- The video discusses the rise in drug overdoses and the dangers of the current drug supply, particularly due to the presence of fentanyl.
- Fentanyl, a synthetic opioid, has been involved in nearly two-thirds of all overdose deaths.
- The lack of consistency in the distribution of fentanyl within the street drug supply makes it difficult for users to know the potency or even if they are taking it at all.
- The video criticizes the fear-mongering and misinformation surrounding drugs, highlighting past mistakes in the war on drugs.
- It exposes the false claims made by law enforcement about the dangers of accidental exposure to fentanyl.
- The video advocates for harm reduction strategies, such as drug checking and naloxone, to mitigate the damage caused by drug use and reduce overdoses.

- Naloxone is an effective tool for reversing drug overdoses.
- The FDA's prescription-only status for naloxone is frustrating and should be changed.
- Overdose prevention centers, also known as supervised injection sites, are crucial for harm reduction.
- These centers provide a safe space for drug users and help prevent overdoses.
- Misconceptions and stigma around drug use hinder the establishment of overdose prevention centers.
- The Biden administration should endorse and support overdose prevention centers.
- More needs to be done to involve drug users in policy discussions and provide funding to community-based organizations.
- It is important to meet drug users where they are, promote safe drug use, and remove barriers to addiction treatment.
- Spreading misinformation and incarcerating drug users is counterproductive.

John Oliver discusses why overdoses in the U.S. have been on the rise and what we should, and shouldn’t, be doing to prevent them.

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They're something that we've often been told to avoid through PSAs like this.

Someone pays you for a move When they say, come on, be cool Just be smart and heed this rule Don't you drive Just tell them you've got better things to do ♪

I mean, everyone knows the hottest spot to snort coke is a bench on a residential street in broad daylight.

These days, you can't even hang out on your split-level porch in your poodle skirt without seeing those pesky teens blowing that snow like it's Jackson Hole.

But despite those very compelling arguments, millions upon millions of Americans still use illicit drugs.

Some, in fact, can be so much fun, they end up ruining your fucking life, because the truth is, that Greece fever dream isn't entirely wrong to imply that engaging with the illicit drug supply can be dangerous.

This past decade has shown a substantial rise in overdose deaths, leading to alarming statistics like this.

The CDC estimates more than 100,000 Americans die from drug overdoses over a 12-month period ending this April, a record.

That's nearly 3 times the number of deaths from traffic accidents last year, and more than twice the number of gun deaths.

And quick side note here, it is depressingly American to be shocked that something could cause more deaths than guns.

We are the only country that would look at that and say, It's hard to believe that drug overdoses are killing more people than 1 of those natural causes of death, highly preventable loss of life by loosely regulated weapons.

The fact is, street drugs are an absolute mess right now.

As they've become so contaminated, 1 Yale researcher said, the whole supply is just so absolutely fucked at this point.

And the rise in overdose deaths has been driven by the presence of 1 drug in particular, and that is fentanyl.

A synthetic opioid often used for prescriptively for things like surgeries or cancer pain, But outside of medical settings, illegally manufactured fentanyl has become a huge problem because it and other synthetic opioids were involved in nearly two-thirds of all overdose deaths during the past year.

And while it is true that fentanyl is incredibly potent, The bigger problem is actually that there is a dangerous lack of consistency in the way it's currently distributed within the street drug supply.

So you can either know that you're taking it on its own or in something like heroin, but not know how potent what you're taking is, or you may not know that you're taking it at all.

What we're seeing is that this opioid is being found in a contaminated pill supply in the whole United States.

They're using pill presses that look like pills for pharmaceuticals that are currently marketed.

1 day, I admitted 3 people into the clinic.

All 3 of them said they were taking oxycodone.

None of those 3 people had any oxycodone tested in their urine that we tested that day.

The only time you should be surprised by what is in your urine is when you forgot you ate asparagus earlier that day, or, worst case scenario, the Shrunk Down Magic School Bus comes out after a biology lesson gone horribly wrong.

So if the current drug supply is this tainted and this dangerous, we thought tonight, it'd be worth talking about the overdoses that it can cause and the things that we should and really shouldn't be doing to prevent them.

And let's start by acknowledging some past mistakes, because for decades, we've been fighting a war on drugs that was often fueled by fear and misinformation, directly leading to bad policy.

