A naloxone kit distributed in British Columbia, Canada (photo from Wikipedia)
With thousands of Floridians dying of drug overdoses caused by fentanyl, Attorney General Ashley Moody has been urging the Biden administration since mid-summer to classify the drug as a “weapon of mass destruction,” warning of the dangers posed if the potent opioid gets into the hands of an avowed enemy of the United States.
“We must not sit idly by until a terrorist chooses to inflict harm using this substance on a large group of Americans – our countrymen are already dying from this poison,” Moody and 17 other attorneys general wrote to Biden earlier this month.
But while the attorneys general push the federal government to act more forcefully to stem the epidemic, the Florida Department of Health and grassroots organizations scattered across the state are working daily in a different way: Help decrease the harms of drug use and prevent overdoses and infectious diseases.
Fentanyl, an opioid, is similar to morphine, but 50 to 100 times more potent, according to the National Institute on Drug Abuse.
The Florida Department of Law Enforcement reported that 5,806 people died of fentanyl overdoses in 2020, a 58% increase over the year before. And in the first six months of 2021, 3,210 fentanyl overdose deaths were reported. The data comes from Florida’s medical examiners.
Florida received a boost of cash from the Biden administration last week to address addiction and the opioid epidemic, which includes fentanyl. The Florida Department of Children and Families received more than $103 million and the Seminole Tribe of Florida received $500,000, part of the more than $1.5 billion in grants the White House distributed around the country to contend with the crisis.
Preventing harmful consequences
Last week in Pinellas County, more than 100 people focused on reducing drug overdoses at the first annual Florida Harm Reduction Conference.
Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use, as defined by the National Harm Reduction Coalition.
Shelby Meaders, executive director of the Florida Harm Reduction Collective, organized the two-day conference last week.
“We really just want to work to save lives,” Meaders told the Florida Phoenix. “To decrease infectious diseases. Decrease overdoses. I mean, we have so many issues going on. We’re just doing our part to save our own people.”
The Florida Harm Reduction Collective was founded in 2019 and received its nonprofit status last year. The group receives funding from the research-based biopharmaceutical company Gilead, AIDS United, the CDC Foundation and other national organizations.
While there have been harm reduction programs in various parts of the country offering sterile syringes for people who inject drugs for decades, the Florida Legislature only sanctioned such a program back in 2016, when it allowed the University of Miami to establish a pilot needle-exchange program. Following documented evidence that the program was working, the Legislature then approved a law in 2019 that would allow counties to start their own exchange programs.
There are five counties in Florida (Hillsborough, Miami-Dade, Broward, Palm Beach and Orange) that have since created syringe exchange programs, and Pinellas is soon expected to become the sixth, according to the Florida Department of Health.
These programs provide new and sterile syringes to help reduce HIV and viral hepatitis infections, while also providing additional prevention services such as vaccinations and testing. And with the surge of opioid overdoses, they now distribute naloxone (also known as Narcan), a medication that can quickly reverse opioid overdoses.
Reducing overdose rates
Harm reduction programs have proliferated over the past five to ten years, says Shana Harris, a cultural and medical anthropologist with the University of Central Florida specializing in drug use and health politics in Latin American and the U.S.
“These programs have proven time and time again through research, let alone anecdotal experiences, to be effective at reducing overdose rates, reversing communicable diseases like HIV and Hepatitis C and connecting people who use drugs with treatment if they so choose,” Harris said at last week’s conference.
The availability of naloxone will improve dramatically this week as every county health department in the state will now distribute the lifesaving medication.
Previously, only 16 county health departments had offered it, said Jennifer Williams, the Overdose Prevention Coordinator with the office of Substance Abuse and Mental Health (SAMH) with the Florida Department of Children and Families. She said at the conference last week that her office has distributed more than 340,000 naloxone kits in the state since 2016, with over 21,000 reported opioid reversals.
Fentanyl test strips
One concrete harm reduction tool that more states are looking to as a way to reduce opioid overdoses is legalizing fentanyl test strips. These are small strips of paper that cost between 75 cents to a dollar that can detect the presence of fentanyl in any drug batch – pills, power or injectables. According to the health website STAT, 31 states have decriminalized their use, but Florida is not among them.
A proposal sponsored in the Florida House by Hillsborough County Democrat Andrew Learned to decriminalize fentanyl strips failed on the last day of the regular legislative session in Tallahassee earlier this year. Learned says that if he’s reelected to his seat in November, there is a “100 percent” likelihood that he will reintroduce similar legislation in the 2023 session and mentioned Palm Beach House Rep. Mike Caruso as one Republican who has spoken about possibly co-sponsoring the bill. Caruso did not respond for comment.
China is the primary source of fentanyl and fentanyl-related substances, according to a 2020 DEA report. That study also predicted that Mexican transnational criminal organizations were “likely poised” to take a larger role in both the production and supply of fentanyl and fentanyl-containing illicit pills to the U.S.
The movement of those drugs coming to the United States has prompted Moody and Gov. Ron DeSantis to call out the Biden administration for what they say has been another tangible failure of having lax security on the southern border.
An NPR-Ipsos poll conducted in late July showed that 39% of Americans (and 60% of Republicans) blame migrants for the rise in deaths from fentanyl in the U.S.
However a report by the libertarian-leaning Cato Institute published earlier this month found that the vast majority of fentanyl smuggled into the U.S. is from Americans — not migrants seeking asylum.
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