Bay Bridge Harm Reduction

07/24/2026

MOTAA 2.0 needs to pass NOW. Period.

For decades, we’ve treated methadone like it’s the MAT boogeyman, somehow more dangerous than other medications used to treat opioid use disorder. It isn’t🤦🏼‍♀️. In fact, like MAT in general, it is considered THE gold standard. The science has been clear for years. The barriers aren’t based on evidence. they’re only based on stigma & outdated policy.

Methadone is the gold standard for treating OUD. Study after study after study has shown that people receiving methadone treatment are more than 50% less likely to ☠️ than those who aren’t in treatment. COVID literally proved what proponents said: “that more ‘take homes’ would equal more OD’s.” But it didn’t. It reduces illicit opioid use, keeps people in treatment longer than any other medication, lowers the risk of HIV & hepatitis C transmission, reduces crime, improves employment, & helps families stay together.

Yet despite all of that, methadone is still locked behind a system created over 50 years ago.

Just take a second to really think about it. What has been the same medical wise for that long? If you have diabetes, you don’t have to drive an hour every morning to a special clinic for insulin. If you have ADHD, you don’t have to report to a government-approved center every day for your medication. But someone with opioid use disorder often has to do exactly that just to receive an FDA-approved medication that’s been safely used for decades. We should be removing hoops, not adding more.

Sorry, but letting JUST OTP’s (methadone/MAT clinics) dispense it still isn’t healthcare. That’s discrimination.

MOTAA 2.0 would allow qualified addiction specialists & other authorized clinicians to prescribe methadone for OUD, with community pharmacies able to dispense it. Just like almost every other developed country already does, & what we do with every other medicine.

There are over 60,000 community pharmacies in the U.S., but only about 2,100 opioid treatment programs (OTPs, “methadone/MAT clinics”). Around 80% of U.S. counties don’t even have an OTP- including QAC until a few years back, forcing many people to travel hours every day or simply go without treatment. Sorry, but that isn’t expanding access, it’s restricting it. It’s making it harder for people.

Some people argue methadone is “too dangerous.” As if pharmacies don’t dispense meds on par or even stronger. (No judgement, these meds are often needed for many) But when it’s prescribed & monitored appropriately, it’s a safe, effective medication. Majority of people wouldn’t even know somebody was on methadone, tbh. The biggest risk isn’t methadone itself, it’s people not being able to access it.

The OD crisis isn’t slowing down because we keep making lifesaving treatment harder to get. In fact, with recent bans & changing of the illegal street supply with a new substance even stronger than fent starting to pop up (starts with a C, can’t spell it) now more than ever; we NEED to use every tool we have. Because bans don’t work.

We’ve trusted the evidence with buprenorphine. It’s time to trust the evidence with methadone, too.

MOTAA 2.0 is about treating opioid use disorder like the medical condition it is, not a moral failing. It’s about replacing stigma with science & giving people a real chance to survive.

It’s long overdue. Let’s get it done. If you feel just as strongly, PLEASE call your legislators & let them know!

07/18/2026

It’s always amazed me how differently people treat MAT compared to every other medication.

Nobody questions someone with chronic pain who depends on medication to function. Nobody asks a diabetic, “But what if you can’t get your insulin tomorrow?” They understand those medications are treating a medical condition & helping that person live a normal life.

But the second it’s methadone or bup, suddenly it’s, “Well what happens if you miss a dose?” or “You’re just trading one addiction for another.”

Why the double standard?

Yes, people on MAT are often physically dependent on their medication. So are people taking steroids for adrenal insufficiency, many seizure medications, antidepressants, benzos, stimulants for ADHD, & countless other medications that shouldn’t be stopped abruptly. Physical dependence is a normal biological response to many medications. It is not the same thing as addiction.

The irony is, MAT is one of the most studied treatments in addiction medicine. Decades of research have shown that methadone & buprenorphine reduce illegal opioid use, help people stay in treatment, lower the spread of HIV & hepatitis C by reducing IV drug use, decrease criminal justice involvement, & most importantly…they save lives.

One large NIH-funded study found that after a nonfatal OD, people treated with methadone had about a 59% lower risk of ☠️ from another opioid overdose, while bup reduced that risk by about 38%.

A more recent federal study found similar results. Among Medicare patients who survived an OD, methadone was associated with 58% lower odds of ☠️ from a later OD, & bup with 52% lower odds. Yet only about 4% of those patients actually received medication for OUD.

We don’t shame people for taking insulin. We don’t shame people for taking blood pressure meds or antidepressants. We don’t - we’ll shouldn’t, but it’s starting to sadly- tell someone with chronic pain they’re “not really in recovery” because they need medication.

So why do we do it to people with opioid use disorder?

