drugs pleaded guilty in federal court. They face prison sentences well in excess of ten years, an outcome that would probably sadden Cecilia Gentili, who spent her life helping sex workers and transgender persons live with pride. She fought laws that punished persons for their life choices.

We don’t know anything about a person if all we know is that they get high. The U.S. hostility to drug use rests on witchcraft, not science. The United States attributes magic powers to drugs like opioids, but in fact some users have no problems with their drugs, while a smaller group experience fatal consequences.

Freedom Democrats, I believe, should recognize the dangers of many illegal drugs, like heroin and methamphetamine, but society should recognize, with medical care, these drugs are and can be used safely. It makes no more sense to interfere with the doctor patient relationship by prohibiting the medical profession from prescribing drugs that help a person get high than it does to interfere with the doctor-patient relationship surrounding pregnancy.

In fact, the number of deaths from illegal abortions plummeted once government allowed women to consult and work with doctors during the difficult decision about abortion. The same positive results would happen if society allowed doctors the freedom to work with patients who use drugs, leaving it up to the doctor whether the patient will have access to pharmaceutical drugs whose purity has been verified.

It is critical to end the stigma attached to drug use that often forces users to take their drugs secretly and alone. There is no more chance of the United States becoming a nation of drugs users than lifting the stigma attached to homosexuality made everyone gay.

In fact, working with public health specialists it is possible to control drug use and prevent dangerous outcomes. Sixty years ago, on a hot summer day millions of Americans drank beer to quench their thirst. Today they drink water. That is a positive public health result, achieved with a minimum of criminal sanctions. Making drug use a crime causes deadly results. It’s time for us to welcome drug users into society rather than punish them for their habit. The law also ruins the lives of drug sellers with long prison sentences. The only reason they have a market is because the law makes drugs illegal. If drugs were legal, doctors and patients could make their problems manageable.

 Overdoses are proof that society is failing to provide healthcare.

Posted on by Nathan Riley

Safe Consumption Delay Prompts City Hall Sit-In

 

BY NATHAN RILEY | Chanting “no more overdoses,” 75 angry New Yorkers packed the steps of City Hall on April 5 and then a smaller group staged a sit-in at the gates leading to Mayor Bill de Blasio’s office, forcing police to eject them. The demonstrators were making an emotional plea to the mayor that he release a feasibility study about safe consumption facilities that give drug users medical supervision while they are getting high.

In such spaces, users consume product they buy on the street under the watchful eye of an overdose prevention worker. Should a user slip into unconsciousness, these workers are only steps away and can administer naloxone, a public health wonder drug that reverses overdoses and restores normal breathing. There have been thousands of overdoses at such facilities in cities like Frankfurt, Sydney, and Vancouver, but nobody — as in zero — has ever died.

On February 5, Dr. Mary Bassett, the city health commissioner told a City Council budget hearing that “the public health literature is clear.” Despite that definitive statement, de Blasio has kept the health department study under wraps. Yesterday’s City Hall protesters charged that in the 59 days since Bassett’s testimony, there have been approximately 236 overdose deaths in New York.

Advocates demand de Blasio release study of facilities where drug users have medical support

Charles King, the CEO of Housing Works, an AIDS services group, opened the protest on a personal note.

“Today marks the 14th anniversary of the death of Keith Cylar, one of the co-founders of Housing Works and my life partner for some 15 years,” he said.

Then adding that he was speaking “not just on behalf of people living with AIDS and HIV, but also on behalf of people who use drugs,” King said, “Keith spoke with particular passion and urgency. He was not only a black gay man living with AIDS, he was also addicted to drugs his entire adult life. And whether it was long-term degeneration caused by AIDS or long time use of cocaine that caused his cardiomyopathy, and whether the heart attack would have happened anyway or was triggered by the crack he smoked that night, his death certificate says he died of a drug overdose. I will go to my grave knowing that if someone had been with him at that moment who knew how to intervene, he might well be standing here with us today.”

Also in impassioned remarks, Kassandra Frederique, the New York State director of the Drug Policy Alliance, said, “Safe consumption spaces are critical to saving lives. We don’t need a report to tell us what we already know, what we need is leadership.”

The mayor, she added, isn’t “leading the parade, he’s following it.”

As other speakers addressed the crowd, King and about a dozen others went inside City Hall and tried to enter de Blasio’s suite of offices. When refused at the gate leading to the mayor’s wing of the building, they sat down chanting “no more overdoses.” Police approached a limp Charles King and, with some difficulty, dragged him out of the building. Some others among the demonstrators were also carried out, while some stood up on their own. Police made no arrests either inside or out, and the rally on the steps lasted an hour and a half.

The mayor, arriving at City Hall in the middle of the demonstration, decided against walking through the protest.

In 2016, Corey Johnson, an out gay city councilmember who then chaired the Health Committee and is now Council speaker, put a $100,000 appropriation into the health department budget to pay for the safe consumption space feasibility study, at a time when overdose deaths in the city had reached 1,300 a year, more than the combined total from vehicle accidents, homicides, and suicides.

King said the report was finished in December, but the mayor has so far declined to release it publicly.

In an email, Johanne Morne, director of the AIDS Institute in the State Department of Health, said flatly, “Safe Consumption Spaces have shown success in other countries.” The idea, she continued, should be “an item of consideration” for “interventions in response to the opioid epidemic.”

In a strongly argued editorial in February, the New York Times declared the safe consumption space approach a “rigorously tested harm-reduction method” that has “proved incredibly effective at slashing overdose deaths.”

Councilmembers Mark Levine of Manhattan, chair of the Council Health Committee, and Stephen Levin of Brooklyn, chair of the General Welfare Committee, support the program.

The citywide coalition of treatment providers, medical professionals, and harm reduction activists are boiling over with anger at a delay that prevents drug users from gaining timely access to a life-saving medicine.

A drug user overdosing is helpless and depends on another person to help them regain normal breathing. Safe consumption spaces are specifically designed to meet this emergency and also allow health professionals to begin a constructive engagement with users about other means of reducing the harm caused by their drug habit.

This article was posted on GayCityNews.com on April 6, 2018