If you鈥檙e not one of the millions of Americans personally affected by it, 鈥渢he fentanyl crisis鈥� can sound like an impossibly complex nightmare. Fentanyl is an especially lethal opioid which has become virtually ubiquitous in the national street drug supply. Politicians, law enforcement, and the media alike have done their part to emphasize all the ways that fentanyl is uniquely dangerous, often implying that it must be responded to with draconian measures.
But many physicians, particularly those of us who specialize in substance use disorders, don鈥檛 see it that way. Although fentanyl is highly potent and extremely lethal, many users of the drug respond and recover well with the use of currently available medical therapies.
I, along with four other Colorado physicians with a combined century of experience in substance use disorder treatment specialties, want to speak out about the harmful policies proposed by Colorado lawmakers.
We can鈥檛 tackle the decades-long opioid crisis and its latest iteration, the fentanyl crisis, without prioritizing funding for evidence-based practices such as harm reduction and treatment. If we aim to alleviate a public health crisis, we must always start and end with public health solutions backed by scientific research.
House Bill 1326, the Fentanyl Accountability And Prevention Bill, does not do that, and its emphasis on felonization and incarceration will only exacerbate this crisis.
I do appreciate our legislators鈥� efforts to respond to worsening death rates from the highly potent synthetic opioids seen in Colorado, as well as much of the country. This past week, bipartisan House members supported new amendments to increase treatment and recovery services funding.
But we cannot in good conscience support this bill because 50 years of research does not support incarcerating and felonizing people who use drugs. Criminalization simply does not decrease drug use in our communities.
Ramping up penalties for simple fentanyl possession takes us back to a frightening time not that long ago when we filled our prisons with citizens 鈥� especially persons of color 鈥� for the purpose of fighting the War on Drugs. Those efforts backfired as disparities worsened and incarceration rates skyrocketed.
Colorado has taken admirable steps back from those laws that harmed thousands of Coloradans and their communities, yet did nothing to dampen individual drug use. In fact, some states with harsher penalties for drug possession have higher overdose rates than our own.
Incarceration in and of itself has an incredibly destabilizing effect. For example, someone who has been recently released from incarceration is 40 times more likely to die of an overdose.
It should also be noted that fentanyl now contaminates the vast majority of the U.S. street drug supply. As written, House Bill 1326 ensures that every person caught with small amounts of any illegal drug could face arrest and felony conviction if trace amounts of fentanyl are detected in it. This would result in thousands of additional people being forced into our already overwhelmed prisons, jails, and treatment facilities.
The repercussions of getting this wrong could not be more serious: flooding our overburdened treatment centers, straining law enforcement resources, overtaxing our judicial system, increasing drug-related transmissible conditions (like HIV, hepatitis C, and others), and even more overdose deaths.
We agree with Colorado legislators that our loved ones, friends, and neighbors need help. But we believe what they need most is data-backed, evidence-based treatment and harm reduction services 鈥� not arrest and incarceration.
Bryon Adinoff is an addiction psychiatrist and clinical professor at CU Anschutz Medical Campus. He is also a distinguished professor of Alcohol and Drug Abuse Research at the University of Texas Southwestern Medical Center (retired), and editor of The American Journal of Drug and Alcohol Abuse. He wrote this op-ed with the help and concurrence of Colorado addiction medicine physicians Joshua Blum, Stephanie Stewart, Julie Taub and Joshua Barocas.
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