In the 1980s, for instance, the risks associated with crack cocaine use, which were very real, got cartoonishly inflated into fear-mongering headlines about a generation of crack babies, with stories like, Crack Babies Turn 5 and Schools Brace, which was obviously shitty and racist at the time, but has also since been completely debunked.

But that hysteria led to policies like, mandatory minimums that fueled mass incarceration, and laws that criminalized everything surrounding drug use, from paraphernalia to even locations where drugs were used.

And unfortunately, we're seeing a similar panic today brewing around fentanyl, which again, is dangerous if ingested or injected.

But to hear law enforcement tell it, it's also dangerous to be anywhere near it.

Take this video from the San Diego County Sheriff's Department.

And before I show it to you, just know, the officer involved here is completely fine, for reasons I'll get to in a minute.

My trainee was exposed to fentanyl and nearly died.

He found a white substance that he suspected was drugs.

That stuff's no joke, it is super dangerous.

A couple seconds later, he took some steps back and he collapsed.

Again, don't worry, that officer is completely fine.

And there should have been a few immediate red flags there.

Not only did the department voluntarily release that body cam footage, they also went to the trouble of scoring it with music that can only be described as funeral home slideshow.

But the idea that that officer could have been passively exposed to fentanyl and then overdosed is completely absurd.

Experts say it is technically impossible to touch fentanyl powder and feel any effects from it, let alone overdose.

And you would have to be in some sort of wind tunnel with massive amounts of fentanyl to accidentally inhale enough to OD.

And by the way, a wind tunnel full of fentanyl is quite the phrase there.

If you just add, and roving gangs, you've pretty much got how a racist uncle describes Chicago after watching too much Fox News.

And the thing is, it's by no means just San Diego.

Multiple police departments have put out similar claims of ODing through accidental skin contact or inhalation, which again, is basically impossible.

What those officers were much more likely experiencing were panic attacks, which makes sense in a way, because they'd just been exposed to something they'd repeatedly heard is deadly to be anywhere near.

This has now become such a trope, it was a plot point on Blue Bloods, where Donny Wahlberg's partner briefly picks up a tray with fentanyl on it, and then this happens.

She was fine 1 second, the next minute she's not breathing.

50 to a hundred times stronger than morphine.

The slightest exposure can trigger an overdose.

Not that you'd expect any more nuance from a show that's basically Adults Paw Patrol.

But the point is, it is deeply irresponsible of police to keep perpetuating a medical impossibility and for media outlets to keep amplifying it for a start.

It might make people afraid to help someone they see experiencing an overdose, while risk giving someone CPR if they might be covered in powder death.

And also, when you treat a drug like a bioweapon, you justify a punitive militarized response to it.

A couple years back, an Ohio man received additional prison time for assault on a police officer after officers searched his car for drugs and found powder that later tested positive for fentanyl.

That exposure to fentanyl alone constituted the assault.

And look, if fentanyl really were smallpox in a bottle, maybe it'd make sense for total eradication to be our goal, but it isn't.

So it frankly makes much more sense to focus on how to protect those genuinely at risk of overdosing on it, and that is the people taking it.

Which is to say that the rest of this piece is actually gonna be about harm reduction.

Essentially, harm reduction accepts the reality that people will use illegal drugs and that some either can't or don't want to stop.

So, rather than arrest them, we might be better off trying to mitigate the damage done.

It's a concept that you might already be familiar with through things like syringe services programs, which give people clean needles and are proven to massively help drive down the spread of disease.

And right now, if you genuinely want to reduce the number of overdoses, there are some important tactics that we could encourage.

The simple act of testing drugs to find out what is in them.

This can be done through things like fentanyl testing strips or reagent test kits.

These are very valuable tools to keep people safe, and yet, thanks to those drug war era laws on paraphernalia that I just mentioned earlier, they're technically illegal in all of these states, making it a liability to carry them, which is just complete madness.

Now, thankfully, some states have written carve-outs for specific methods, like fentanyl testing strips, and others are choosing not to enforce their stupid laws criminalizing them.

The problem is, though, police officers may not be aware or indeed care about those carve-outs and are still very much arresting people or using the presence of testing equipment as probable cause for further searches.

And all of this means people are still getting locked up because they were carrying a life-saving tool, which is ridiculous.

