 Latest war on drugs is not being fought on dark street corners and in back alleys millions of Americans are getting their fixes from pharmacies and medicine cabinets at home. Every 19 minutes a person dies from prescription drugs. The number of women dying from overdoses in America is skyrocketing. More women die from overdoses on all drugs than die from car accidents. Illicit drugs in the street are always going to be there but now young people are going to their medicine cabinets and finding a new way to get high. The United States has the highest per capita consumption of opioid painkillers. It also has the highest overdose death rates in the world. In the United States there are about a hundred drug overdose deaths a day. It's more than more deaths than from HIV AIDS. It's more deaths than motor vehicle fatalities, more than firearm deaths. So it's a serious problem. Pain control is a need and anxiety medication is a need. This is good stuff. It's maybe over-prescribing, saturating the streets and there's not an easy answer. I think certain things could be drug monitoring, making sure folks can't go to multiple doctors to get multiple drugs. What we are seeing is when we come down in a criminal justice way on prescription drugs, when we sort of dry up the source people turn to street drugs and to street heroin and then they turn to injecting and that leads us full circle back to where we were except more people who were never involved in street drugs are now involved in street drugs. So any response that we have to prescription drugs has to take that into account and not to go back to a restricting prescription drugs for pain and not to go back to a place where we're punishing people for no reason and we need to have access to adequate drug treatment. We've been dealing with heroin overdoses for decades and no one really cared and now we have people experiencing overdoses and prescription drugs and people taking notice and because of the work that we've done on the ground with heroin users we can begin to apply some of our lessons to prescription drugs. There are four things that we can do from the harm reduction perspective when it comes to preventing overdoses. The first is we need to teach people the signs of symptoms of an overdose. An opiate overdose looks like someone is falling asleep where they're not breathing and they're really maybe too shallow. Second is we have to help people understand how to prevent overdoses in their drug use and this includes pain patients who may take too many pills because they're not getting enough pain relief and we need to help them understand that that's not okay it's not safe to take oh just one more pill if it's not if the pain doesn't go away and for folks who are mixing these pills with alcohol or benzodiazepines like Xanax, clonopin, valium, things like that that's a dangerous situation and the third and most pharmacologically powerful thing is a drug called naloxone. It's an antidote for reversing opioid overdoses. It's been used for decades and it's commonly used in emergency rooms in hospitals, ambulances and it's very safe and pretty easy to administer that can be made available to drug users to pain patients with the instructions on how to use them. These programs that have done this in the United States have have had reports of over 10,000 reversals. There are efforts in many many states to deal with the issue of fatal overdose and Narcan or naloxone distribution made to anyone who gets a prescription for opiates is a solution to that problem that when you get that prescription you also get Narcan or naloxone and then the importance of having syringe exchange programs and outreach programs also being able to distribute it to illicit opiate users is going to be critical. The fourth thing I think as harm reductionists is to what do we do with folks after they have an overdose. There are legal, social, medical implications of surviving an overdose. There are hospital bills to pay there. You may have lost your job because you were you missed work for two or three days because you were recovering from the overdose. We don't do enough to support people in that part of recovery. There are some serious barriers especially with naloxone politically and legally financially at the moment and the first thing is that the price of naloxone in the United States has increased astronomically and it's largely because there's a monopoly and there's one company that has a is the only one who makes the liquid injectable and only one company that makes the intranasal. There's no competition and they have been able to increase the price year after year. This is putting programs who have been doing naloxone distribution out of business. Programs that work with injected drug users across the United States are losing funding. There's always the you know the fear of physicians are writing prescriptions around Narcan because of some of the real or not real feeling of liability around things. These programs could be saving many more lives if there were specific exemptions in the law that allowed for trained non-medical professionals to go into the field and provide the naloxone prescription and naloxone to people who are at most risk for an overdose. In Thurston County you're technically allowed to have naloxone on you but the problem is is that in Olympia especially like a lot of police are still like persecuting people who have naloxone on them and arresting them. Local New York who I'm from where I'm from is has also initiated a 911 Good Samaritan bill in New York that can help save lives by allowing people to call 911 without being without fearing being implicated in a crime. For the first time many middle-class white people with access to health care are actually getting into trouble and dying and so all of a sudden there's an incredible amount of political interest. Honestly like heroin users were overdosing for years and there wasn't so much interest and now that it's people's children who got the prescriptions from doctors or got the drugs from their grandmother's medicine cabinet people are interested and that's great. I think the challenge is not to throw the illegal drug users or the people who didn't get their drugs from a doctor under the bus. It is very easy to say we're just going to focus on the on mechanisms to get naloxone into pharmacies or figure out how to get doctors to give people naloxone and there are a lot of people in this country who aren't getting drugs from doctors and who still need protection and who still deserve to live and naloxone is critical for them too and if we're not careful we'll create a system where the prescription drug users and the people with access to health care get protection and the people on the streets get nothing but more of the same which is doors shut in their face and people saying sorry you deserve to die.