The catchphrase that caught fire over the past two years of the COVID-19 pandemic is “follow the science”. The phrase simply means that private decisions and public policy should be evidence-based. Basing actions on available evidence increases our chances of having a good outcome versus basing actions on gut feelings or personal preference. With COVID-19 the evidence suggests masking and vaccination will reduce our chances of infection. But why don’t those voices calling for us to follow the science for COVID-19 also call upon us to follow the science for the opioid crisis? The number of deaths due to opioid abuse reached a new record of more than 100,000 in 2021, so it is remarkable that we hear so little in the media about the science that could inform drug policy.

Follow the Science for the Opioid Crisis

During the 2020 presidential campaign, then candidate Joe Biden argued that we should decriminalize illicit drug use and consider drug abuse a mental health rather than criminal justice issue. Yet his response to the news that the opioid death toll reached a new record in 2021 was to double down on the War on Drugs by taking law enforcement action to stem the flow of dangerous synthetic opioids like fentanyl. Consider that the half a century of the U.S. War on Drugs has failed to solve the problem, so why should we expect this approach to be effective? Rather than following the science on the most effective ways to reducing drug abuse and overdose deaths, the current administration joins prior ones from both sides of the political aisle in focusing on law enforcement solutions. President Biden recently announced that the U.S. government would begin distributing half a billion free home tests for COVID-19 as a strategy for controlling the disease. Why hasn’t the administration also distributed half a billion free at-home drug checking kits that can identify dangerous synthetic opioids so that drug users can reduce the chances of overdose? The science supports this strategy as a means of reducing overdoses and deaths.

Drug Abuse Is a Mental Health Issue

A better approach to dealing with illicit drug abuse is to consider it a mental health rather than criminal justice issue. Individuals who use such substances should be given mental health and social services rather than prison. Following the science takes us to Portugal, a country that responded to their severe drug abuse problem by decriminalizing drug use rather than adopting a U.S.-style war on drugs. Their drug problems got better in terms of drug abuse and overdose deaths which today are far better than in the U.S. and other European countries where drug use is illegal.

Harm reduction is the idea that the goal should not be to prevent people from using drugs, but to take steps to make drug use as safe as possible. By focusing on reducing harm, not only can we reduce overdose deaths, but we have a better chance of getting people into treatment and off drugs. Policy changes and funding at the national and local levels can go a long way to expanding the available network of sites that can provide harm reduction and other services for drug users. These include:

• Needle exchanges where intravenous drug users are given sterile syringes, reducing the chances of hepatitis and HIV infection.
• Drug checking kits that can show if dangerous synthetic opioids are present in a drug before use.
• Naloxone hydrochloride (Narcan) nasal spray that can reverse the effects of opioids when someone overdoses. Providing Narcan cannisters and training to drug users can be a first line of defense when overdoses occur.
• Information and referral for medical and social services.
• Mental health counseling and referral.

If we follow the science for the opioid crisis by treating it as a mental health issue, we can reduce overdose deaths as well as the number of people using illicit drugs.