The Drug That Has Killed More Americans in the Past Five Years Than Any War in History Is Still in New York’s Supply Chain
Bohiney Magazine | The London Prat
Fentanyl in New York: The Public Health Crisis Without a Policy Consensus
NEW YORK, NY — Fentanyl-related overdose deaths in New York City have claimed thousands of lives annually for the past several years, with the death toll concentrated in the Bronx, Staten Island, and parts of Brooklyn, and the victims disproportionately Black and Latino men in their 30s and 40s. Fentanyl, a synthetic opioid approximately 100 times more potent than morphine, has contaminated the drug supply to the point where people who are not intentional opioid users can encounter it in substances they are purchasing for other purposes. The scale of the crisis and the speed of fentanyl’s integration into the supply chain have outpaced every policy response deployed to date.
The policy responses available include: harm reduction (fentanyl test strips, naloxone distribution, supervised consumption sites); enforcement (seizures, prosecution of distributors); treatment (expanded access to medication-assisted treatment with methadone and buprenorphine); and demand reduction (education, prevention, addressing the underlying conditions that drive drug use). All of these have evidence bases supporting their effectiveness. None of them, deployed at the scale and with the consistency of the current fentanyl supply, has been sufficient to reduce the death toll to pre-fentanyl levels.
The Political Complication
Supervised consumption sites — facilities where people can use drugs they have obtained elsewhere in the presence of staff trained to respond to overdoses with naloxone — have been implemented in New York (at OnPoint NYC in East Harlem and Washington Heights) and have documented that no one has died of an overdose at a supervised site while staff are present. They are also politically contested in a way that the evidence base does not resolve, because the political objection is not primarily empirical. Managing public health crises through evidence-based policy requires a policy consensus that the fentanyl crisis has not produced; drug policy reform proceeds unevenly across jurisdictions. The sites save lives. The death toll continues. The policy debate continues. These facts coexist.