Because if any life-saving tool should be criminalized, it obviously should not be drug-checking equipment, it should be the Heimlich maneuver.

I'm sorry, but let's get this very clear here.

If you see me choking, that is frankly, none of your business.

If I die, let me die doing my favorite thing in the world, not being surprise hugged by a stranger.

Then, there is the harm reduction method that you're probably already aware of, and that is naloxone, also known by the brand name Narcan.

Naloxone, as this woman who works in harm reduction explains, can quickly reverse an opioid overdose.

So pretend that this here, this is fentanyl coming in your system, right?

So when you shoot some up with Narcan, it's like a wall goes up.

And so the fentanyl hits the wall, it can't keep on going.

The more Narcan you put to the system, the bigger that wall gets.

So what you're saying is, is it's actually quite easy to reverse an overdose.

Naloxone has got to be in the Hall of Fame for erasing mistakes.

Right up there with the pencil eraser, the control Z key, and starring in Daddy's Home 2.

I wonder if there are any fun pranks or voicemails on the set.

The point is, though, naloxone is a fucking miracle, which is why it is so frustrating that the FDA currently has it under prescription-only status.

Something even the AMA has said should be changed.

And while every state has adopted some kind of workaround, meaning an individual can theoretically get it without seeing a doctor first, it can be very difficult.

And for community groups who want to buy it in bulk so that they can distribute it directly to the people who need it the most, it can be basically impossible.

And look, there are certain things you would want to go out of your way to discourage people from having in their homes.

Nazi flags, pet chips, a TV playing an episode of Blue Bloods.

But perhaps the biggest step that we could make regarding harm reduction is to properly support overdose prevention centers.

Sometimes called supervised injection sites.

They're places where people can bring their own drugs and have access to clean supplies and trained professionals who can intervene in the event of an overdose, as well as direct them toward tons of other services, including addiction treatment, if they so choose.

Here's a look inside 1 of them, right here in New York City.

When we were inside, there were half a dozen clients using drugs.

No more improperly discarded syringes on the streets, near our schools, in our subway stations.

I'm on site, safely, securely, without having to worry about overdose things.

The voice behind the divider belonged to a man named Oz, who told us he's a Marine Corps veteran and was using heroin as we spoke.

I've gotten more help here than I've gotten from, you know, from the VA.

And I know that we as a society have learned not to trust anyone named Oz, who is either yelling at you from behind a curtain, or trying to talk to you about something medical.

But we should make an exception here on both counts, because this particular Oz makes a very important point.

Overdose prevention centers provide crucial services that keep people who use drugs as safe as possible.

And yet, whenever they are floated as an option, people freak the Fuck out.

It's actually a heroin shooting gallery, and that's really what it is.

It is a community center for heroin addicts to go and shoot up under supervision, which I think is crazy.

The best way to prevent overdoses from heroin is to have people stop doing heroin.

But in my way of thinking, it's really harm enabling centers.

There's so many other things to deal with than, you know, letting people shoot up safely.

Okay, but that's not at all what these centers are for.

They're not for the heroin curious to sample flights of syringes like IPAs.

They're to help people who already use drugs do so in a way that won't fucking kill them.

We know overdoses often happen when people use drugs alone with no 1 around to help them, and these facilities are designed to make sure that that doesn't happen.

And politicians who actually study these sites, like the former mayor of Ithaca, New York, come away impressed.

The first time I heard it, I thought it sounded like we were just enabling people to use drugs.

But the truth is, in the places where it's worked, in Australia, in Europe, in Canada, more people get off of drugs.

People who use supervised injection are 30% more likely to enter into treatment.

In fact, there has never been a recorded death in any overdose prevention center on Earth.

The ball pit there is, and this is true, mostly bones.

And yet, despite the fact that clip was from 6 years ago, Ithaca still doesn't have an overdose prevention center.

Because when cities float opening 1, questions around their morality and even legality make it next to impossible.

Just recently, an OPC in Philadelphia was prevented from opening after a three-judge panel found it violated a provision in federal law known as the Crack House Statute, which bans facilities that operate for the purpose of using illegal drugs.

Yet another 1980s law that we're still suffering from, which is just infuriating.

So often, the problem facing all harm reduction programs is that people are so angry with those who use drugs, they want to try and punish them into abstinence.

And advocates have been trying to tell us this for a long time.

