By Dunstan Prial

Fentanyl is the latest in a long line of self-destructive weapons that in recent decades has included heroin, crack, crystal meth and OxyContin. In a few years, another drug will replace fentanyl, and the cycle will repeat.

Unless policymakers change their approach to addiction.

Unfortunately, federal lawmakers, distracted by an all-consuming presidential election and escalating global conflicts, have lost focus on arguably the defining domestic issue of the last decade.

October 1 marks one year since the expiration of the SUPPORT Act, which provided funding for opioid use prevention, recovery and treatment, and this failure by Congress to reauthorize the money has hit grassroots programs in cities ravaged by fentanyl , like Paterson, destroyed. Newark and Camden.

The SUPPORT Act was a rare act of bipartisan cooperation, and its goal was to save lives by distributing $20 billion across a range of treatment programs and educational resources, many of which relied on innovative harm reduction methods.

That was before fentanyl, the powerful synthetic opioid, emerged as a cheaper alternative to heroin and OxyContin. Fentanyl is now in everything – cocaine, counterfeit benzodiazepine pills, even marijuana.

Fortunately, the overdose numbers are just beginning to fall. But overdoses occurred in the six years between the SUPPORT Act’s passage in September 2018 and May 2024 U.S. deaths rose nearly 40%, according to the U.S. Centers for Disease Control and Prevention.

Despite this troubling increase, the issue of addiction has been buried under issues that are more easily polarized – such as immigration – even though 100,000 Americans die from overdoses each year.

Aside from acknowledging the scourge of fentanyl and blaming it for the rise in overdose deaths, Kamala Harris and Donald Trump have largely spoken out about addiction as a separate issue.

Instead, both candidates have approached the issue from a criminal justice perspective, preferring to describe their plans to reduce illegal fentanyl shipments across the U.S. border. This is the same approach that led to the failed “War on Drugs” four decades ago.

What is needed is a new approach that acknowledges the reality of substance use while eliminating harmful stigma. Harm reduction measures achieve both, and this is where state lawmakers can have a profound impact.

I worked as a counselor at a substance abuse treatment center in Paterson for three years. Few American cities have been hit harder by the opioid crisis. Every day I saw how harm reduction can save lives.

I met opioid addicts who used medical marijuana to satisfy cravings and relieve the terrible withdrawal symptoms that derail many attempts to quit smoking. Still, most treatment centers, including mine, require total abstinence, a policy that can discourage opioid users from seeking treatment.

I met many others who were taking Suboxone, a prescription medication that helps reduce cravings and ease withdrawal symptoms. The catch is that Suboxone is opiate-based, meaning it can be addictive if abused.

The Biden administration has been instrumental in increasing access to Suboxone prescriptions via telemedicine, but the drugs remain difficult to obtain in many areas of the United States

I met a crack addict who was taking opiates to distract from his cocaine rush. He said he always showed up at a safe injection site where opiate users would use their drugs under the supervision of trained staff armed with naloxone, a nasal spray that reverses the effects of an overdose.

There are two consumption sites in New York City – in Harlem and Washington Heights – the only two in the U.S., and a third is scheduled to open in December in Providence. The New York facilities, known as OnPoint, were used by 4,000 people in their first two years of operation. The result: 1,100 overdoses were prevented and there were no deaths.

Europe, Australia and Canada have recorded the same 100% success rate across their combined 200+ locations. For decades, they have provided spaces that keep drug use out of dark public spaces, saving countless lives through routine fentanyl testing and the availability of naloxone alone.

Plans for safe injection sites in New Jersey and Philadelphia were scuttled by political pressure and fear-mongering. However, opponents argue that harm reduction methods enable or even encourage substance use.

Health Committee Chairman Sen. Joseph Vitale (D-Middlesex) agrees that it is time to establish a pilot program with four injection sites in New Jersey because “the data is undeniable that these sites save lives.”

But harm reduction measures will only be accepted and implemented when policymakers have the courage to move beyond the tired stereotypes that stigmatize substance users as criminals and/or moral deviants who need to be punished and shamed. How many more deaths will there be?

Dunstan Prial is a substance abuse counselor in Caldwell.

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