The coronavirus pandemic has compounded North America’s overdose crisis. Just in the United States, drug overdoses have already claimed nearly a half million lives since 1999. Now authorities across the country are reporting a surge in overdose deaths as part of the pandemic fallout, with fatality rates rising by 100% in some counties. By disrupting treatment and harm reduction services, triggering economic shocks and trauma, and severing social support networks, the pandemic is undermining any progress being made in overdose prevention. At the same time, people who use opioids and other drugs are especially vulnerable to coronavirus infections and severe disease because of health and structural stressors.
In responding to these overlapping public health emergencies, we must draw on the full spectrum of science-driven prevention measures. Such measures include rapid scale-up in access to critical overdose prevention medications, including methadone, buprenorphine, and the opioid antidote naloxone. But we must also expand the limited toolkit of overdose prevention efforts in the United States to include overdose prevention sites.