If someone is alive, rebuilding their life, working, raising their kids, & staying out of the dangerous unregulated illegal drug supply because of a medication prescribed by a doctor…that’s not failure. That’s healthcare. That’s recovery. & frankly, we should be celebrating it instead of stigmatizing it.

Drugs for opioid-use disorder reduced the risk of death by about half for people who’d previously had an opioid overdose. But less than a third of participants received these drugs.

06/26/2026

Get your Narcan in Kent County at this kiosk!

06/26/2026

Let’s talk about how we treat addiction in this country, because the current system is broken, punitive, & actively working against the people it’s supposed to help.

Imagine if you had to stand in a line outside at 5:30 AM every single day just to get your insulin or blood pressure medication. If you’re 10 minutes late because your kid missed the bus or your car didn't start? Too bad. Got a flat? Sorry🤷🏼‍♀️ No medicine for you today.

That is exactly how we treat people on methadone. We force them into a highly restrictive clinic system that treats a medical condition like a criminal probation program. & it makes zero sense. Methadone & MAT in gen is THE gold standard for OUD, & studies show it cuts mortality rates by 50% or more. Yet, we lock it away behind a multi-layered wall of bureaucracy. Let’s not even go into the fact on average, most drive 45 mins-1 hour one way to get to their clinic, because especially in rural areas, there may not be one close. QAC just got our first- & still only- MAT clinic just a couple years ago. But most other rural counties don’t have one. That’s a lot of people without access. There’s no reason methadone should be treated any differently than bup, IMO.

We need to completely rethink addiction treatment, starting with three major shifts:
1. Move methadone out of *just* specialized clinics: It belongs in community pharmacies & primary care offices. During COVID-19, the government relaxed some methadone rules, & guess what? Peer-reviewed studies found that giving people easier access didn't lead to a spike in overdoses or diversion. It actually kept people in treatment longer. For those that like the clinic system, fine. But allowing regular doctors to prescribe, like they do other MAT meds, perhaps even telehealth one day, can also be a good thing.
2. End the punitive "take-home" gauntlet: Right now, getting a few days of take-home doses requires jumping through hoops for months. But the second someone has a "slip" or tests positive once? Heck, with some clinics, you don’t have to fail a UA, just violate even one of the most minute policies they may have, that has nothing to do with slipping/relapsing. The system immediately strips their take-homes away & forces them back into the daily line. Relapse is a documented, normal part of recovery. Punishing someone by destroying their daily stability (and often risking their job because of rigid clinic hours) is counterproductive & cruel.

3. Individual care over rigid rules: Treatment has to be case-by-case. If a system's rules make it impossible for a person to hold down a job or take care of their family because of limited morning hours, that system is failing the patient.
Methadone saves lives, but only if the barriers to getting it don't break a person first. It’s healthcare, not a punishment detail. We need less red tape & more actual compassion.

What yall think: How has the clinic system impacted you or your loved ones?👇

06/14/2026

🚨Harm Reduction Hot Take🚨

I know this may be an unpopular opinion in some circles, but I don’t agree with replacing the term “overdose” with “poisoning.” 🤷🏼‍♀️

Before anyone comes for me, hear me out.

An overdose is the medically accepted term used by the CDC, SAMHSA, NIH, addiction treatment providers, emergency departments, medical examiners, & pretty much every major public health organization. An overdose simply means a person took more of a substance than their body could handle. It does NOT imply intent, blame, recklessness, or that someone “deserved” what happened.

People overdose for all kinds of reasons.
• They unknowingly consume fentanyl.
• They knowingly consume fentanyl.
• They relapse after a period of abstinence & their tolerance is lower.
• The potency is stronger than expected.
• Other substances are involved.
• Their health status has changed.

Those situations are all different, but they’re still overdoses.

I completely understand why some advocates use the term “poisoning.” The illicit drug supply today is absolutely more dangerous & unpredictable than ever before. Fentanyl, nitazenes, xylazine, medetomidine, benzodiazepines, & other substances have changed the landscape dramatically.

But here’s where I disagree:

Not every fentanyl-related death is a poisoning.
If someone intentionally uses fentanyl & experiences respiratory depression because the dose exceeds what their body can tolerate, that is, by definition, an overdose.

If someone unknowingly consumes fentanyl in another substance, that’s still an overdose medically, even though contamination played a role.

Changing the word doesn’t change the event.

What concerns me is that we’re spending so much time arguing over terminology when there are much bigger issues staring us in the face:

- People still can’t access treatment when they need it.
- Many communities still don’t have adequate naloxone distribution.
- Stigma is still killing people.
- The drug supply remains unregulated & increasingly toxic.
- Housing, mental health care, transportation, & recovery supports remain inadequate.

As someone who works in treatment AND harm reduction, I’d rather focus on the things that actually save lives:

- Naloxone
- Drug checking
- Methadone & Buprenorphine (MAT)
- Outreach
- Education
- Meeting people where they’re at

Words matter. Accuracy matters. But keeping people alive matters more.

