Managing drug use on public transit: A case for smarter enforcement and practical harm reduction

Public transit systems across the country have become front lines of the overdose crisis. While there is not a single national database tracking overdose deaths on public transit systems, independent investigations and municipal health data point to a growing problem.

Between 2018 and 2022, Chicago recorded 158 opioid-related overdose deaths on Chicago Transit Authority property, New York City documented 79 fatal overdoses in the subway system in 2022 alone, and Los Angeles Metro recorded 19 fatal overdoses within just the first few months of 2023. As transit agencies are pushed to manage a public health crisis they were never designed to handle, it places unsustainable pressure on transit workers, undermines rider confidence in the transit system, and exposes the need for a more practical model that combines targeted enforcement, public health expertise, and dedicated safety resources instead of expecting a single workforce to do everything.

Public transit systems are increasingly caught in a negative feedback loop. Visible drug use has lowered public confidence and perceived safety on transit, and riders have responded by avoiding certain times and routes, or public transit altogether. Lower ridership leads to less farebox revenue, which in turn lowers the agency’s capacity to maintain staffing, cleanliness, safety infrastructure, and service reliability. As service quality declines and workforce stress worsens, more riders disengage from the system, creating additional operational strain and compounding existing workforce shortages, as illustrated below. Each stage of the cycle leaves transit agencies with fewer resources and less institutional capacity than before.

The term “role creep”, or “mission creep,” is an apt description for what has happened within transit systems: People who were hired to operate public transit (like bus drivers or train operators) are increasingly expected to take on additional roles, such as fare enforcers, social workers, and overdose first responders. These roles require rapid decision-making, de-escalation attempts, overdose responses, and coordination with emergency services. This stretches transit systems beyond their core institutional purpose and places responsibilities onto workers and agencies that they were not trained or designed to manage.

Each overdose response also carries a cost, takes time, and exposes the agency to liability. When a passenger is found unresponsive, frontline staff alert security or law enforcement, coordinate with emergency medical services, and document the incident. Some administer naloxone—an opioid-overdose reversal medication—then manage the aftermath, including the confusion, agitation, or acute withdrawal that can turn volatile onboard or in a station. Routes are delayed, operators are pulled from their primary responsibilities, and other passengers are affected.

This tension between overdose response and transportation workers sits at the center of a 2025 report from the federal Transportation Research Board’s Transit Cooperative Research Program, titled “The Impacts of and Response to Drug Use on Transit.” The publication reviewed five of the largest U.S. agencies and reached a parallel conclusion: Harm reduction measures such as naloxone administration and syringe access are effective, yet they “may present challenges in ensuring a safe and orderly transit environment for all users.” That tradeoff is worth taking seriously, but it’s not a reason to abandon either goal. Both harm reduction and transit safety are worth pursuing.

Drug use on transit does not exist in isolation from the broader systems surrounding it. Reason Foundation’s interdisciplinary harm reduction framework recognizes that these issues cannot be addressed effectively through siloed policymaking where each agency responds only to its own narrow mandate. Instead, the framework focuses on identifying where systems overlap, where gaps in coordination create avoidable harm, and how agencies can build responses that are practical, proportionate, and operationally sustainable. In the transit context, that means combining transportation policy, targeted enforcement, environmental design, outreach coordination, public health infrastructure, and data-driven evaluation into a shared operational strategy rather than treating each issue as a separate problem with a separate response.

The elements of a proper transit response to the overdose crisis 

A workable response to drug overdose on public transit needs to operate like an actual system with defined responsibilities, clear expectations, and dedicated personnel. As the riders who skip fares and those generating safety incidents are largely the same group, both revenue and safety problems can be effectively mitigated at the entry to the system. Fare gates, tap-to-enter or tap-to-exit systems, onboard validation, and visible fare inspection teams create a layer of accountability before problems spread deeper into stations, platforms, buses, or train cars.

Physical barriers to entry apply the same rules to every rider, making them more of a design tool than an enforcement mechanism. Additionally, they can reduce maintenance costs, lower crime, and increase farebox recovery. For example, San Francisco’s Bay Area Rapid Transit (BART) system replaced older waist-high barriers that a fare evader could jump or skip with new six-foot-tall saloon-style fare gates. That change alone is projected to raise revenue by $10 million per year, paying for itself in under a decade. 

