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As drug overdoses proliferate, one obvious and important policy solution stands out

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Photo: Adobe Stock

Behind the headlines of COVID-19 deaths, the story of North Carolina’s drastic increase in fatal drug overdoses has gone largely untold

During the COVID-19 pandemic, our country has been on a terrifying roller coaster ride of COVID deaths and hospitalizations with dizzying falls and catastrophic rises. But for those of us working in reducing harms from drug use, the pandemic has been a never-ending nightmare of accidental overdose deaths.

Aug. 31 marks Overdose Awareness Day [2]. As we spread awareness about overdose, it’s critically important we uplift the truth: Drug users don’t want to die.

Long before COVID, society was already practicing social distancing with people who are active drug users, sex workers and formerly incarcerated. Our communities were already on the margins of society and having difficulties accessing basic needs; health care, housing and jobs.

With COVID’s arrival so did the start of our nightmare on the frontlines of America’s failed drug war. COVID managed to further marginalize, isolate and exclude people and communities that were already vulnerable and struggling to survive.

After steady progress in reducing overdose deaths by scaling-up syringe access programs in which drug users can access lifesaving harm reduction education and resources, in 2020 we saw a reversal in the progress we had been making.

Last year wasn’t only a terrible year for drug users, but society at large started to experience deteriorating mental health during the pandemic.

But these stressors caused by the pandemic were exacerbated for drug users. Unemployment, homelessness and loss of loved ones contributed to increased reports of depression and anxiety. Pandemic-related stress led to more chaotic drug use.

Another risk factor that’s been more pronounced during the pandemic is polydrug use. We saw supply chains for common household items and commodities experience all kinds of disruption during the pandemic. But this was even more conspicuous for drug supply chains leading to an increased proliferation of adulterated drugs in the informal market, substantially increasing people’s risk for accidental overdoses.

Accidental overdose deaths are entirely preventable through a combination of harm reduction and public health policies.

At a bare minimum, North Carolina’s policy makers can expand Medicaid to increase access to affordable healthcare including medication-assisted treatment and comprehensive health services for drug users. This decision would provide health insurance to over 600,000 North Carolinians with low incomes.

While COVID-19 brought many unexpected challenges, lack of health insurance isn’t a barrier drug users and our communities should still face. Medicaid expansion would not only provide the health coverage necessary for many drug users to access care that isn’t in a jail, prison or emergency room, but expansion now comes with “bonus” federal funding.

Under the American Rescue Plan, North Carolina’s cost of expansion is more than fully covered by the federal government. The additional funding could be invested in any number of ways that would further prevent overdoses in our communities; investment in syringe access programs, scaling-up harm reduction resources and increased funding for treatment centers.

As we recognize Overdose Awareness Day, our state legislature is once again debating whether or not to accept the federal dollars that would bring life-saving health care to many of our state’s drug users. These budget negotiations are more than political games—they will have a significant impact on our state’s future reports of drug overdose mortality, for better or worse.

To help end overdose, North Carolina must expand Medicaid.

Jesse Bennett MSW, LCAS is a former drug user and a formerly incarcerated person. He is the executive director for the North Carolina Harm Reduction Coalition [3]. He participates in the implementation of harm reduction interventions, public health strategies, drug policy transformation, and justice reform in North Carolina through leadership, advocacy, resource and policy development, and education. Jesse has a master’s degree in social work from North Carolina State University and is a certified in integrated harm reduction psychotherapy.