Fentanyl-Detecting Laser Beams Won't Stop the Overdose Crisis

The technology-obsessed failure of a new blockbuster report on opioids.

Zachary Siegel is a journalist focusing on drugs and runs the Substack Substance.

A press release announcing a gigantic paper on the overdose crisis from Stanford University and the prestigious medical journal The Lancet mentioned some combination of the words “innovation” and “innovative” seven times. The urgent need for innovations to solve America’s overdose crisis is mentioned precisely 40 times in the body of the article, a 50-page opus structured around numerous policy recommendations, ranging from continuing the long search for non-addictive, non-opioid pain relief to using new technology to disrupt the illicit drug supply. 

The paper’s 17 authors, who refer to themselves collectively as “The Commission” tell readers that they are, “dismayed to note the slow pace of innovations in society’s response to drug problems across law enforcement, health care, data science, drug development, and technology.” 

The paper made a huge splash in the science and drug communities, and the reaction was a mix of praise and exasperation. While written with the best of intentions, the authors further a failing philosophy of how to combat overdoses. By focusing on technocratic “innovation” the authors obfuscate the real causes of (and therefore the real solutions to) the epidemic. 

The Lancet researchers spend too much time thinking of ways to limit, control, surveil, and disrupt the drug supply, and give little space to unraveling why, in the 21st century, so many people see an allure, escape, or something else entirely, through drug use. It’s much more difficult to offer a suite of technocratic policy proposals to the latter question. 

Some of the innovations called for by the researchers are genuinely pretty cool. Opioid users who overdose when they’re alone cannot benefit from the life-saving overdose reversing drug naloxone, the authors write. “A possible solution is a wearable device that automatically triggers a naloxone injection based on respiration rate.” 

But the theoretical naloxone injection device is a good example of how technocracy can paper over the base problem.