By Perla Brito
SACRAMENTO, CA — Laura Guzman, Acting Executive Director at National Harm Reduction Coalition, held a virtual press conference here last week with medical and public health experts to address the overdose crisis to announce legislative plans to address the “fentanyl” crisis.
Guzman said, “We are here today because California lawmakers made a set of legislative proposals that will increase penalties for fentanyl-related offenses and our communities our dying…we all agree we have to have a serious and collective response to address these deaths.”
She added, “We firmly believe we need to pursue data-driven, evidence-based, public health solutions, not incarceration and no criminalization. For that reason we’re here today with a pile of experts that are collectively urging the public safety committee to reject such proposals.”
Dr. David Goodman-Mesa, Assistant Professor in the Division of Infectious Diseases at the David Geffen School of Medicine at UCLA, said, “I’m tasked with talking about why the overdose crisis must be treated like a public health issue… 50 years of attempting to address drug use through criminalization in the United States, that has been an epic failure.”
“The results are clear, tougher laws, longer sentencing have only really resulted in mass incarceration and mass deaths… Less than 20 percent of people with substance use order get the care that they need and this is dismal. Imagine if we treated diabetes, breast cancer, heart diseases this way. We just don’t, we only treat substance use disorders in this way,” said Dr. Goodman-Mesa.
According to Dr. Goodman-Mesa, society typically views substance use disorders as something voluntary, but many factors beyond an individual’s control lead to substance use including where someone is born, their parents, the genes inherited, where someone lives and what their socioeconomic educational situation may be.
He continues, “We need to provide low barrier easy access care. We typically provide less services to people who use drugs. While given their trauma over their decades of life, we really need to be providing more services and more than just quantity of services, we need to be providing quality dignified social and health services.”
Dr. Goodman-Mesa was also part of the INTEGRA study in Los Angeles where they tested the impact of a mobile health unit to provide medical care for people who use drugs, and noted, “For most it is really not until our mobile units arrive that they’re encountering some sort of healthcare for the first time in many years.”
“There is no disease in America that has more restrictions for treatment than substance use disorders,” he added.
“(T)he epidemic is shifting. Early in the pandemic overdose rates were highest in white individuals. However over the past 10 years rates of overdose have grown the highest in Black and Latino communities. In many parts of the country, including California, the highest overdose rates are now in Black communities. We really need to make access to care and prevention equitable across all communities regardless of race and ethnicity,” said Dr. Goodman-Mesa
Dr. Ricky Bluthenthal, Associate Dean for Social Justice and Professor in the Department of Population and Public Health Sciences at USC, spoke on the impact of stiffer penalties and its effects on the overdose crisis.
Bluthenthal said, “We’ve known literally for decades that law enforcement involvement in substance use disorder has had negative impacts on infectious diseases. In the case of penalties related to fentanyl use, it’s highly likely that increasing these penalties will result in less bystander response for concern that they might be caught up and arrested.”
He also said it “will likely result in more death” and that “there really isn’t any evidence that stiffer penalties reduce substance use in our society. We’ve had stiff penalties for crack cocaine, for methamphetamines, and now these proposals for fentanyl and there’s no real evidence to suggest that they result in any decline in supply.”
Dr. Blumenthal added, “(I)n much of California a lot of the street level drug sellers are actually people who use the drug. We’ve known this for at least 15, 16 years that incarceration actually, once people are released, greatly increases their chances of drug addiction. So, I think a sort of criminal legal approach to our third fentanyl overdose death crisis doesn’t make a lot of sense.”
Karen Lenyoun, Board Member of A New Path and San Diego Public Health Advocate, is also a mother to a son who has struggled with substance use disorder.
“Thank you for this opportunity to speak on behalf of all of the parents who have children who struggle with substance misuse and in particular opioid misuse conditions as my younger son does. I really resonated with what both doctors just explained because our family has experienced all of those issues and many many more,” said Lenyoun.
Lenyoun added, “Our road down this path started over 20 years ago when our son started seeking relief for maltreated mental health conditions, as well as some other things that were going on with learning difficulties. Back in those days, we didn’t have terms like being on the spectrum or neurodiversity and so we weren’t really familiar with what was going on with him.”
As her son moved down that path, they had many interactions with the justice system, said Lenyoun, noting, “He is a person that is biracial, so he does not look very much like me and I do believe that that interacted and interfered with a lot of the interactions he had with the justice system. Those interactions were never positive, so he never ended a cycle in the law enforcement system on a positive note.”
According to Lenyoun, her understanding of addiction was very linear in the beginning.
She said, “I thought that people either recovered and got well and stopped using and lived happily ever after or died of an overdose. That was kind of my mindset and I feel like these punitive laws that are coming out are still kind of taking a step back to that mindset. We have since learned in the treatment world that recovery is a process and so people ebb and flow in and out of different stages of recovery and that harm reduction does work and it keeps people alive.”
Norma Palacios, part of the Drug Policy Alliance, identified alternatives that state legislation should be looking at to address the overdose crisis.
She said “there are budget acts that we are supporting this year. For instance, we are supporting the governor’s budget proposal to fund the distribution of naloxone and fentanyl test strips to community groups.”
“We are also supporting the legislative proposal by Assemblymember Holden and Senator Weiner to fund staff of syringe observing service programs… There are already examples in our community of what works,” added Palacios.
