The Colorado legislature is apparently ready to try once again to do something significant — if something also significantly controversial — toward combating the state’s fentanyl-fueled, opioid-overdose crisis, which is not unlike the devastating fentanyl-fueled, opioid-overdose crisis facing the rest of America.
And once again, the attempt will probably fail, just as it did last year. And that would be a shame.
Still, in a party-line vote, the legislature’s opioid study committee has called for a bill to be drafted that would authorize cities to create what they’re calling overdose prevention centers — or, maybe more accurately, supervised safe-injection sites.
At these sites, people could legally use illicit drugs while under the supervision of health care workers, who would have naloxone — which, as Narcan, is a legal nasal spray that treats opioid overdoses — on site. The site would have fresh needles, so people wouldn’t share them. They could also offer, in the best case, food and showers and, yes, drug counseling. You get the idea.
But you also see the rub, right? The plan would mean that the state government is saying it’s OK for people to use illegal drugs, from heroin to fentanyl, so long as the usage can be supervised.
Opponents of the plan say that would make the state an official enabler of illicit drug use. Proponents argue that the drug use is already there, and that preventing death and disease is what’s critical.
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It would work this way: Users would bring the drugs they illegally purchased to a site that wouldn’t be the usual destination — say, a back alley or a public park or behind a car parked across the street from where you live. Instead, they’d bring the illegal drugs to a site where, if there’s an overdose, a life can be saved.
And everyone agrees that lives need saving. In Colorado, opioid deaths rose by 59% from 2019 to 2020 and then another 27% from 2020 to 2021, a year in which there were 1,881 drug overdoses in the state. The huge increase in fatalities is mostly due to dealers mixing fentanyl — a synthetic drug that is 50 to 100 times more potent than heroin — with another opioid.
The concept — bring your drugs here, and we’ll help if you need it — doesn’t fit into the mostly discredited just-say-no philosophy, which, of course, never worked.
And it seems like a direct counterpoint to the war on drugs, which has been ongoing for approximately forever with little success. But the lack of success hasn’t stopped calls for not just a figurative war, but a literal one.
As you may have heard, many Republicans, including presidential candidates and Ukraine war skeptics like Donald Trump and Ron DeSantis, are calling for military intervention into Mexico. They would use American might to take on the cartels, with or without approval from the overmatched Mexican government.
That’s probably just so much campaign talk. But it’s getting attention because it’s hitting a nerve and because, well, it’s as much about the GOP obsession with immigration as it is about drugs.
But also getting attention are the supervised injection sites that have opened in New York City and the one set to open Friday in Providence, Rhode Island. But America’s few examples leave us years behind the rest of the world. The first such site was opened in Switzerland in 1986 during the AIDS crisis, and now there are hundreds across Europe. In Canada, there are 38 sites, with Vancouver, which has about 1,700 people using its site per month, the most prominent. According to Canadian authorities, they have treated 47,000 overdoses since 2017 — and without a single loss of life.
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Not everyone trusts the statistics. Some have argued they contribute to more overdoses. The California legislature passed a bill to allow a few cities to begin safe injection-site programs, but Gov. Gavin Newsom vetoed it. He wasn’t the first California governor to do so. Jerry Brown vetoed a similar bill in 2018. Newsom, though, had hinted during his last campaign that he’d be interested in such a bill and says now he wants more clarity on the issue. But it may be fair to wonder whether Newsom’s veto had anything to do with his obvious presidential aspirations.
Meanwhile in Colorado, Jared Polis has made it pretty clear he does not support the idea, which, unless he changes his mind, would almost certainly doom any such bill becoming law. Of course, many people — myself included — expect Polis to run for president someday.
Still, state Rep. Elizabeth Epps and state Sen. Kevin Priola, both Democrats, will work to draft a new bill. They were both among the leading sponsors of last year’s bill.
When advocating for it last year, Priola made a pretty convincing case: “It’s about saving lives. If people overdose, and there’s no one there to provide naloxone to save their life, they’ll never be able to go to rehab. They’ll never be able to kick the habit because they’re dead.”
Getting to rehab matters, of course. The cartels are not just about drugs and violence, but more to the point, about money. And there’s money because there is a constant market for the product. Attacking Mexico won’t solve that part of the problem. And if the cartels could be stopped — and let’s hope they are somehow — the drugs would simply come from someplace else. China is apparently playing a key role in the fentanyl crisis today.
But, as Priola says, there’s no rehabbing if the users are dead.
One person at the legislature I look to on matters medical — and this is an urgent medical matter — is Sen. Kyle Mullica, a Thornton Democrat who also happens to be a nurse. A year ago, Mullica was one of the key votes in shooting down the bill in committee. What passed instead — and was signed by Polis — was a bill toughening punishment for dealing fentanyl. Does anyone really think that will work?
This year, Mullica was the critical vote in allowing a draft of a bill to go forward, not that he’s completely sold on the idea. But something more, he knows, needs to be done.
As he told The Sun’s Unaffiliated newsletter, “I’ll be honest with you and transparent: I’m not convinced that this policy is the most effective policy for us to do. But I do believe that it’s a conversation that we should be having and I’m not afraid of that conversation — even if I do have concerns.”
The opioid legislative committee will take a look at whatever draft is proposed in October.
There are concerns. There are concerns that studies of the effectiveness of these sites haven’t been sufficiently rigorous. There are concerns about possibly normalizing the use of a dangerous drug like fentanyl. There are concerns that cities that adopt these programs may not be ready to properly administer them.
In San Francisco, as an example, the Board of Supervisors decided, after Newsom’s veto, to start its own program, but one that was to be conducted by nonprofits. Months later, they’ve made little progress in finding a site. And in fact, last week — because, I guess, it’s San Francisco — there was even an unauthorized pop-up site in the city’s Tenderloin district.
There have been moves over the years to open a safe-injection site in Denver. Maybe the legislature, which has tried before, would allow Denver to be a model. Maybe — and this may be the only way it gets done — it’s time that cities like Denver demand it.
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