Re: “Fentanyl crisis needs a turning point, so what is being done?” [March 3, A1]:
The fentanyl overdose epidemic warrants novel approaches supported by proof. Traditionally, when a affected person’s in poor health well being introduced a threat to others, as in a tuberculosis epidemic, well being officers had the authority to quarantine and make sure the in poor health individual acquired ample therapy earlier than returning to the neighborhood. There understandably must be limits to conduct that places others at important threat, not to mention the person. The prison authorized system shouldn’t be the primary to impose these limits when a treatable medical sickness exists. The prison authorized system was not designed for and doesn’t guarantee skilled medical care.
Proof strongly helps contingency administration in addressing substance use issues. Profitable contingency administration rewards wholesome conduct, typically with nominal rewards. That is in distinction to the present punitive and shaming approaches.
We should ultimately tackle social determinants, the supply of abusable substances and different threat elements. The precedence is to make sure these struggling and who’re at important threat of dying obtain well timed care. I urge care to be free and to implement a public well being and contingency administration strategy the place punitive and shaming approaches are hardly ever wanted. We hold doing it in the identical outdated methods whereas anticipating completely different outcomes.
J. Kimber Rotchford, MD, MPH, FASAM, FACPM, Port Townsend
