In a recent interview, Republican House Minority Leader Mike Lynch said of the overdose crisis: “I lose sleep at night that my kids are gonna accidentally take the wrong thing or take anything. And so I’ll continue on the fentanyl fight.”
As a physician who treats people with substance use disorders, I am highly skeptical of how Rep. Lynch and other lawmakers intend to continue this fight. My main concern is how their “fight” will affect my patients.
My concern is based on how their so-called “fight” has manifested in the past. Last year, Lynch initially co-sponsored House Bill 1326, the controversial bill to “fight fentanyl” that was signed into law.
While the bill also added some funding for harm reduction and provided an unfunded mandate for jails to require medications for opioid use disorder, the primary focus was on increasing criminal penalties for fentanyl possession. The most controversial part of this bill was that it qualified possession of more than 1 g of any substance, with any amount of fentanyl, as a level 4 felony. In a rare turn of events, Lynch removed his name from the bill and voted against it, citing that the penalties were not harsh enough. Despite this, the bill passed and was signed into law by Gov. Jared Polis.
So when Lynch and other lawmakers say that they are going to “fight fentanyl,” I can’t help but think that they are going to fight [people who use] fentanyl rather than concentrate on fighting fentanyl itself.
If lawmakers are actually concerned about fighting the drug, then they should pass legislation to expand access and availability of medications for opioid use disorders. Buprenorphine, methadone and naltrexone are the three medications approved by the U.S. Food and Drug Administration to treat opioid use disorder and have been studied for more than 50 years.
They reduce drug use, decrease the chances of an overdose, and improve social function and quality of life. Decreasing demand by treating people with opioid use disorder is an effective way to fight fentanyl, but burdensome regulations and restricted access limit medication availability. Lawmakers should change that.
If lawmakers are serious about “fighting fentanyl,” then they should expand access and availability to naloxone, not oppose the expansion as Lynch did by voting “no” on Senate Bill 11 in 2021, which allowed pharmacists to prescribe naloxone directly to patients. Without being hyperbolic, naloxone literally fights fentanyl by reversing the toxic effects of too much fentanyl. Lynch should introduce legislation to decrease barriers to naloxone distribution, require first responders and law enforcement to carry it at all times and ensure that naloxone is as readily available in the community (including schools) as automated external defibrillators are available now in many public buildings.
If lawmakers want to “fight fentanyl” effectively and in a cost-effective way, then they should introduce legislation informed by evidence-based practices that work. This includes increased funding for harm reduction, including syringe service programs and outreach services, as well as overdose prevention sites. Yes, there is robust evidence for overdose prevention sites, places where people can bring pre-obtained drugs and be monitored so that they don’t overdose and die.
If Lynch is really concerned about his “kids accidentally tak[ing] the wrong thing,” then he and others should support legislation that would make it nearly impossible for them to fatally overdose. To date, there have been zero overdose deaths at New York’s overdose prevention sites.
If lawmakers are serious about fighting fentanyl, not the people that use fentanyl, then they should address the upstream factors that often lead to substance use — untreated mental illness, housing instability, and unemployment. Want to fight fentanyl, Rep. Lynch? Help people who use drugs and address the social determinants that make use more likely.
Finally, if lawmakers are serious about fighting fentanyl, they will do all of this without increasing penalties for simple possession. Increasing criminal penalties for drug use may play well with law enforcement because it provides them with more funding, but it simply doesn’t work in treating addiction.
If lawmakers want to reduce overdose deaths in Colorado, then they have the evidence-based tools to do so and a cadre of public health and medical professionals, as well as people with lived experience to help advise them. There is no need to fight us as we actually “fight fentanyl.” I invite Lynch and other lawmakers from across the political spectrum to join us in fighting the drug, not the people.
Joshua Barocas is an associate professor of Medicine at the University of Colorado School of Medicine. He is an addiction researcher and infectious diseases physician who treats people with substance use disorders.
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