Blame Overdoses on Syringe Programs? Classic.

Conclusions from a new economics paper fly in the face of 30 years of data. It's the "moral hazard" of naloxone paper redux.

*Update at the end of this post: after it was published I saw the author post an FAQ.

I just read a new paper in the Journal of Public Economics titled, “Syringe exchange programs (SEP) and harm reduction: New evidence in the wake of the opioid epidemic.” What new evidence does this paper reveal? Rather simply: Syringe programs cause an increase in opioid overdoses, especially in rural areas.

From the paper:

“SEPs lead to greater risk of fatal opioid overdoses. Moreover, these estimates reflect large relatively [sic] increases in injection drug-related mortality in treated counties, largely supporting the causal interpretation of the results.”

The study claims that opening a syringe program causes overdoses to increase by a staggering 21.6 percent. Yes, you read that right: causes.

Some people on the internet were very eager to share this new evidence, evidence that in absolutely no way whatsoever comports with their own politics. (p.s. I love that “harm reduction” is in quotes, as though the entire endeavor is made up and bogus).

Matthew Yglesias @mattyglesias

Needle exchange programs are supposed to generate "harm reduction" by reducing HIV rates. @analisapackham finds that they achieve that goal, but also increase opioid overdose mortality — especially in rural areas. sciencedirect.com/science/articl…

So, where to begin with all this?

First, these findings fly in the face of the past 30 years of research examining syringe programs. But those studies weren’t done by economists doing fancy math, so that evidence doesn’t seem to count. Here’s what the CDC and NIH say about syringe programs, which, to be sure, is the exact opposite of what this paper says:

• “New users of SSPs are five times more likely to enter drug treatment and three times more likely to stop using drugs than those who don’t use the programs.”

• “SSPs prevent overdose deaths by teaching people who inject drugs how to prevent overdose and how to recognize, respond to, and reverse a drug overdose by providing training on how to use naloxone.”

• “These programs are not associated with increased drug use, crime, or syringe litter in communities.”

Somehow, decades of evidence got it wrong and those researchers missed the fact that, actually, syringe programs cause a massive surge in overdose deaths after they open, a phenomenon that nobody has ever documented until right now. Only economics and the right set of numbers can reveal societies hidden secrets.

WTF Is Going on Here?