Hilary Swift

In 2021, roughly 108,000 Americans died of drug overdoses. And yet only a slim fraction—roughly 11%—of people with opioid use disorder (OUD) managed to access evidence-based care in 2020. If we were being graded, that’s an F.

Sam Rivera has pioneered an approach to help, rather than abandon or simply jail—as we usually do—an estimated 7 million Americans with OUD. As executive director of OnPoint NYC, he meets drug users without judgment, instead offering support, clean needles, and critical connections to care that include providing medically supervised injection spaces at three sites in New York City.

To turn our declining life expectancy around, we must scale up Rivera’s harm-reduction approach, which means supporting people who use drugs, not stigmatizing them. Despite what the racist war on drugs told us growing up—and despite archaic abstinence-only models that too many 12-step programs still push—Rivera’s approach actually works to prevent death, hasten recovery, and restore humanity.

Macy is an author who wrote Dopesick and most recently Raising Lazarus: Hope, Justice, and the Future of America’s Overdose Crisis

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