Call it an overdose. Carry naloxone. Love people where they’re at.

05/15/2026

Texas is trying to push a bill called the “Deal Death, Face Death Act” that would make fentanyl distribution cases eligible for the 💀PENALTY if someone overdoses and passes. Yes, seriously. Now yall already know my feelings regarding DIH laws- & the reasoning is pretty much the samw for this bill….

& I already know people are gonna comment “good.” But have we learned absolutely nothing from the failed war on drugs? Nope.

We punished & arrested our way straight into the fentanyl era. Crackdowns don’t magically stop demand, they just make the supply smaller, stronger, easier to hide, & WAY more dangerous. That’s literally why fentanyl replaced he**in on the streets in so many cities, including Baltimore. Now we’re seeing xylazine, benzo & fent analogues, nitazenes, medetimine (sp) & other tranquilizers replacing each other too. Heck- we’re now at th point where new, stronger substances than Fent is being laced into fentanyl…. Every time they crack down on one thing, another stronger or riskier substance pops up.

This bill will NOT stop overdoses. It will make them worse.

People will be terrified to call 911 during overdoses if they think they could end up charged with murder or facing life-ending consequences themselves. Witnesses disappear. People use alone. Supply gets pushed further underground. Harm reduction workers have a harder time reaching people. Everybody gets quieter, more scared, & more isolated, & people 💀

We already have evidence showing punitive drug laws don’t reduce overdose 💀: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8154745/

Even public health experts have warned that harsh drug-induced homicide laws discourage people from calling for help during overdoses:
https://www.networkforphl.org/wp-content/uploads/2023/08/Drug-Induced-Homicide-Laws-and-Overdose-Prevention.pdf

& meanwhile? The people actually making millions at the top usually aren’t the ones getting caught up in this. These laws overwhelmingly hit low-level users, friends, partners, people that use together & only one survives & people struggling with substance use disorder themselves. (yes, I know somebody that did prison time because his GF passed. He wasn’t a dealer, they just used together. He was grieving too, but yet caught an m-word charge)

You cannot 💀 your way out of a public health crisis.

If politicians actually cared about saving lives, we’d have:
• more detox beds
• more treatment access
• affordable healthcare WITH doctors actually being able to treat people- even if that requires controlled medications (yes he pendulum has swung to the other extreme at this point)
• expanded MAT access (ALL options)
• housing
• fentanyl & ALL test strips
• overdose prevention programs
• real mental health support

Harm reduction saves lives. Fear & punishment never have. & they never will.

https://roy.house.gov/media/press-releases/rep-roy-introduces-deal-death-face-death-act-targeting-fentanyl-dealers-who

This review provides an update on recent published literature on the rise of illicit fentanyls, risks for overdose, combinations with other substances, e.g. stimulants, consequences and treatment.Overdose due to illicit synthetic opioids (e.g. fentanyl ...

05/07/2026

People really do not understand how dangerous this is🤦🏼‍♀️

Harm reduction is not “supporting addiction.” It’s keeping people alive long enough to have a chance at recovery someday. You cannot recover if you’re 💀

Getting rid of or limiting things like test strips, syringe services, outreach, Narcan distribution, education, etc. is NOT going to stop people from using. It’s just going to make the drug supply even more dangerous & people even more isolated. We already have enough people 💀 alone as it is.

& honestly, politicians & people making these decisions are once again showing they are completely out of touch with what is ACTUALLY happening on the streets. They focus on one substance or one additive & act like banning or cracking down on it fixes the problem. It doesn’t. Prohibition never has worked! We saw it with h, then illegal fent, then with xylazine/tranq. Now that that been banned, medetimeine.. plus the benzo & fent analogues, nitazenes, & the bulking cuts. The second one thing disappears, another tranquilizer or sedative replaces it. That has ALWAYS happened. The supply adapts faster than policy ever will.

People in harm reduction, outreach, recovery, EMS, ERs, shelters, MAT clinics, etc. have been saying this for YEARS. You cannot arrest or punish your way out of this epidemic. Fear tactics & abstinence-only approaches alone are not enough. Multiple pathways to recovery exist whether people like it or not.

Meanwhile we STILL don’t have enough detox beds, rehabs, long-term treatment, mental health resources, transportation, housing support, or even basic help for people trying to get better. But somehow taking away harm reduction tools is supposed to help?

No. It’s going to cost lives. Again. That steady decline of f-OD’s is slowing.

A lot of us carry Narcan because we’ve already buried too many people. Some of us do outreach because we lost family or friends ourselves. This isn’t politics to us. These are real people.

Meeting people where they are at saves lives. Period.

The Trump administration underlines a “clear shift away from harm reduction and practices” that it says facilitates illegal drug use.

05/05/2026

Welp- it’s happening again….

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