Like Louise Vincent, who points out that for decades, we've been going at this completely wrong.

All we do is disconnect people in the United States.

So if you are found to be a person who uses drugs and needs help, we start with disconnecting you.

And I truly believe that addiction is the opposite of connection.

So what we do is everything wrong to help a person.

We disconnect people from their families, we disconnect people from their friends, we alienate people from work, we disconnect them from community, and then we disconnect them from their freedom, finally.

And when people finally have nothing left...

When people have nothing left, they will use until they die.

It is fucking dark, it's horrible, and right now, you can make a pretty good case that, deliberate or not, it is the end goal of U.S.

Well, for starters, the FDA should remove naloxone's prescription-only status, and they should do that right now.

And crucially, not just for expensive brand-name nasal sprays like Narcan, but for low-cost generic naloxone, which is 30 times cheaper.

As for state legislatures, they should re-examine their paraphernalia laws to make sure that people aren't held liable for holding basic protective tools like drug testing equipment.

And finally, we need a full-throated endorsement of overdose prevention centers from the Biden administration.

Because remember, right now, as Philly is finding out, they are arguably illegal thanks to that crack house statute.

Now, the Biden administration could intervene here and take a stand in their favor, which is, frankly, the very least that Biden could do.

Because if you're wondering, who is the guy who authored the crack house legislation, I've got some bad news for you.

I'm the guy who authored the crack house legislation.

And look, this administration has done some real good in being the first to broadly endorse harm reduction tactics.

But advocates say that much, much more is needed, including making sure that people who use drugs have a seat at the table during policy discussions and the funding gets to community-based organizations providing the most services for them.

Our ingrained stigmas around drugs and the people who use them run really deep.

And if we actually want to minimize deaths and keep people safe, the facts point in a very clear direction.

We need to meet people where they are, help them transition into safe drug use to stay alive, and remove barriers for those seeking addiction treatment.

And what we absolutely need to stop doing is spreading misinformation and warehousing drug users in prisons.

Or to say all of that much more succinctly, it is well past time to start paying attention to the man behind the curtain.


Speaker 0: MUSIC

Speaker 1: Our main story tonight concerns drugs. They're something that we've often been told to avoid through PSAs like this. MUSIC

Speaker 0: Don't do drugs. Oh, no. Oh, don't you do it now. Don't do drugs. Oh, no.

Someone pays you for a move When they say, come on, be cool Just be smart and heed this rule Don't you drive Just tell them you've got better things to do ♪

Speaker 1: Cool. I mean, everyone knows the hottest spot to snort coke is a bench on a residential street in broad daylight. These days, you can't even hang out on your split-level porch in your poodle skirt without seeing those pesky teens blowing that snow like it's Jackson Hole. But despite those very compelling arguments, millions upon millions of Americans still use illicit drugs. And it is easy to see why.

Drugs can be a lot of fun. Some, in fact, can be so much fun, they end up ruining your fucking life, because the truth is, that Greece fever dream isn't entirely wrong to imply that engaging with the illicit drug supply can be dangerous. This past decade has shown a substantial rise in overdose deaths, leading to alarming statistics like this.

Speaker 2: The CDC estimates more than 100,000 Americans die from drug overdoses over a 12-month period ending this April, a record. That's nearly 3 times the number of deaths from traffic accidents last year, and more than twice the number of gun deaths.

Speaker 1: Wow. That is staggering. And quick side note here, it is depressingly American to be shocked that something could cause more deaths than guns. We are the only country that would look at that and say, It's hard to believe that drug overdoses are killing more people than 1 of those natural causes of death, highly preventable loss of life by loosely regulated weapons. The fact is, street drugs are an absolute mess right now.

As they've become so contaminated, 1 Yale researcher said, the whole supply is just so absolutely fucked at this point. And the rise in overdose deaths has been driven by the presence of 1 drug in particular, and that is fentanyl. A synthetic opioid often used for prescriptively for things like surgeries or cancer pain, But outside of medical settings, illegally manufactured fentanyl has become a huge problem because it and other synthetic opioids were involved in nearly two-thirds of all overdose deaths during the past year. And while it is true that fentanyl is incredibly potent, The bigger problem is actually that there is a dangerous lack of consistency in the way it's currently distributed within the street drug supply. So you can either know that you're taking it on its own or in something like heroin, but not know how potent what you're taking is, or you may not know that you're taking it at all.

