White House will push ‘harm reduction’ in latest fight against drug overdoses

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• Amna Nawaz:

  While the country is still wrestling with the COVID-19 pandemic, deaths from drug overdoses have been spiking and are expected to top 100,000 for 2021.

  Today, the White House released its plan to address the crisis.

  William Brangham gets an initial assessment.

• William Brangham:

  The administration is promoting what's known as harm reduction, which is a suite of practices to make drug use safer and less deadly.

  It wants to expand access to needle exchanges, to the overdose reversal drug naloxone and to fentanyl test strips, so people know what they're actually consuming. The plan also calls for expanded drug treatment and cracking down on drug trafficking.

  So, will this make an actual dent in the crisis?

  To help explain that, I'm joined by Dr. Andrew Kolodny. He studies opioid policy at the Heller School at Brandeis University.

  Dr. Kolodny, great to have you back on the "NewsHour."

  The administration is now very publicly saying, we are getting behind harm reduction as a strategy.

  Do those practices work? And does this plan do enough to implement those strategies?

• Dr. Andrew Kolodny, Brandeis University:

  So, harm reduction approaches do work. And making clean syringes available to injection drug users is a proven way to reduce injection-related infectious diseases. It's a positive, important public health intervention.

  Making naloxone for reversing an opioid overdose more available, when opioid overdoses has become the leading cause of accidental death in the United States, is also something that makes sense. It's really a no-brainer. We should make sure that naloxone is available just about anywhere that people could potentially overdose from an opioid.

  But will these approaches make a significant dent in the dramatic increase we have seen in overdose deaths? I don't think so. I think they will help. I think naloxone will save lives, and we should do it. But to really see deaths start to come down, there are other approaches that we should be moving further on.

• William Brangham:

  Such as?

• Dr. Andrew Kolodny:

  Such as making treatment much more easily available. The vast majority of deaths are occurring in people who are opioid-addicted, not all of the deaths. We have seen a sharp increase in young recreational drug users because the supply is so dangerous.

  Young people who might not be addicted are dying of overdoses. And those deaths are significant, and they're increasing. But the vast majority of deaths occur in people with opioid addiction, which is a preventable, treatable condition. And we need to be doing more to both prevent it and treat it.

  If we want to see deaths start to come down significantly in the short run, people who are opioid-addicted need access to effective treatment. And that treatment has to be easy to obtain and essentially free. It has to be easier to get treatment, particularly with a medicine called buprenorphine, than it is to find a bag of heroin or fentanyl.

• William Brangham:

  But do we have enough beds, enough practitioners, enough buprenorphine to stem this crisis? I mean, the administration says they want to double treatment admissions in just a few years.

  Even if that was possible, do we have enough people to man those beds and to treat all of those people?

• Dr. Andrew Kolodny:

  We may have enough beds. There are a lot of rehab beds in the United States. But rehab isn't really what we need.

  We need outpatient treatment programs where somebody can walk right in, and that same day get started with effective treatment. We really need to build a system that doesn't exist yet.

• William Brangham:

  I want to ask you about the criticism.

  Conservatives have often said that they're not fans of harm reduction. They think of it as enabling drug use. And they argue that interdiction at the southern border is what has got to be priority number one. What do you make of those arguments?

• Dr. Andrew Kolodny:

  Yes, it's not an either/or.

  And I think conservatives, if they take a close look at the harm reduction interventions that are being put forward, like making naloxone more available to prevent an overdose or making clean syringes available to prevent injection-related infectious diseases, I think most conservatives will agree these are important interventions.

  We should, though, also be thinking about trying to keep fentanyl from coming into the country. Interdiction efforts do make sense. There is a role for law enforcement. But the law enforcement efforts only really work if you're also making treatment much easier for people to get.

  What you need to do is everything we can so that heroin and fentanyl is made more expensive on the black market, harder to obtain, and treatment is essentially free and easy to get. And if you can do that, if you can make it harder for people to keep using and easier for people to access effective treatment, more people will seek treatment.

  I think there are many who are under the impression that heroin users are choosing an alternative lifestyle or maybe they're enjoying their drug use. They're not. Their quality of life is very poor. These are individuals who are suffering and generally want treatment. It's just that the treatment has been too difficult to access.

• William Brangham:

  Dr. Andrew Kolodny of Brandeis University, always good to see you.

  Thank you very much.

• Dr. Andrew Kolodny:

  Thank you.