February 13, 2022
Shane Sullivan is a community outreach coordinator at HIPS, a D.C.-based harm reduction nonprofit, and a core organizer with #DecrimPovertyDC, a coalition aiming to decriminalize drugs in D.C.
The profit-driven underpinning of all of our systems — including our public health infrastructure — has become plainer than ever through this ongoing pandemic. Eclipsed by the coronavirus’s pervasive impact, however, is another ongoing public health emergency that has received even fewer resources to adequately address it: overdose fatalities.
According to data from the Centers for Disease Control and Prevention data, D.C. recorded 511 overdose deaths in 2020; preliminary 2021 estimates suggest a similar figure, both largely driven by the increasingly toxic street drug supply wherein fentanyl has largely replaced heroin and increasingly been found in cocaine and pills sold as opiates such as OxyContin and Vicodin. Though an imperfect analogy, the Iron Law of Prohibition — a phrase coined in 1986 — posits that as drug enforcement efforts increase, the potency of the street drug supply does as well.
Fentanyl and other even more potent opiate analogues, such as nitazene, which was recently detected in D.C., highlight this link, especially as medical access to opiates has fallen to its lowest rate in 15 years, much to the detriment of chronic pain patients.
Black D.C. residents accounted for 84 percent of overdose fatalities in the past six years; they make up an even higher percentage of the 1,200 people arrested in D.C. for drug charges, despite similar rates of use by race. In contrast to the mainstream narrative of clinicians “overprescribing” opiates in economically disenfranchised and primarily White rural areas, people dying from fatal overdoses in D.C. are overwhelmingly older Black men, many of whom self-medicated with heroin for decades and did so with vastly lower overdose rates before fentanyl’s arrival.
Despite bipartisan agreement that the so-called drug war is a failure, we continue its barbaric practice of caging people for their drug use and target those most marginalized. The District’s LIVE. LONG. DC. initiative — the city’s strategic plan for addressing overdoses — recently allocated $1.75 million in its anti-stigma-focused marketing campaign while ignoring the obvious reality: Criminalization is stigma. How can we expect people who are actively using drugs to speak honestly with medical providers or loved ones about their use when often that use is a felony charge?
We also need to begin a national conversation about implementing a safe supply of drugs, as decriminalization alone won’t end the increasingly toxic drug market. Although relatively new, there are pilot programs in Canada we can look to as models. The concept of a safe supply seems “radical” only because of decades of drug war propaganda that has demonized certain classes of drugs while obfuscating the potential harms of alcohol. Very few among us desire a return to Prohibition. There is no innovative program, no brilliant new treatment modality that can stem the gaping wound caused by the bullet hole of these drug war policies of criminalization, surveillance and punishment.
We’ve been in a sustained state of emergency for so long that it’s easy to accept this as the status quo. But nothing is normal about losing more than 500 of our community members to fatal overdoses every year (or 100,000 nationally), and it’s unheard of in countries that have shifted toward compassionate models.
I am a person who uses drugs who has worked in harm reduction for nine years and loved people who have used drugs for much longer. It’s long past time we listened to front-line workers and people who use drugs — especially those most directly affected — and uproot the policies of Prohibition that have been the driving force behind so much preventable grief and trauma.