President Joe Biden’s calls in his State of the Union speech for strong criminal penalties in response to soaring deaths linked to the potent opioid fentanyl are being rebuked by harm reduction advocates who say that approach could make the problem worse, even as some in Congress jeered the comments and blamed the Democrat’s border policies for deepening the crisis. The reactions laid bare how preventing drug deaths touches on deep political, practical and philosophical differences even in addressing an unrelenting U.S. overdose crisis connected to more than 100,000 deaths a year.

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