Sarah Wakeman, MD is the Medical Director of the Massachusetts General Hospital Substance Use Disorder Project and an Associate Professor of Medicine at Harvard University Medical School. She has a wealth of experience treating addiction and has published research on the comparative effectiveness of various treatment modalities for opioid use disorder.

Dr. Wakeman recently gave an interview to the Harvard Gazette in response to the recent news that overdose deaths for the 12 months ending April 30, 2021 reached a stunning 100,000, 75 percent of which were opioid-related, with 85 percent of opioid-related overdoses involving illicit fentanyl.

Her exposition on the overdose crisis covered much more ground than I was able to cover in my letter to the editor of the Wall Street Journal. Among the many excellent points she made was the fact that drug prohibition is a major cause of overdose deaths:

The crisis and its worsening are related to a number of factors. One is the ongoing unpredictability and poisoning of the illicit drug supply. Increasingly, the drug supply is contaminated with fentanyl, and there is a lot of unpredictability in what people are using.

You could compare it to alcohol, where we have a regulated supply. We of course still worry about alcohol use disorder and identify and treat it. But if you’re going to a restaurant or a bar or a store and you’re consuming alcohol, you know the alcohol level by volume content of the product you’re consuming. But imagine if you ordered a drink, and it could be 5 percent beer or it could be 80 proof liquor — that would be huge difference, and you would have no sense of how to regulate that.

She also criticizes the current policy that focuses on curtailing supply and reducing prescriptions, which is an abject failure:

This “let’s just make it harder for people to access it” strategy — a focus on opioid prescriptions, cracking down on the borders, increasing funding to the DEA, and increasing criminal prosecution for drug-related charges — has been wholly ineffective. Yet that’s what we continue to hear about, even now in 2021, and that’s where our funding gets directed.

I encourage readers to read the entire interview, which is available here.