On International Overdose Awareness Day, August 31, more than 50 harm reduction groups in California called on the state government to take action to end the overdose crisis. The groups—which include the San Francisco AIDS Foundation, the Harm Reduction Coalition of Santa Cruz County and the HIV Education Prevention Project of Alameda County—are all part of the California Syringe Exchange Programs (CASEP) Coalition, a statewide mutual-aid and advocacy network of syringe service providers.
“California’s $308 billion 2022-23 state budget does not include the word overdose one time despite it continuing to be the leading cause of accidental death in California,” stated a coalition press release. There were more than 10,000 drug-related deaths in California in 2021, among more than 107,000 nationwide as the crisis continues to grow year-on-year.
The coalition announced that it would host rallies during the day, demanding that the state legislature and administration do more to fund harm reduction programs. Earlier this year, the release noted, the legislature actually cut funding for the California Harm Reduction Initiative, “used to staff low-barrier harm reduction programs at over 1,000 unique sites in 42 counties.”
The collective move comes a little over a week after Democratic Governor Gavin Newsom—who in the past said that he had “long supported the cutting edge of harm reduction strategies” and was “very, very open” to safe consumption sites (SCS)—vetoed legislation that would have funded pilot programs in Oakland, San Francisco and Los Angeles. Like naloxone, medications such as methadone and buprenorphine, and safe supply programs, SCS are proven to save lives.
“Governor Newsom not only used his pen to cosign our participants to death, he did so while blaming his choice on our harm reduction infrastructure.”
Advocates had held out hope until the last minute that Newsom would sign the bill (SB 57), or at the very least let the deadline expire, which would have seen it become law. Instead, he wrote in his veto letter that “the unlimited number of safe injection sites that this bill would authorize—facilities which could exist well into the later part of this decade—could induce a world of unintended consequences.”
“The veto of SB 57 by Governor Newsom to pilot overdose prevention programs in San Francisco, Oakland, and Los Angeles further signals a trend by the state to continue to abandon entire communities of people who use drugs, the majority of them unhoused, without essential life-saving tools,” Laura Guzman, the senior director of the National Harm Reduction Coalition in Oakland, said in a press statement. “We believe that overdose deaths are preventable, and will continue to organize and demand that our communities are a priority and must be taken care of first.”
Newsom’s apparent reversal, which arrived after reports that he was waffling on his decision, has mainly been viewed in the context of a potential presidential run in 2024—and how the would-be candidate feared right-wingers might portray the narrative of a lawmaker with sympathy for people who use drugs.
“Governor Newsom not only used his pen to cosign our participants to death, he did so while blaming his choice on our harm reduction infrastructure,” Soma Snakeoil, the executive director and co-founder of Sidewalk Project in Los Angeles, said in a press statement. “The harm reduction community in California has strong, engaged local leadership, thoughtful drug policymakers, government & public health buy-in, and a well-documented history of evidence based on the ground practices. Some of our programs are so sustainable they have been around for 30 plus years. We are ready & willing to save lives, even if Newsom is not. This decision was not about our lack of preparation, it was about his lack of political courage.”
The bulk of events were in North America, where the presence of illicit fentanyl in drug supplies—but above all, the punitive prohibition that fosters this and other unsafe conditions—has driven deaths to an all-time high.
International Overdose Awareness Day, which has been marked each year since 2001, saw more than 600 registered events taking place all over the world, from Denmark to Tanzania. The bulk of them, however, were in North America, where the presence of illicit fentanyl in drug supplies—but above all, the punitive prohibition that fosters this and other unsafe conditions—has driven deaths to an all-time high.
Commemorating the dead and amplifying calls for harm reduction were the purposes of the launch—by Newark Mayor Ras Baraka, with Vital Strategies, Newark Community Street Team and the New Jersey Harm Reduction Coalition—of a “traveling national Overdose Memorial” featuring a physical installation and digital display. “The memorial is part of a national ‘Support Harm Reduction’ media campaign,” said a press release, “highlighting key interventions—such as safer use supplies, naloxone, medications for opioid use disorder, and drug checking resources like fentanyl test strips—that are proven to save lives, but remain difficult to access for most people in the United States.”
One of the most high-profile protests has been in Manhattan, where VOCAL-NY led demands on the streets for Governor Kathy Hochul to authorize SCS statewide. The first two sanctioned sites in the United States, which opened in the city in late 2021, have since averted hundreds of overdoses.
In Canada, the Vancouver-based Drug User Liberation Front marked one month of operating an evaluative pilot of its compassion club safe supply model by giving away “30 grams of community regulated safe supply” to drug user groups in British Colombia, and by launching a new legal bid for its model to be federally sanctioned. Health Canada denied authorization earlier this year; DULF has repeatedly distributed checked drugs, highlighting the urgent need for safe supply amid a toxic unregulated market.
In recognition that the word “overdose” is frequently a misnomer—most deaths involve combinations of different drugs, often consumed unknowingly—the Canada-based National Safer Supply Community of Practice meanwhile announced that it was reframing the day as Toxic Drug Poisoning Awareness Day, “because we know that the unregulated drug supply is the predominant cause of overdose deaths in Canada.”
Without radical policy changes to increase access to proven harm reduction resources and make drugs safer, the signs are that the North American crisis will continue to worsen. When hundreds of thousands of preventable deaths haven’t been enough to prompt this shift from policymakers, advocates’ anger is as warranted as it is palpable.
Photograph by Bethany Medley