- Opioid crises are very old in New York.

(pensive music) There was a particular problem right after World War II with heroin injection.

Governor Nelson Rockefeller in the early '60s decided that federal criminalization was simply not enough, so he decided to try treatment.

Now, that treatment was punitive.

It was mandatory treatment.

Most treatment prior to methadone maintenance, which began in New York in 1965, was talk therapy, abstinence-based, stuff we know does not really work.

And so, although methadone maintenance began in New York in 1965, it was not scaled up until about 10 years later.

Governor Nelson Rockefeller became impatient with what he saw as the failure of drug treatment prior to the 1970s.

He didn't really give methadone maintenance a chance and he decided in 1973 to double down on criminalization.

He decided we should lock people up.

And if we took people off the streets for possession and trafficking, then we would nip it in the bud.

That turned out not to work, in part because of the way that illicit drug suppliers responded.

In many ways, the Rockefeller laws spur innovation among illicit drug dealers and suppliers.

Mass incarceration disproportionately affected communities of color, families, partners, spouses and of course, the incarcerated individual.

In the late '70s opioid overdose deaths begin to tick up at a rate of 9% a year into the present day.

It began to become a public problem.

It had to be made a public problem.

The people who made it a public problem are what we call harm reductionists.

Harm reduction is practical intervention, any positive change that you can make in a drug user's life or health.

In New York City, harm reduction grew out of the HIV/AIDS movement in the 1980s.

It doesn't criminalize, it doesn't punish.

It was meant to address health at a much broader social level.

So treatment and harm reduction are the main ways that we are going to reduce opioid overdose deaths in this country.

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