While the health impacts of mass incarceration have been explored, less attention has been paid to how the “war on drugs” in the United States exacerbates many of the factors that negatively impact health and wellbeing. This paper examines the ways that “drug war logic” has become embedded in key SDOH and systems. We argue that, because the drug war has become embedded in these systems, medical practitioners can play a significant role in promoting individual and community health by reducing the impact of criminalisation upon healthcare service provision and by becoming engaged in policy reform efforts.
Type: Advocacy
How the war on drugs impacts social determinants of health beyond the criminal legal system
Legal Mapping of Harm Reduction Laws and Overdose Prevention Center Legislation
ASTHO, with support from CDC’s Overdose Data to Action (OD2A) cooperative agreement, developed an interactive resource visualizing state and territorial laws that support harm reduction activities as of January 1, 2023. This report highlights the public health importance of three harm reduction policies and practices to reduce overdoses: Facilitating community distribution of naloxone; Facilitating community distribution of fentanyl test strips (FTS); Overdose prevention centers.
Harm Reduction Laws in the United States
This brief is designed to help individuals and organizations better understand how the legal landscape in their state may impact access to harm reduction services and supplies, including overdose Good Samaritan laws, which provide limited protection from criminal sanctions to encourage people to call for help in an overdose emergency. Specifically, it covers laws related to syringe possession and distribution, naloxone access, statewide naloxone standing orders, and overdose Good Samaritan overdose protections in all 50 states and the District of Columbia. Use the embedded hyperlink to navigate to New York!
Preventing opioid overdose with peer-administered naloxone: findings from a rural state
Findings support the feasibility of naloxone distribution to peer opioid and heroin users and provide recommendations for policy improvement, including effective and well-advertised Good Samaritan laws and links to treatment for opioid use disorder.
Estimating naloxone need in the USA across fentanyl, heroin, and prescription opioid epidemics: a modelling study
The US overdose crisis is driven by fentanyl, heroin, and prescription opioids. One evidence-based policy response has been to broaden naloxone distribution, but how much naloxone a community would need to reduce the incidence of fatal overdose is unclear. We aimed to estimate state-level US naloxone need in 2017 across three main naloxone access points (community-based programmes, provider prescription, and pharmacy-initiated distribution) and by dominant opioid epidemic type (fentanyl, heroin, and prescription opioid).
Best practices for community-based overdose education and naloxone distribution programs: results from using the Delphi approach
We utilized a modified Delphi approach to develop a set of best practices for OEND delivery. The top 5 ranked best practices were ensuring that SSP participants have low barrier, consistent, needs-based access to naloxone and that there is ample naloxone available within communities. While the remaining fifteen best practices were deemed important, they had more to do with organizational culture and implementation climate.
Overdose Prevention Centers, Crime, and Disorder in New York City
This cohort study found no significant increases in crimes recorded by the police or calls for emergency service in NYC neighborhoods where 2 OPCs were located. Consistent with the city’s commitment to ensuring clients could use the centers free from law enforcement interference, large, statistically significant declines in police narcotics enforcement around the OPCs were observed. These findings suggest that concerns about crime and disorder remain substantial barriers to the expansion of OPCs in US cities, and initial data from NYC do not support these concerns.
OPC Info
The People Place and Health Collective (PPHC) of Brown University School of Public Health established this website as a nexus for research about overdose prevention centers. It includes a searchable database of all papers published on OPCs plus fact sheets, infographics, and other resources.
Supervised Injection Facilities as Harm Reduction: A Systematic Review
Supervised injection facilities in included studies were mostly associated with significant reductions in opioid overdose morbidity and mortality, significant improvements in injection behaviors and harm reduction, significant improvements in access to addiction treatment programs, and no increase or reductions in crime and public nuisance.
