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Epidemic of deaths from fentanyl overdose

BMJ 2017; 358 doi: (Published 28 September 2017) Cite this as: BMJ 2017;358:j4355
  1. M Eugenia Socías, postdoctoral fellow1 2,
  2. Evan Wood, professor1 2
  1. 1British Columbia Centre on Substance Use, Vancouver, BC, Canada
  2. 2Department of Medicine, University of British Columbia, Canada
  1. Correspondence to: M E Socías esocias{at}

Another serious side effect of the war on drugs

Strategies to tackle the harms of substance misuse and addiction remain among the most controversial areas in public policy.12 Although new ways of thinking are slowly emerging, the overwhelming model in the past century has involved the criminalisation of production, sale, and possession of illicit drugs.12 This is despite a large body of research showing that this approach has not only been unsuccessful in decreasing the availability and use of drugs, but has also had numerous severe unintended negative public health consequences, including increased health harms, incarceration rates, and violence in the drug market.12

History has also shown repeatedly that the emphasis on criminalisation often results in the emergence of more potent and potentially toxic drugs.3 Such behaviour was observed during alcohol prohibition in the US and with the criminalisation of opium, which prompted a shift from smoking to more potent forms of opioids and riskier modes of administration, including heroin injection.3 To make matters worse, controlling the potency …

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