OPIN- This might not be a popular opinion—but it’s the truth.
We’re witnessing the devastating consequences of a broken system that’s been ignored while the status quo continues to fail us.
There’s not even legitimate heroin on the streets anymore- for the most part in many parts of the countries. I’ve spoken with colleagues who haven’t seen a positive H test in years. One said it’s been over a decade. But don’t take that as a win—because what’s replaced it is far more dangerous.
Synthetics like fentanyl, its analogues, nitazenes, & now tranquilizers like Xylazine (& the newer medetomidine) have made the supply unpredictable, deadly, & honestly, straight up terrifying.
Xylazine—literally a horse tranquilizer—is causing necrotic wounds, which if not treated, can lead to amputations. At the least, severe scarring will be left over. It also breaks down nasal tissue & ruins teeth.
Right here in Maryland, we were the first in the country to confirm medetomidine, another tranquilizer, in our supply. These aren’t drugs people are choosing—this is just what’s out there now.
A lot of people are getting sober because of this, which is a win I’ll take. But at what cost? What of those still on the streets? They’re stuck dealing with an unregulated, ever-changing poison supply—& we have no idea what the next “cut” will be or how bad it’ll be.
And the scariest part?
Xylazine & similar sedatives do NOT respond to Narcan. We need better tracking, tox results (& what’s being tested for) & transparency around what’s actually out there so we’re not blindsided again by the next “tranq surprise.”
I don’t claim to have all the answers, but here are some ideas other countries have tried—and they’re already working elsewhere:
Portugal: Decriminalized all drugs in 2001 & invested heavily in treatment and harm reduction. It’s treated like a public health issue, not a criminal one. The result? OD deaths dropped to 5 per million—the lowest in Western Europe.
Mali: Implemented free door-to-door healthcare using community health workers. In Yirimadio, child mortality dropped from 154 to 7 per 1,000 live births in under a decade.
Switzerland: Legalized & prescribed heroin in clinical settings. This reduced overdose deaths, HIV transmission, & even crime. Their model is now studied worldwide.
Canada: Implemented “Safe Supply*” programs providing prescribed medications as alternatives to toxic street drugs. These initiatives have been associated with reduced overdose deaths and improved health outcomes.
(Safe Supply programs provide people with legal, pharmaceutical-grade alternatives to toxic street drugs, reducing OD deaths & improving public health)
It’s a harm reduction approach that prioritizes safety, stability, & survival.
QAC NEEDS more than just a MAT clinic. We need real, honest harm reduction. Turning the county purple for a month isn’t solving anything, it’s time we did real solutions- with real evidence based results. More treatment centers would be nice, same as housing like Sober living or Recovery Houses.
Let’s discuss what a safer, regulated model could look like here. Because right now? This is survival mode—& people are dying.