Beyond the impact on annual revenue, these fare gates also had a major impact on maintenance needs and crime. One thousand fewer hours were spent cleaning up the stations, and crime on BART fell by 41% in 2025. This sort of approach worked in Los Angeles, too. LA Metro CEO Stephanie Wiggins said tap-to-exit turnstiles lowered incidents of vandalism and “concerns about safety and security” by 50% at the station where it was implemented. LA Metro data shows that 94% of all arrests on the system and 97% of violent arrests involved riders who did not pay their fare. Buses can’t use turnstiles, but the underlying logic still applies. While these findings do not establish that fare evasion causes crime, they suggest that access control and fare validation can play an important role in improving system management, reducing disorder, and identifying recurring safety concerns.

Transit workers also need clearer operational boundaries. Several transit systems have already begun building more specialized response models.

After repeated concerns about safety, disorder, visible drug use, and declining rider confidence, LA Metro established one of the largest “ambassador” programs in the country. Ambassadors are uniformed employees stationed throughout trains, buses, and transit hubs, but they are not armed law enforcement. Their role centers on visibility, customer assistance, de-escalation, wellness checks, and connecting vulnerable riders with services before situations escalate into emergencies. They also carry and administer naloxone during overdose incidents and coordinate with outreach teams, transit security, or EMS when necessary. The program was designed partly to reduce the burden on transit operators and partly to create a more constant human presence throughout the system.

Several agencies have also begun integrating naloxone access directly into transit infrastructure. For example, the Chicago Transit Authority partnered with the Chicago Department of Public Health to install public health vending machines that distribute naloxone, fentanyl test strips, and other harm reduction supplies in transit settings. 

Denver Regional Transportation District and LA Metro have also invested heavily in environmental design changes alongside staffing responses. These changes included modified station layouts, improved lighting, expanded camera coverage, restricted access to isolated areas, increased custodial staffing, and redesigned circulation patterns to reduce opportunities for open drug use and disorder in stations with high incident rates. After Denver Union Station implemented environmental improvements, calls for security-related services dropped by 60%. 

One feature that makes these programs effective is that they divide responsibilities appropriately. Outreach teams focus on engagement and service connection. Ambassadors focus on visibility and de-escalation. Safety personnel focus on enforcement and emergency response. Transit operators focus on operating transit. Transit agencies that separate these roles more clearly reduce the likelihood that incidents turn into a policing issue or a crisis pushed onto frontline transit staff with little support.

Effective approaches also need to address repeat violators. Riders repeatedly using drugs on transit, threatening passengers, assaulting staff, or creating unsafe conditions will continue to cycle through the system indefinitely without intervention. Temporarily restricting access to transit due to behavioral violations protects other riders while acknowledging that public transportation remains essential for many people trying to access treatment, work, housing, or medical care. Agencies should pair those restrictions with a pathway back into the system through harm reduction education modules, meetings with outreach workers, treatment referrals, or behavioral agreements tied to restored transit access.

Poor data collection remains another barrier to addressing drug-related issues in transit systems. Many agencies still lack consistent tracking for overdoses, repeat incidents, response times, outreach outcomes, or the operational impact these emergencies have on staffing and service reliability. Agencies cannot refine interventions when they do not have a clear picture of where incidents are occurring, who is responding, how long responses take, whether outreach efforts lead to treatment engagement, or which stations and routes consistently generate repeat emergencies.

Public transit systems are not going to solve the overdose crisis on their own, but they also cannot continue functioning as improvised public health systems without a clearer operational structure, better coordination, and more targeted responses. Riders need safe and reliable transportation. Workers need support and defined responsibilities. Transit agencies need revenue to increase response capacity. People struggling with addiction need realistic pathways toward treatment and stability. Agencies that build systems around those realities will be far better positioned to reduce harm, maintain public trust, and keep transit systems functional in the long term.

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Source: https://reason.org/commentary/managing-drug-use-on-public-transit-a-case-for-smarter-enforcement-and-practical-harm-reduction/