Biden’s fentanyl position has drawn criticism from two quarters

President Joe Biden calls for tough criminal sanctions in response to rising deaths linked to the powerful opioid in his State of the Union address fentanyl are being rebuked by harm reduction advocates who say this approach could make the problem worse, though some in Congress derided the comments and blamed Democrats’ border policies for deepening the crisis.

Reactions highlighted how preventing drug deaths touches deep political, practical and philosophical differences, even when dealing with an unrelenting drug overdose crisis in the US associated with more than 100,000 deaths each year.

After introducing a New Hampshire father whose 20-year-old daughter died of a fentanyl overdose eight years ago, Biden presented a grim statistic: “Fentanyl kills more than 70,000 Americans a year.”

A few lawmakers shouted, “That’s the limit.” The voice of Rep. Andy Ogles, a Republican from Tennessee, rang out loudly, “It’s your fault!”

Biden paused, grinned and continued, laying out his approach to dealing with the crisis, including calling for inspecting more packages and cargo coming into the country.

One sentence in particular — “strong penalties to tackle fentanyl trafficking” — drew applause in the House chamber, but criticism from harm reduction advocates work to contain the crisis.

While such advocates support other aspects of Biden’s framework, they believe that handling the crisis largely as a law enforcement problem is making it worse and that “heavy penalties” could come with the continued inclusion of fentanyl-related drugs in the highest level of controlled substances. This carries higher penalties and makes it harder for researchers to work with them. All fentanyl-related drugs are listed at this tier through 2024, but it’s up to Congress to decide if it becomes permanent.

“When you criminalize things, you create a stigma around substances,” said Maritza Perez Medina, director of federal affairs at the Drug Policy Alliance. “If people know they’re going to get into trouble because of substance use, they’ll be reluctant to call for help.”

Harry Cullen, an organizer for the PAIN harm reduction advocacy group, said efforts to control the supply of fentanyl have led to the emergence of other, even more dangerous substances in the drug supply, such as: xylazineused as a veterinary tranquilizer, and nitazeneanother class of opioids.

“Doubling criminalization isn’t the way to go,” Cullen said.

Harm reduction advocates are calling for increasing availability of drug-assisted treatment and taking action to prevent fatal overdoses through measures such as providing supplies to test drugs for fentanyl and naloxonea drug that reverses opioid overdoses.

Asked about the disappointment of some public health advocates that Biden failed to introduce new treatment initiatives, White House press secretary Karine Jean-Pierre said Wednesday that Washington “has more work to do.”

The government has taken some efforts further than previous governments, such as B. Allowing more federal funds to be used for naloxone and making it easier to prescribe anti-addiction drugs.

Not everyone was critical of Biden’s actions. Anne Zink, chief medical officer for the Alaska Department of Health and president of the Association of State and Territorial Health Officials, said in a statement she applauds his efforts to prevent overdoses, make access to treatment equitable and stop the fentanyl trade.

However, among some Republicans, the overdose crisis is viewed primarily as a border and law enforcement issue.

Fentanyl and related synthetic opioids are potent and can be transported in small amounts. When they first made a big impact in the US about a decade ago, they were mostly made in labs in China and shipped to the country.

That has changed over time. Experts say most of the supply is now made in Mexico from chemicals imported from China. The drug is compressed into fake prescription pills and added to other illegal drugs. Officials say it is brought into the US primarily through legal ports of entry and eludes detection.

Some who overdose on fentanyl are unaware they are using it. But other times, drug users are specifically looking for it.

On Wednesday, 21 Republican attorneys general wrote a letter to Biden and Secretary of State Andrew Blinken urging them to label Mexican drug cartels foreign terrorist organizations.

“The same cartels that produce and distribute this dangerous chemical also murder rivals and government officials, ambush and kill Americans at the border, and participate in an armed insurgency against the Mexican government,” the letter said. “This dangerous terrorist activity on our border will not abate unless we escalate our response.”

Last year, a group of Republican AGs called on the President to declare fentanyl a weapon of mass destruction. No action has been taken.

Regina LaBelle, who served as acting director of National Drug Control Policy earlier in Biden’s presidency, said the US needs to deal with groups bringing fentanyl into the country. “These are transnational criminal organizations that deal in people, gas and drugs,” she said.

But she warned, “If you only focus on that part of the problem, you’re not doing your job.”

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Associated Press writers Aamer Hadhani and Lindsay Whitehurst in Washington contributed to this report.