New Mexico has long had the highest rates of substance abuse in the country and the problem continues to worsen

 In January 2020, the New Mexico Department of Health (DOH) completed a gap analysis for substance use disorder treatment and found an estimated 134,000 New Mexicans needed treatment yet did not receive it. DOH estimated that roughly 10% (13,000) of that population might enter treatment if it was made more accessible. 

The Image above shows Mortality Rates for Unintended Overdoses in the U.S., New Mexico, and Bernalillo County (Source UNM, 2016)

In 2020, New Mexico reached an all-time high in drug overdose deaths, despite a threefold increase in spending on substance use treatment since 2014, and an 85% increase in service delivery. Drug possession also accounts for a high number of admitted inmates into the state's prison system, increasing 18 % over the last decade. 

Outside factors also contribute to an increase in drug use in the state, the COVID-19 pandemic, also restricted access to services like medication for opioid dependency which must be administered in person. Most of the dollar investments have been appropriated towards the criminal justice system as a direct effect on the criminalization of drugs. However, incarceration is not an adequate solution to the drug war. A different approach is necessary as these actions have not adequately addressed the increasing demand for substances. 

I recommend the following policies to address substance abuse through a harm reduction lens. Targeting substance abuse without the negative stigma, centering on the individual by providing accessible services. 

School-based drug prevention programs

Generate large savings in future health costs and cause a significant reduction in substance use in the community. The New Mexico DOH should expand school-based programs to include opioid prevention, in addition to alcohol, tobacco, and cocaine. According to the RAND Corporation, an effective school-based drug prevention program would cost $150 dollars per student. The state of New Mexico has roughly a total of 50 million (NCES) students multiplied by $150 per student, which would be an estimated investment of seven billion five hundred million. Funding would come from the state of New Mexico to prevent students from experiencing drugs, and ever transitioning to a substance use disorder. 

The difficulty of implementing this policy option does not come from the cost in dollars, but from the lost learning opportunity by students. Diverting limited class time from academics to substance use prevention education could be problematic. 

Overdose prevention centers 

Can reduce overdose deaths. This policy option would call for the operation of two overdose prevention centers, one in the Bernalillo County which has a higher rate than New Mexico in drug-induced death rates, and one in the Rio Arriba County which has an even greater rate of drug-induced death rates in the state. Overdose prevention centers would provide a safe space for people to consume pre-obtained drugs in controlled settings under the supervision of trained staff. The centers would also provide additional services such as medication-assisted treatment (MAT) drugs such as buprenorphine and methadone, these drugs are used to treat opioid dependency. Overdose prevention centers would have a rehabilitation aspect to them, connecting people who have the goal of rehabilitation. In New Mexico, Medicaid funds 91% of substance use services, such as medication, Medicaid would also fund the medication needed to treat substance use disorders. The New Mexico state legislation would barrow the initiative from New York governor De Blasio to create overdose prevention centers as an extension of existing harm reduction services and co-locate with previously established sterile syringe exchange services providers in the Bernalillo and Rio Arriba Counties. 

An example of an overdose prevention center in New York (Source: GothamGazzette https://www.gothamgazette.com/state/11167-new-york-city-expand-overdose-prevention-centers)

The difficulty of this option is the negative stigma substance has in a community. Overdose Prevention centers would require an educational aspect as others would need to understand that overdose prevention centers keep infected supplies out of the streets and save lives. 

Decriminalization of Drugs Local and State governments can determine their enforcement priorities and have broad latitude to enact reforms to reduce the harm of problematic drug use and punishment (expand on background about state powers). Drug criminalization disproportionately affects minorities and low-income people, and a criminal record created barriers that can trap people in cycles of poverty.  New Mexico would increase the number of drugs carried by a person for personal use, removing criminal penalties such as arrest and incarceration. Drug decriminalization is not drug legalization, but instead a matter that results from the high demand for drugs in the state. Instead of wasting millions of dollars criminalizing people for drug use, the money would be directed toward harm reduction treatment and social services. 

Incorporating an information campaign that centers those with a substance abuse disorder as people suffering from a condition of dependency, can help the negative stigma attributed to drug abuse by others. 

These policies are all aimed at reducing the amount of substance use disorders in the state of New Mexico.