From stricter penalties to safe injection sites, states continue to grapple with devastating effects of fentanyl as they develop policies to fight it.

The explosion of fentanyl on the illicit opioid market has been overwhelming public safety and public health officials across the country. While these government agencies have a significant role to play in curbing the crisis, experts still debate whether more or less criminalization will help. This incertitude is made clear in the different policies states are enacting to slow the overall impact and overdose totals caused by this alarmingly potent drug.

Some approaches prioritize getting the drugs off the streets and increasing penalties, while others are leaning into policies that help users partake safely and avoid overdoses. According to a Route-Fifty article, 28 states have enacted one or more fentanyl criminal provisions, and this year alone, lawmakers introduced hundreds of fentanyl crime bills in at least 46 state legislatures. On the other hand, states including New Hampshire, North Carolina, Missouri, and Rhode Island to name a few have explored a variety of alternative options to criminalization such as decriminalizing fentanyl testing strips, legalizing safe injection sites, and establishing syringe exchanges.

More specific details in the article discuss research and different state programs that have been launched, but for all, overdose death tolls are a major driving factor for these policies. From the article:

More than 110,500 people in the United States died of drug overdoses in 2022, according to provisional statistics released by the National Center for Health Statistics, a federal agency. Sixty-eight percent, or 75,778, of those deaths involved synthetic opioids, such as fentanyl.

Even more middle-ground policies that focus attention on distributors rather than individual users run into trouble by this metric. Some evidence has shown upstream solutions, such as large scale drug seizures from dealers, has led to more overdoses as individual users seek new sources when the regular supplier is not available. Since different batches have potency variations this switch can be deadly to someone unfamiliar with that particular product or dealer.

Research will certainly continue as evidence-based solutions should be top of mind for lawmakers looking to get ahead of this problem. Overdose prevention strategies will even be front and center at the MACo Summer Conference session titled, “Detention Dilemma: Mobilizing MAT in Local Corrections Facilities.” An esteemed panel of leaders on medication-assisted treatment in local jails will explore how this overdose prevention policy is working in Maryland.