3-Point Action Plan for the Overdose Crisis

The bipartisan U.S. Commission on Combating Synthetic Opioid Trafficking recently issued a set of groundbreaking recommendations that give Colorado a clear roadmap for attacking fentanyl overdose crisis and saving lives:

  1. Immediately reduce overdose deaths
  2. Permanently reduce demand
  3. Disrupt supply from major transnational criminal organizations

Any evidence-based policy that furthers these goals is worthy of consideration in Colorado’s action plan. Any policy that does not will, at best, be an ineffective and weak response that will divert critical resources. At worst, it may make the crisis even worse. In Colorado, it is clear we are largely on the right track, but we need to focus even more intently on a few key areas.

 

Immediately Reduce Overdose Deaths: Fully addressing the synthetic opioid crisis will require long-term efforts over years, but there are things we can do right now to start saving lives today:

     ✅  Life-saving overdose reversal and fentanyl testing
Narcan and fentanyl testing strips can dramatically reduce overdose deaths. Colorado is already on the leading edge of these efforts and should stay focused on ensuring the full implementation of existing programs.
 
    

✅ Local responses to local challenges.
The fentanyl crisis does not look the same in every community. We can save lives by giving local leaders on the frontlines the flexibility they need to access every possible tool to combat the criss. This includes passing legislation like HB23-1202 that would finally clear the path for local communities to pilot proven strategies like overdose prevention centers.
 
         ✅ Good Samaritan Laws
The evidence is clear. Good Samaritan laws save lives. Laws like HB23-1167 will allow people to call for help when someone is experiencing an overdose without fear of being prosecuted.

 

 

Permanently Reduce Demand: The Commission found “real progress can come only by pairing illicit synthetic opioid supply disruption with decreasing the domestic U.S. demand for these drugs,” and highlighted prevention, treatment, and recovery strategies to accomplish that goal:

     ✅ Prevent synthetic opioid use
Effective prevention strategies include public education campaigns, improved access to mental health care and services, prescription buy-back programs, training public health officials to interrupt pathways to substance use disorder, medically-assisted treatment, and increased access to opioid alternatives. Colorado is implementing many of these strategies, including a Household Medication Take Back Program, and should continue to maintain and expand these efforts.
 
     ✅ High-quality treatment options 
Expanding access to evidence-based treatment, including medically-assisted treatment, is an essential component of permanently reducing demand. Advances are being made in Colorado because of recent policy and funding efforts utilizing dollars from the American Rescue Plan Act, federal funds from the State Opioid Response Grant, and recent opioid settlement funds. Maintaining and expanding these efforts will successfully reduce demand and increase community safety.
 
         ✅ Recovery and re-entry support
Saving lives and permanently reducing demand requires long-term support for sustained recovery, including workforce re-entry, access to housing, and reducing the stigma of drug use and recovery. As Colorado engages a robust legislative agenda regarding housing access this session, policymakers should not lose sight of removing all barriers to entry to housing for people in recovery. In addition, investments should be considered for ongoing funding of Colorado's Individual Placement Support Program, which links people in recovery to employers and employment supports, as well as in funding peer recovery support services.

 

 

Disrupt supply of unsafe synthetic opioids from transnational criminal organizations. As the Commission stated, “[t]he supply of illicit fentanyl cannot be permanently stopped through enforcement alone—only temporarily disrupted before another cartel, trafficking method, or analogue steps in to fill the market that addiction creates.” Notably, the Commission was clear that only a focus on major Transnational Criminal Organizations would make any dent in the supply of unsafe synthetics. It did not recommend any new or increased criminal penalties. It did provide specific recommendations on how local law enforcement and prosecutors can best contribute to efforts that will actually have a measurable supply-side impact:

     ✅ Disrupt supply chains and markets with unsafe and counterfeit tablets
The key strategies must be implemented at the federal level, and include enhanced monitoring of mail and border screening, international cooperation to restrict precursor chemicals, working with the private sector to reduce the distribution of opioids and precursor chemicals via the internet, and countering transnational criminal organizations’ money-laundering operations.
 
     ✅ Aid federal investigation of transnational organizations and darknet sales
The recommendations note that local law enforcement is “uniquely placed” to aid federal investigations of Transnational Criminal Organizations manufacturing unsafe synthetic opioids. Local law enforcement can also provide essential investigatory assistance that would disrupt the distribution of synthetic opioids and precursor chemicals on the darknet. Colorado law enforcement should provide far more information to policymakers about how they are prioritizing their available resources and personnel to aid these federal efforts.
 
         ✅ Promptly investigate and map overdose deaths and non-fatal events  
The Commission recommended local law enforcement must play an essential role in quickly mapping nonfatal and fatal overdoses to identify “retail dealers that transact in the most-dangerous combinations of drugs” so the community can be warned about the circulation of unsafe and deadly synthetics–before additional deaths occur. There is evidence of serious gaps in Colorado’s law enforcement investigation of fentanyl deaths.This can be immediately addressed by local law enforcement agencies, and there is no need for a new law or additional resources to do so.

 

 

In Colorado, there are policies currently under consideration that would not reduce overdoses, disrupt supply, or reduce demand, and should be rejected in favor of the evidence-based alternatives above:

     ❌ So-called “Drug-Induced Homicides” laws
Laws like SB23-109 have long existed under federal law and in twenty states. There is a long track record of their inefficacy and unintended consequences. These laws do not help law enforcement disrupt supply, can increase the risk of overdoses, deplete limited prosecutorial resources that would be better spent elsewhere, ensnare people who are often simply friends or family of the deceased, and have a disproportionate impact on people of color. These laws have proven to be so ineffective and distracting that a national association of elected district attorneys has recommended prosecutors cease using them. In any event, Colorado can pursue prosecutions under existing federal law in the very rare circumstances in which they would ever possibly be justified.
 
     ❌ Criminalization and prosecution
The criminalization and prosecution of people who use or possess drugs has long proven to be counterproductive to reducing overdoses and to have no impact on supply or demand. Any laws that would impose harsher criminal penalties on people for drug use or possession would make outcomes far worse. Policymakers should reject proposals to increase criminal penalties or to fund more prosecution. They should also carefully analyze the impacts of last year’s legislation increasing criminal penalties for fentanyl possession and consider whether that policy should be repealed.

 

 

Additional Resources