Over the past 2 years, the opioid epidemic in the United States has received considerable attention from lawmakers in Washington and from media all across the country. This focus on opioid use disorders in particular--and increasingly on the entire spectrum of substance use disorders--has been unique not only for the sheer amount of coverage it has received, but for the degree of compassion and understanding that has been forthcoming to those living with and affected by the epidemic regardless of political ideology or party. Unfortunately, in many respects this outpouring of surface-level sympathy and desire to eschew punishment for public health approaches to drug user issues is more about the race of who is perceived to be suffering and not the intrinsic humanity of the drug users themselves. 

While there has been a good deal of excellent analysis on why the opioid epidemic's impact on white communities has resulted in a much kinder and gentler approach to drug user health than the crack epidemic of the 80s that predominantly affected black communities and pretty much the length and breadth of the "war on drugs" in general, it is also worth mentioning that the conception of the opioid epidemic we are living through right now as a predominantly white epidemic is a false one. As recent studies have shown, the rate of opioid overdose among Black Americans has skyrocketed in recent years with the influx of fentanyl into the country, and overdose rates for Latinos is on the rise as well, particularly in Puerto Rico, where the devastation of Hurricane Maria and the ubiquity of fentanyl in the island's heroin supply has placed the drug using population at tremendous risk.

According to Carla Correa Cepeda of the harm reduction organization Intercambios Puerto Rico, roughly 90% of the heroin supply in the communities they serve on the island's east coast contains fentanyl. However, the true human cost of the opioid epidemic in Puerto Rico is largely unknown, as the island's government has not released statistics on overdose related deaths and the bulk of the information we have has been collected by small non-profit organizations like Intercambios who don't have the resources and time they need to serve everyone in their communities, much less keep track of morbidity and mortality data for all of the island's drug users. And to make matters worse, their harm reduction efforts have been hampered by a Puerto Rican law that states it is illegal for civilians to possess or administer the life saving drug naloxone (NarCan).

Fortunately for the tens of thousands of Puerto Ricans living with and affected by HIV and the opioid epidemic, a piece of legislation was introduced in the Puerto Rican Senate in 2017 that would undo this damaging law and enable groups like Intercambios and the people they serve to have increased, legal access to naloxone. The bill--known as Senate Project 341--would serve as a "Good Samaritan law", providing drug users and their allies with protection from criminal prosecution for the possession, distribution and use of naloxone. Senate Project 341 would also potentially enable the creation of government-sponsored harm reduction programs, expansion of medication assisted treatment, and even the decriminalization of certain drugs. 

Given the severity of the opioid epidemic on the island in recent years, time is not a luxury that organizations like Intercambios and the people they serve have. And yet, Senate Project 341 has languished in the Puerto Rican legislature for well over a year as the epidemic on the island worsens. The Puerto Rican House of Representatives recently passed their version of Senate Project 341, but the Senate has yet to address the legislation.  

In order for organizations like Intercambios to be able to effectively provide care to the communities that they serve, they must have the support of the Puerto Rican government and the ability to lawfully engage in public health best practices. The passage of Senate Project 341 would serve both of those aims and go a long way towards ending the opioid epidemic in Puerto Rico. AIDS United and our partner organizations in Puerto Rico strongly urge the Puerto Rican Senate to pass Senate project 341 as soon as possible so that it can be sent to the desk of Governor Ricardo Rossello and signed into law. 

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