Kentucky lawmakers are considering a bill that would increase criminal penalties for fentanyl distribution.

But critics say the legislation will only result in people being locked up for longer amounts of time and doesn't include any measures to address the state's overdose crisis.

House Bill 215 passed the House yesterday and now heads to the Senate. It would require individuals convicted of aggravated trafficking or importing of fentanyl to serve at least 85% of their sentence before being eligible for release, and prohibits pre-trial diversion.

Carmen Mitchell - criminal justice policy researcher with the Kentucky Center for Economic Policy - explained that it can be challenging in practice to differentiate between importing and possession, and could result in harsher sentences for people who use drugs but have never sold them.

"So there's a lot of discretion with system actors to decide what to charge people with
based on the context," said Mitchell.

She said research shows that as long as demand is high, incarcerating more people for selling drugs does not reduce the supply of drugs or make communities safer.

Under current Kentucky law - people who are convicted of aggravated trafficking of carfentanil, fentanyl, or fentanyl derivatives can be sentenced to between ten to 20 years in prison and must serve at least half of their sentence before being eligible for release.

She added that extending sentences for fentanyl also can potentially exacerbate racial disparities in the criminal justice system, pointing to a 2020 report that found 75% of people serving federal sentences for trafficking fentanyl were people of color.

"And so we know that unfortunately, from the start," said Mitchell, "Black people tend to be charged with the higher, harsher sentences like trafficking and aggravated trafficking."

Mitchell said she believes lawmakers should focus instead on expanding access to mental and behavioral health treatment.

"Kentucky is in the midst of a very serious overdose crisis," said Mitchell. "We stay around the top 10 nationally of all states for overdose fatalities, and it's a very serious problem that continues year after year."

Nationwide, drug overdoses have hit record levels. According to the National Center for Health Statistics, more than 100,000 Americans died of overdoses in 2021 - up almost 30% from the 78,000 deaths in the prior year.

Expanded treatment for opioid addiction is now available in New Mexico.

The state's Department of Health is offering medication-assisted treatment for opioid use disorder in four regions around the state.

Josh Swatek, harm reduction program manager for the New Mexico Department of Health, said medication to treat the addiction should help reduce opioid cravings.

"This is really designed to help reach some of the most rural communities, to really create a safety net," Swatek explained. "Folks have options for substance-use treatment in their local communities."

Swatek noted more than 2 million people in the U.S. have an opioid-use disorder. New Mexico previously offered outpatient disorder treatment in Las Cruces, Albuquerque and Roswell but has now expanded treatment to 30 public health offices. He pointed out in 2022, the state recorded slightly more than 700 deadly opioid overdoses.

Swatek emphasized his department is focused on harm reduction -- acknowledging people use drugs for a variety of reasons -- but can also live healthy, self-directed and purpose-filled lives by adopting specific strategies. He added research shows people are five times more likely to enter substance treatment programs and three-and-a-half times more likely to succeed if they have first participated in harm-reduction programs.

"We're working closely with the New Mexico department of corrections," Swatek stressed. "They're going to be required to offer substance-use treatment as well in their facilities, so that when folks are discharged there's a plan. No matter where they are in New Mexico, we can hopefully continue their treatment in a public health office, if need be."

Swatek acknowledged those struggling with addiction often are stigmatized by their community and harm-reduction programs can minimize risks until they're ready to take steps toward treatment or recovery. He observed some patients have told researchers telehealth has helped them have a greater sense of autonomy and control over their treatment.


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Often celebrated in popular culture, Wisconsin's relationship with alcohol continues to give way to troubling statistics that center around excessive drinking and there are calls to step up prevention efforts.

The Badger State still ranks high for beer production.

Maureen Busalacchi, director of the Wisconsin Alcohol Policy Project at the Medical College of Wisconsin, said consumption levels for all types of alcohol overshadow market gains. For example, all Wisconsin counties exceed the national average for excessive alcohol use. In 2022, the state recorded more than 3,300 alcohol-related deaths.

"This has been an ongoing problem in Wisconsin, in part, I think, how our regulatory system works, how our culture works," Busalacchi observed. "There's maybe not as much enforcement of policies as there are in other states."

She pointed out binge drinking is a major problem, and boosting age compliance checks at places that sell alcohol could help curb the activity among young adults. Busalacchi sees hope at the local level with stronger enforcement at community events, as police agencies take notice of the ripple effects of people being overserved or minors gaining access to these products.

However, she reported people who have developed a drinking problem often encounter waiting lists for treatment programs.

Faith Gladem, executive director of the Harbor Recovery Center, a nonprofit in central Wisconsin emphasizing family support in transitioning to recovery. She said they are able to meet demand through their services but referrals for more intensive help can be an issue.

"When someone needs treatment, we do not have enough treatment beds in Wisconsin," Gladem asserted. "We do not have enough detox facilities that detox with dignity."

Her team wants to help foster a mindset in Wisconsin where alcohol is put on the same level as other substance use disorders. The State Council on Alcohol and Other Drug Abuse recommends more evidence-based education and Busalacchi added it is important to understand not just the short-term effects, such as traffic fatalities but the cumulative impact as well.

"The long-term impact of alcohol use can be cancer. It can also be high blood pressure, heart disease, liver disease, stroke," Busalacchi outlined. "And then there's the social and wellness issues; your family gets frustrated or you're losing work."


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More than 1,000 New Mexicans die from drug overdoses each year, and while there's been a slight drop in overdoses from opioids nationwide, it's mostly offset by those from cocaine and other stimulants.

James Besante, chief medical officer at the Santa Fe Recovery Center, said the opioid crisis is evolving - sometimes described as "waves." Now in its fourth wave, he said the nearly 4% decrease reported by the Centers for Disease Control and Prevention is good news, but doesn't reflect what he's seeing on the ground. He noted that it's common that multiple drugs are involved in overdose deaths.

"Increasingly we are seeing individuals overdose on substances other than opioids," he said, "where their substance has been adulterated with an opioid like fentanyl."

When the United States' opioid crisis was at its peak, New Mexico was sixth among the 50 states for overdoses - about 50 individuals per 100,000 people. If preliminary CDC data showing opioid deaths decreased in 2023 is confirmed, it would be the first annual decrease in drug-overdose deaths since 2018. Besante said any success is good news and offers hope to suffering individuals and families.

About 30% of New Mexico residents live in rural counties, which Besante said are medically underserved - with fewer treatment centers and providers prescribing life-saving medications.

"While in some areas of the country we've seen an explosion of tele-medicine, tele-addiction treatment - that has not found its way into very rural communities," he said, "and oftentimes the local pharmacy is not stocking the medications that are prescribed."

In 2021, almost 107,000 drug-overdose fatalities occurred in the United States. West Virginia was the hardest-hit state, approaching twice the number in New Mexico. Besante saif approximately 25% of clients at the Sante Fe treatment center are unhoused and don't have health insurance.