To the editor:

In reading the Nov. 10 article, “Opioid overdose deaths continue to rise in Massachusetts,” I was reminded of a story told by Irving Zola, in which he is feeling like he is standing on the side of a swiftly flowing river, and he hears the cries of a drowning man. He jumps into the water, pulls the man to shore, applies artificial respiration, and just as the man starts to breathe, he hears another drowning person crying for help. And so, he jumps in again, rescues the person, and then there’s another cry for help. It continues: a drowning person calling for help, the rescue, another drowning person calling for help, again and again. It’s so bad, he says, that he has “no time to see who the heck is upstream pushing them all in.”

We must not fail to clearly hear his message. Opioid deaths are most often due to contaminants such as the synthetic opioid fentanyl in the substances being used. We must certainly address the socioeconomic conditions that lead many to addiction, providing support, education, economic resources, and treatment for individuals and communities affected, whether or not disproportionately so. But to truly make lasting and meaningful change, we must focus upstream to see “who is pushing them all in.” We must practice harm reduction. We must acknowledge the use of opioids, and reduce the deaths by stopping the flow of opioids, deliberately laced with fentanyl, cocaine, and other contaminants, into our communities by those upstream, pushing substance users into the river.

Joseph Rukeyser


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