AS THE TOLL from COVID-19 continues to climb, health misinformation has taken an increasingly visible role in stoking this deadly pandemic. Rumors and politicization of masks, vaccines, and other basic prevention measures are costing lives, while straining already threadbare health care resources.
When it comes to America’s other historic public health crisis—drug overdose—the role of health misinformation is less recognized. But it is no less deadly.
The overdose crisis has spiraled from bad to worse, claiming over 840,000 lives since it began in 1999. Most recent statistics suggest that the COVID pandemic sparked a major surge in overdoses, with disproportionate impact on Black and brown communities. Just like with COVID-19, basic public health prevention measures are known and available to prevent death and suffering related to drug use. And just like with COVID-19, these vital tools remain tragically under-utilized. Health misinformation is a major culprit.
Take, for example, lifesaving harm reduction measures like syringe services programs (SSPs). These programs offer overdose education and distribute the opioid antidote naloxone, along with access to (and disposal) of syringes, other injection equipment, linkage to addiction treatment services, and vaccination, testing, and treatment referral for infectious diseases such as hepatitis C and HIV. Reams of research conclusively show that SSPs are some of the most beneficial and cost-effective tools to address addiction, overdose, and other negative consequences of drug use. These include a 50 percent reduction in new cases of HIV and hepatitis C and huge uptake of lifesaving drug treatment.
Over the decades, SSPs have sparked panic over supposedly “sending the wrong message,” fueling crime, and causing litter. In response, researchers have repeatedly studied, but could not confirm, alleged harms of SSPs, finding instead that SSPs reduced discarded syringes, didn’t have impact of crime, and did not encourage mythological “naloxone parties” or initiation of injection drug use.
Buoyed by evidence, SSPs have proliferated across the globe. But in the US, their number and scope remain dangerously limited. This is because policymakers and various “NIMBY” interest groups continue to parrot debunked claims about SSPs, evidence be damned.
Misinformation on SSPs and other harm reduction programs has been weaponized to propagate toxic laws, designed to create barriers for program funding and operation. Many states still do not authorize syringe services, while treating syringe possession as a crime. Others only allow for operation of programs under a declared “state of emergency,” creating endless red tape and making these already fragile programs vulnerable to political winds. Until 2018, federal law blocked the use of federal funding to support SSPs; a ban on purchase of syringes with federal funds remains in force.
This misinformation also directly impacts whether syringe programs live or die. In March of 2020, the CDC determined that 44 states and Washington, DC, 1 tribal nation, and 1 territory were at risk for outbreaks of hepatitis and HIV and could benefit from the presence of syringe services programs. As a result, just 1 out of every 5 young individuals with hepatitis C live within 10 miles of a syringe service program. This issue has become even more pressing during the COVID-19 pandemic, which has seen a worsening of the overdose crisis and the emergence of HIV and hepatitis C outbreaks across the country.
When progress has been made, it has been fragile. Just recently, commissioners in Scott County, Indiana, voted to shutter the very syringe services that had halted that county’s drug-related HIV outbreak—the worst in United States history. Their deliberations cited many of the myths about syringe services debunked by research, including that these programs drive syringe litter.
Driven by misinformation, West Virginia’s senate voted in favor of a bill that would increase restrictions on accessing syringe services programs. Most recently, Atlantic City, New Jersey, is set to close Oasis, the largest syringe services program in the state, leaving thousands of individuals who inject drugs without access to vital prevention services.
And this is just the tip of the iceberg: over the past year, the number of syringe services programs in the United States has dropped nearly 10 percent. The unceremonious closure of these programs highlights the dire consequences of allowing misinformation go unchecked.
Syringe services are just one example of the broader infodemic on prevention of overdose and other drug issues. Many of the myths are actively promoted by government agencies, including DEA’s sensational warnings about supposed deadly risk of touching the synthetic opioid fentanyl. As governments at all levels continue to mislead the public on drugs, the rehab-industrial complex is fleecing patients and families with “treatments” that often do more harm than good.
As we struggle to contain COVID-19, we are spectacularly failing to flatten the curve of the overdose crisis, already two decades in the making. We need to do much more to track and extinguish health misinformation that is driving policy and other responses to these critical challenges. The public’s health demands it.
John Messinger is a Harvard Medical School student interested in the intersection of addiction treatment and policy and a member of the Health in Justice Action Lab at Northeastern University School of Law. Leo Beletsky is a professor of law and health sciences and is the faculty director of the Health in Justice Action Lab at Northeastern University School of Law. He holds an interdisciplinary appointment with the School of Law and Bouvé College of Health Sciences.