A March for Science in Addiction Treatment and Drug Policy

By Zachary Siegel 04/23/17

If America wants to solve the overdose crisis, policymakers need to listen to real scientists, not so-called experts whose primary qualification is that they beat their own addiction.

Sign Holder at Science March
Citizens marching for a science based approach to drug treatment

The sun beamed down on the March for Science in downtown Los Angeles last Saturday.

The event, considered unprecedented by many, was predictably attended by concerned environmentalists, science teachers and physicists sporting NASA t-shirts.

Beneath the snarky signs, “I can’t believe I have to march for objective reality,” scientists, engineers, doctors and researchers marched in the heat with a sense of urgency: to stand up to an evidence-adverse Republican administration known to manipulate statistics and ignore data that contradicts its hunger for coal, oil, deportation and incarceration.

Unique among the marchers was a small group of public health researchers who specialize in drug policy with a harm reduction bent. Their research, among other things, tests the efficacy of interventions such as syringe-exchange programs, drug consumption rooms and naloxone distribution. These strategies, if implemented correctly, may reverse America’s overdose crisis.

“I marched for policy based on science, not ideology,” said Leo Beletsky, a professor of law and health sciences at Northeastern University, who also holds an adjunct position at UC San Diego’s Division of Global Public Health, a research arm of the university’s medical school.

Yet politicians and legislators on both sides of the aisle, entangled in American morality, ignore evidenced-based policies to America’s overdose crisis. They criticize these harm reduction approaches for “enabling drug use,” despite decades of evidence showing they actually reduce the spread of bloodborne diseases, lower the risk of fatal overdoses and promote health and well-being for risky, hard to reach populations.

Perhaps the most infamous example is when Vice President Mike Pence, while Governor of Indiana, once said he would pray on whether or not to lift the state’s ban on syringe-exchange programs. While he contemplated the situation and then prayed for the answer to his moral dilemma, Indiana saw its biggest HIV outbreak due to hundreds of drug users sharing needles. Why wait for god to tell you what to do when a simple Google Scholar search for “syringe exchange programs” tells you the answer.

This arsenal of effective harm reduction interventions remains untapped, even as fatal overdoses surge from heroin tainted with illicitly manufactured fentanyl. The result: tens of thousands of premature deaths, many of whom tragically die alone in gas station bathrooms and private bedrooms.

That’s why they marched.

Beletsky uses his specialized expertise in public health to design and evaluate laws with a goal not just to curtail fatal overdoses, but to hopefully reverse the deadly trend plaguing America.

Laws can be effective when they link drug users to social and medical services instead of a jail cell, Beletsky often says to powerful adversaries, like Attorney General Jeff Sessions and Steven H. Cook, who Sessions recently brought into his inner-circle. Both are keen on policies that lock up dealers and users.

“The federal criminal justice system simply is not broken. In fact, it’s working exactly as designed,” Cook once said.

Dan Werb, also of UC San Diego’s Division of Global Public Health, marched alongside Beletsky.

“Police-based efforts for supply reduction hasn’t worked,” Werb said. His statement is backed by empirical data. “So we have to connect people who inject drugs to services that can help them, like evidence based addiction treatment: methadone or buprenorphine.”

Stunningly, there is stigma, even in the addiction treatment community, for both drugs, which evidence shows can cut the rate of fatal overdoses in half.

Former Surgeon General Dr. Vivek Murthy, just days before he was fired by the Trump Administration last Friday, called out stigma against these medications at an event hosted by Hollywood, Health and Society, a firm affiliated with the University of Southern California that consults the entertainment industry on how to accurately weave storylines about health and science into scripted television.

“A leader on the issue of opioids in his community proceeded to tell me he believed that methadone increased people’s sexual drive, and increased their likelihood of pregnancy, which was making the problem worse,” said Dr. Vivek Murthy to a chuckling audience. “In case anyone has any doubts, that is not true about methadone.”

If America wants to solve the overdose crisis, policymakers need to listen to real scientists, not so-called experts in addiction whose primary qualification is that they beat their own habit. Like Werb, for instance, who's an epidemiologist and policy analyst, and who also received the National Institute on Drug Abuse’s prestigious Avenir grant, awarded only to researchers on the cutting edge of drug policy.

Werb marched for a rational, sane response to problematic drug use. Right now, he’s evaluating structural interventions in America and around the world aimed at preventing the initiation of injection drug use, as well as the spread of injection-driven HIV epidemics.

In France, for example, Werb’s tracing what probably appears counterintuitive to legislators: how safe injection spaces may actually prevent others from starting their own injection drug use. “These spaces allow users to inject in private (under medical supervision) rather than in the public -- where they may increase someone’s curiosity,” he said.

Peter Davidson, a medical sociologist also at UC San Diego and a veteran harm reduction researcher, also marched alongside Werb and Beletsky. Since 1997 he’s studied how interventions prevent opioid overdoses, hepatitis C transmission and sexually transmitted infections among drug users in both Australia and America.

“I marched to protest against the undermining of the scientific enterprise in the United States, which is essential for the economy and the well being of Americans,” he said.

America is facing numerous crises. Unfortunately, many of them require complicated fixes (sorry environmentalists). The overdose crisis, however, does have proven solutions. What’s needed is the political will to implement them.

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.