Speaker 3: What we're seeing is that this opioid is being found in a contaminated pill supply in the whole United States. They're using pill presses that look like pills for pharmaceuticals that are currently marketed.

Speaker 4: 1 day, I admitted 3 people into the clinic. All 3 of them said they were taking oxycodone. None of those 3 people had any oxycodone tested in their urine that we tested that day. It was all fentanyl.

Speaker 1: Well, that's not great, is it? The only time you should be surprised by what is in your urine is when you forgot you ate asparagus earlier that day, or, worst case scenario, the Shrunk Down Magic School Bus comes out after a biology lesson gone horribly wrong. So if the current drug supply is this tainted and this dangerous, we thought tonight, it'd be worth talking about the overdoses that it can cause and the things that we should and really shouldn't be doing to prevent them. And let's start by acknowledging some past mistakes, because for decades, we've been fighting a war on drugs that was often fueled by fear and misinformation, directly leading to bad policy. In the 1980s, for instance, the risks associated with crack cocaine use, which were very real, got cartoonishly inflated into fear-mongering headlines about a generation of crack babies, with stories like, Crack Babies Turn 5 and Schools Brace, which was obviously shitty and racist at the time, but has also since been completely debunked.

But that hysteria led to policies like, mandatory minimums that fueled mass incarceration, and laws that criminalized everything surrounding drug use, from paraphernalia to even locations where drugs were used. And unfortunately, we're seeing a similar panic today brewing around fentanyl, which again, is dangerous if ingested or injected. But to hear law enforcement tell it, it's also dangerous to be anywhere near it. Take this video from the San Diego County Sheriff's Department. And before I show it to you, just know, the officer involved here is completely fine, for reasons I'll get to in a minute.

Speaker 5: My trainee was exposed to fentanyl and nearly died. He found a white substance that he suspected was drugs. It tested positive for fentanyl. That stuff's no joke, it is super dangerous. A couple seconds later, he took some steps back and he collapsed.

Speaker 1: Again, don't worry, that officer is completely fine. And there should have been a few immediate red flags there. Not only did the department voluntarily release that body cam footage, they also went to the trouble of scoring it with music that can only be described as funeral home slideshow. But the idea that that officer could have been passively exposed to fentanyl and then overdosed is completely absurd. Experts say it is technically impossible to touch fentanyl powder and feel any effects from it, let alone overdose.

And you would have to be in some sort of wind tunnel with massive amounts of fentanyl to accidentally inhale enough to OD. And by the way, a wind tunnel full of fentanyl is quite the phrase there. If you just add, and roving gangs, you've pretty much got how a racist uncle describes Chicago after watching too much Fox News. And the thing is, it's by no means just San Diego. Multiple police departments have put out similar claims of ODing through accidental skin contact or inhalation, which again, is basically impossible.

What those officers were much more likely experiencing were panic attacks, which makes sense in a way, because they'd just been exposed to something they'd repeatedly heard is deadly to be anywhere near. This has now become such a trope, it was a plot point on Blue Bloods, where Donny Wahlberg's partner briefly picks up a tray with fentanyl on it, and then this happens.

Speaker 3: Any idea what she came in contact with?

Speaker 5: Herb says she got fentanyl on her hands. What the hell's happening here? She was fine 1 second, the next minute she's not breathing.

Speaker 3: Fentanyl is a synthetic opioid. 50 to a hundred times stronger than morphine. The slightest exposure can trigger an overdose.

Speaker 1: Yeah, that is complete horseshit. Not that you'd expect any more nuance from a show that's basically Adults Paw Patrol. But... But the point is, it is deeply irresponsible of police to keep perpetuating a medical impossibility and for media outlets to keep amplifying it for a start. It might make people afraid to help someone they see experiencing an overdose, while risk giving someone CPR if they might be covered in powder death.

And also, when you treat a drug like a bioweapon, you justify a punitive militarized response to it. A couple years back, an Ohio man received additional prison time for assault on a police officer after officers searched his car for drugs and found powder that later tested positive for fentanyl. That exposure to fentanyl alone constituted the assault. And look, if fentanyl really were smallpox in a bottle, maybe it'd make sense for total eradication to be our goal, but it isn't. So it frankly makes much more sense to focus on how to protect those genuinely at risk of overdosing on it, and that is the people taking it.

