(NewsNation) — With the deadliest year yet of the opioid epidemic now ended, lawmakers across the country are considering or passing laws aimed at reducing the use of drugs.
Some of the most innovative ideas have come at the state level, where risk to users is being debated against penalties for mixing the deadly fentanyl with other drugs.
“It’s a fine line to help people and try to get people clean, and at the same time incarcerate and get the drug dealers off the streets,” Republican Ohio state Sen. Nathan Manning, told The Associated Press recently.
The following are some approaches being considered across the country.
Supervised injection sites
How it works: People use drugs under the supervision of social and medical workers to curb overdoses and infections. Proponents say by building relationships with people using drugs increases the likelihood they’ll enter substance abuse programs or get treated for other related health problems. In Rhode Island, officials are using $2 million from a settlement with opioid manufacturers to fund the pilot site.
Why this matters: As in much of the country, in Rhode Island, more people died by accidental overdoses in 2021 than in any other year — mostly due to fentanyl, a deadly synthetic opioid. Some experts say the increase is so staggering, solutions should focus on saving lives until people are willing or able to enter drug treatment programs.
Evidence of success: Studies of legal consumption sites in other countries have found these sites benefit both the general public and people using drugs. For example, a study of 25 sites in Canada found they reduced overdoses as well utilization of paramedics and emergency rooms.
At an unsanctioned injection site in the U.S., a majority of users reported fewer public injections and more hygienic disposal of syringes.
Limitations: Critics point out these sites have not substantially reduced the number of people abusing drugs and fear they may normalize it. For example, in Vancouver, where injection sites have become the norm in certain neighborhoods, some long-term drug users say the availability takes the pressure off to get clean.
“There is a fine line between enabling and keeping someone safe,” Winook Wilannish, a long-term drug user in Vancouver, told the Los Angeles Times earlier this year, “and they’ve crossed it a long time ago.”
Anyone struggling with addiction can contact the Substance Abuse and Mental Health Services Administration’s National Helpline at 1-800-662-HELP (4357 for English and Spanish referrals to local treatment facilities, support groups, and community-based organizations.
Decriminalizing low-level drug use
How it works: Passed in fall of 2020, Oregon’s Measure 110 changes the punishment for people possessing personal amounts of heroin, LSD, cocaine or other drugs with a high risk of abuse. Instead of spending money on putting users in jail, the law funnels the savings into substance abuse treatment. Those found in possession would face a $100 fine or a health assessment that could lead to addiction counseling.
Why this matters: At the time of Measure 110’s passing, Oregon officials said the state had the highest rates of drug use and lowest access to treatment.
Evidence of success: Oregon’s law was based on Portugal’s success with a similar approach, started more than two decades ago. The European country’s efforts have been widely touted for decreasing drug use, overdose deaths, the rate at which HIV and other sexually transmitted infections spread, and the number of people incarcerated.
In Oregon, bureaucratic and pandemic delays have meant the almost $300 million in funds just began being distributed in fall 2022, so we don’t yet know the impact of Oregon’s law. Still, researchers have been able to show decriminalizing personal use did not increase crime, as some critics feared.
Limitations: Oregon’s Secretary of State Office released a report calling out the problematic implementation of the program. Meanwhile, the state faced a 30% increase in overdose deaths in the second year of the program, and very few drug users have sought treatment as expected, perhaps due to national addiction trends outpacing the slow rollout.
Unlike Portugal’s system, Oregon doesn’t force users into treatment, and the European country’s free health care removes cost barriers, NewsNation affiliate KGW recently reported.
How it works: A new program in Rice County, Minnesota, allows police and other officials within the criminal justice system to offer addiction treatment rather than criminal charges to people using drugs.
Why this matters: It’s estimated that 50% of all people incarcerated meet the criteria for drug abuse or dependence, according to research from the National Institute on Drug Abuse.
Evidence of success: Addiction treatment for drug-involved offenders can change neuropathways that reduce the likelihood of repeat offenses, while punishment alone has proved ineffective. A six-month diversion program in Madison, Wisconsin, was found to reduce criminal activity while increasing community trust in local law enforcement.
Limitations: As in much of the rest of the country, spots at in-patient addiction treatment facilities are very limited, reports KYMN radio. Research shows that the longer the wait, the more likely a person with an addiction will drop out of treatment. The funding for Rice County’s program will pay for temporary housing while patients wait.
Experts also say police-assisted programs are not as effective unless officers receive training on the “science of addiction,” including interactions with individuals in recovery and training on the overdose-reversal treatment naloxone.
NewsNation’s Katie Smith contributed to this report.