In the Netherlands, Safe Drug Consumption Sites Are Saving Lives. The U.S. Is Resisting.

When lawmakers try to tackle gun violence, they often turn to measures like adding police officers or cracking down on illegal guns. But what happens when they treat violent crime as a public-health problem? Counselors invite patients to join the Violence Intervention Program, offering a host of services intended to break the cycle of violence.

While the decriminalization effort Measure 110 failed to fully meet the mark, the Health Justice Recovery Alliance joined forces with local law enforcement to create a pilot program that helped locals struggling with addiction. Through the program, police can contact an outreach worker who will come to the scene and connect the person struggling with addiction to support services such as detox care and housing, helping lead them toward long-term recovery. So far, the pilot program has helped over 200 people.

Since introducing both the decriminalization of a range of substances like heroin and cocaine and new harm-reduction strategies in 2001, Portugal has seen success in driving down HIV cases, overdoses, and needle sharing. The country attributes their progress to treating the issue of drug use as a human rights issue rather than a criminal one, because they consider external factors that contribute to addiction like gender, class, or race.

To address overdose deaths, multiple organizations across Athens County and Ohio University have implemented free Narcan distribution and training programs since 2023, including overdose response training sessions and no-barrier access to free Narcan kits through campus cabinets, health departments, and community organizations partnered with Ohio's Project DAWN network. The programs have helped distribute hundreds of Narcan boxes and to normalize overdose response training and reduce stigma around addiction.

Chesterfield County, Virginia implemented a multi-faceted response to the opioid crisis, including a jail-based recovery program, Helping Addicts Recover Progressively (HARP), that brings people in recovery to the local jail to talk about addiction and treatment resources. Combined with other efforts, overdose deaths have dropped by half in a single year, and around 4,000 people have participated in HARP.

Black mothers at Griffon Manor organized community activism, advocacy campaigns, and coalitions to demand equitable government support and recognition after the Love Canal, New York, environmental disaster—eventually resulting in partial victories such as federal relocation assistance, although persistent structural racism and media neglect severely limited their initial visibility, effectiveness, and lasting recognition.

Technology like chatbots, motion detectors and hotlines are helping prevent overdose deaths, which typically happen when people use alone. The Never Use Alone hotline which was started in 2019 by volunteers with experience using drugs or who have lost someone to an overdose. Since starting, they have received more than 45,000 calls and have called emergency responders about 200 times.

CalAIM’s contingency management program gives people gift cards for not using drugs. For every negative drug test, patients receive gift cards, and the payouts increase after each test. Patients who test negative every time over six months can earn up to $599. The treatment style is based on the concept of reinforcement as an effective motivator. Studies suggest the excitement of getting a gift card mimics the dopamine rush from using drugs.

Talk Overdose provides peer-delivered education to youth in seventh to twelfth grade about overdose prevention. The group of teens also provides naloxone training, hosts guest speakers and interactive workshops that teach empathetic listening skills. Talk Overdose was formed in 2021 and has since reached over 1,500 youth across the country and has stated to offer Indigenous culture workshops, as a connection to culture has shown to have a positive impact on mental health and wellbeing.

Amidst the ever-present opioid crisis, there has been a shift among judges, prosecutors and law enforcement agencies beginning to let go of the stigma associated with medication for opioid use disorder. As of 2022, more than 90% of drug courts in communities with high opioid mortality rates have reported that they allow medications to be used to treat addiction. Some areas have also seen the emergence of drug recovery courts that specialize in helping people facing addiction get treatment, rather than jail time.