Which is to say that the rest of this piece is actually gonna be about harm reduction. Essentially, harm reduction accepts the reality that people will use illegal drugs and that some either can't or don't want to stop. So, rather than arrest them, we might be better off trying to mitigate the damage done. It's a concept that you might already be familiar with through things like syringe services programs, which give people clean needles and are proven to massively help drive down the spread of disease. And right now, if you genuinely want to reduce the number of overdoses, there are some important tactics that we could encourage.

First, there is drug checking. The simple act of testing drugs to find out what is in them. This can be done through things like fentanyl testing strips or reagent test kits. These are very valuable tools to keep people safe, and yet, thanks to those drug war era laws on paraphernalia that I just mentioned earlier, they're technically illegal in all of these states, making it a liability to carry them, which is just complete madness. Now, thankfully, some states have written carve-outs for specific methods, like fentanyl testing strips, and others are choosing not to enforce their stupid laws criminalizing them.

The problem is, though, police officers may not be aware or indeed care about those carve-outs and are still very much arresting people or using the presence of testing equipment as probable cause for further searches. And all of this means people are still getting locked up because they were carrying a life-saving tool, which is ridiculous. Because if any life-saving tool should be criminalized, it obviously should not be drug-checking equipment, it should be the Heimlich maneuver. I'm sorry, but let's get this very clear here. If you see me choking, that is frankly, none of your business.

If I die, let me die doing my favorite thing in the world, not being surprise hugged by a stranger. Do not touch me under any circumstances. Then, there is the harm reduction method that you're probably already aware of, and that is naloxone, also known by the brand name Narcan. Naloxone, as this woman who works in harm reduction explains, can quickly reverse an opioid overdose.

Speaker 5: So pretend that this here, this is fentanyl coming in your system, right? So when you shoot some up with Narcan, it's like a wall goes up. And so the fentanyl hits the wall, it can't keep on going. The more Narcan you put to the system, the bigger that wall gets.

Speaker 1: So what you're saying is, is it's actually quite easy to reverse an overdose.

Speaker 5: Yes, it is.

Speaker 1: Right, it's incredibly effective. Naloxone has got to be in the Hall of Fame for erasing mistakes. Right up there with the pencil eraser, the control Z key, and starring in Daddy's Home 2. What a fun family! What a cranky dad!

I wonder if there are any fun pranks or voicemails on the set. I bet there were. The point is, though, naloxone is a fucking miracle, which is why it is so frustrating that the FDA currently has it under prescription-only status. Something even the AMA has said should be changed. And while every state has adopted some kind of workaround, meaning an individual can theoretically get it without seeing a doctor first, it can be very difficult.

And for community groups who want to buy it in bulk so that they can distribute it directly to the people who need it the most, it can be basically impossible. And look, there are certain things you would want to go out of your way to discourage people from having in their homes. Nazi flags, pet chips, a TV playing an episode of Blue Bloods. But Narcan is absolutely not 1 of them. But perhaps the biggest step that we could make regarding harm reduction is to properly support overdose prevention centers.

Sometimes called supervised injection sites. They're places where people can bring their own drugs and have access to clean supplies and trained professionals who can intervene in the event of an overdose, as well as direct them toward tons of other services, including addiction treatment, if they so choose. Here's a look inside 1 of them, right here in New York City.

Speaker 6: When we were inside, there were half a dozen clients using drugs.

Speaker 7: No more improperly discarded syringes on the streets, near our schools, in our subway stations. You won't find way less.

Speaker 8: I'm on site, safely, securely, without having to worry about overdose things.

Speaker 6: The voice behind the divider belonged to a man named Oz, who told us he's a Marine Corps veteran and was using heroin as we spoke.

Speaker 8: I've gotten more help here than I've gotten from, you know, from the VA.

Speaker 1: Wow. That is incredible. And I know that we as a society have learned not to trust anyone named Oz, who is either yelling at you from behind a curtain, or trying to talk to you about something medical. But we should make an exception here on both counts, because this particular Oz makes a very important point. Overdose prevention centers provide crucial services that keep people who use drugs as safe as possible.

And yet, whenever they are floated as an option, people freak the Fuck out.

Speaker 9: It's actually a heroin shooting gallery, and that's really what it is. It is a community center for heroin addicts to go and shoot up under supervision, which I think is crazy.

Speaker 7: The best way to prevent overdoses from heroin is to have people stop doing heroin. They called it harm reduction centers. But in my way of thinking, it's really harm enabling centers.

Speaker 0: There's so many other things to deal with than, you know, letting people shoot up safely. It's... It's just like condoning doing drugs. It's like, why don't I go do it?

Speaker 1: Okay, but that's not at all what these centers are for. They're not for the heroin curious to sample flights of syringes like IPAs. They're to help people who already use drugs do so in a way that won't fucking kill them. We know overdoses often happen when people use drugs alone with no 1 around to help them, and these facilities are designed to make sure that that doesn't happen. And politicians who actually study these sites, like the former mayor of Ithaca, New York, come away impressed.

Speaker 10: The first time I heard it, I thought it sounded like we were just enabling people to use drugs. But the truth is, in the places where it's worked, in Australia, in Europe, in Canada, more people get off of drugs. People who use supervised injection are 30% more likely to enter into treatment. And they're 100% less likely to die.

Speaker 1: Just to underline that last point, 100%. No 1 has ever died there. In fact, there has never been a recorded death in any overdose prevention center on Earth. That is insane. People die everywhere.

People die at Chuck E. Cheese. All the time, by the way. The ball pit there is, and this is true, mostly bones. You want to know that rat's real name?

It's Charles Execution Cheese. And yet, despite the fact that clip was from 6 years ago, Ithaca still doesn't have an overdose prevention center. Because when cities float opening 1, questions around their morality and even legality make it next to impossible. Just recently, an OPC in Philadelphia was prevented from opening after a three-judge panel found it violated a provision in federal law known as the Crack House Statute, which bans facilities that operate for the purpose of using illegal drugs. Yet another 1980s law that we're still suffering from, which is just infuriating.

So often, the problem facing all harm reduction programs is that people are so angry with those who use drugs, they want to try and punish them into abstinence. But that is not how any of this works. And advocates have been trying to tell us this for a long time. Like Louise Vincent, who points out that for decades, we've been going at this completely wrong.

Speaker 11: All we do is disconnect people in the United States. So if you are found to be a person who uses drugs and needs help, we start with disconnecting you. And I truly believe that addiction is the opposite of connection. So what we do is everything wrong to help a person. We disconnect people from their families, we disconnect people from their friends, we alienate people from work, we disconnect them from community, and then we disconnect them from their freedom, finally.

And when people finally have nothing left... Then they will use until they die.

Speaker 1: Right. When people have nothing left, they will use until they die. It is fucking dark, it's horrible, and right now, you can make a pretty good case that, deliberate or not, it is the end goal of U.S. Public health policy. So, given that, what do we do from here?

Well, for starters, the FDA should remove naloxone's prescription-only status, and they should do that right now. And crucially, not just for expensive brand-name nasal sprays like Narcan, but for low-cost generic naloxone, which is 30 times cheaper. As for state legislatures, they should re-examine their paraphernalia laws to make sure that people aren't held liable for holding basic protective tools like drug testing equipment. And finally, we need a full-throated endorsement of overdose prevention centers from the Biden administration. Because remember, right now, as Philly is finding out, they are arguably illegal thanks to that crack house statute.

Now, the Biden administration could intervene here and take a stand in their favor, which is, frankly, the very least that Biden could do. Because if you're wondering, who is the guy who authored the crack house legislation, I've got some bad news for you. I'm the guy who authored the crack house legislation. Oh, thanks for clarifying, Joe. Nice Larry King costume, by the way.

And look, this administration has done some real good in being the first to broadly endorse harm reduction tactics. But advocates say that much, much more is needed, including making sure that people who use drugs have a seat at the table during policy discussions and the funding gets to community-based organizations providing the most services for them. But we all need to get on board here. Our ingrained stigmas around drugs and the people who use them run really deep. And if we actually want to minimize deaths and keep people safe, the facts point in a very clear direction.

We need to meet people where they are, help them transition into safe drug use to stay alive, and remove barriers for those seeking addiction treatment. And what we absolutely need to stop doing is spreading misinformation and warehousing drug users in prisons. Or to say all of that much more succinctly, it is well past time to start paying attention to the man behind the curtain.

Speaker 0: You

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Harm Reduction: Last Week Tonight with John Oliver (HBO)