Substance use and abuse touches virtually every family in the United States. The New York Times ran a front page story last week documenting the explosion of overdose deaths throughout the country. 47,000 Americans died from an overdose in 2014 — more than from either car crashes or guns.
Addiction, overdose, and drug policy reform have become major issues in both the Republican and Democratic Presidential primaries. It has been striking to see how many of the leading candidates have a personal connection to these issues. Jeb Bush has been open about his daughter Noelle’s addiction and time behind bars for using unprescribed Xanax and for being busted with crack cocaine. Carly Fiorina has spoken out about losing her stepdaughter to “the demons of addiction”. Gov. Chris Christie of New Jersey has spoken emotionally about a law school friend who died of a Percocet overdose. The Clintons have lost family friends to overdose and these experiences have been an impetus behind Hilary’s proposals.
I appreciate the new rhetoric from the many candidates saying that drug use and addiction are a health issue, not a criminal issue. But there’s a huge disconnect between this rhetoric and their actual policy proposals. If candidates truly believe that drug use is a health issue, why have none of them come out in support of ending arrests and criminal penalties for drug use and possession? Well over a million people — disproportionately black and Latino — are still getting arrested each year in the U.S. for nothing more than using or possessing an illegal drug.
It’s time that we hold the candidates’ feet to the fire and demand real solutions. Here are eight concrete steps that they should all get behind:
1. Decriminalize drug use and possession. Roughly two dozen countries — most notably,Portugal — and dozens of U.S. cities and states, have taken steps toward ending arrests and criminal penalties for drug use and possession. By decriminalizing possession and investing in treatment and harm reduction services, we can reduce the harms of drug misuse while improving public safety and health. A DPA poll released earlier this week found that 61% of New Hampshire voters support ending arrests for possession of any drug. Punishing people for possessing drugs doesn’t make things better. As long as drug use is a crime, people will be afraid to get help.
2. Make treatment available to those who want and need it. It is tragic that so many people who need treatment can’t get it. It is outrageous that we taxpayers spend, on average, $30,000 a year to incarcerate someone with a drug problem, but we skimp on treatment programs that are less expensive and more effective in reducing illegal drug use and other crime. Too many people who want treatment are told there are no open slots and turned away.
3. Offer methadone and bupunorphine to those with opioid addiction. Methadone and buprenorphine have been the gold-standard treatment for opioid addiction for decades. These replacement therapies can allow people to live normal lives without the highs and lows of illegal heroin and other opioids.
We need to remove the obstacles to making these life-saving medications more readily available and end the stigma that discourages people from seeking out the most effective treatment.
4. Honest drug education. We urge young people to stay clear of alcohol, tobacco and other drugs, but the reality is many will experiment with using substances no matter what. We must teach them the risks and consequences of drug use.
Most overdose deaths are a result of mixing opioids and alcohol but most people don’t know that. Anyone who receives a prescription for a pain medication, knows a person misusing heroin or other opioids, or who cares about keeping people alive, needs to know the incredible risks of mixing with alcohol.
5. Good Samaritan laws for 911 callers. Most people who overdose don’t die. But the chance of surviving an overdose, like that of surviving a heart attack, depends greatly on how fast one receives medical assistance. Unfortunately people are afraid to call 911 because they don’t know if the police who respond will focus on arresting those present rather than saving someone’s life.
More than two dozen states and D.C. have passed “911 Good Samaritan” laws that encourage people to call for help without fear of arrest.
6. Make naloxone, the antidote to an overdose, more available. Naloxone is a safe, generic, inexpensive, non-psychoactive drug that works quickly and is easy to administer. It has saved hundreds of thousands of lives but could be saving many more.
Many states are just starting to take some great steps to get naloxone in the hands of more people, including law enforcement and emergency responders. Anyone who uses opioids for any reason at all should have naloxone readily available, and friends and family who know how to administer it.
There’s no really good reason, moreover, why this antidote should only be available by prescription. If we really want to save lives, pharmacists should be allowed to sell it to whoever needs it.
7. Supervised injection facilities. Dozens of cities around the world have supervised injection facilities where people can inject their drugs in a clean, safe place with medical professionals on hand.
These facilities eliminate overdose fatalities, reduce dangerous drug consumption practices as well as HIV and hepatitis C, minimize the public nuisance of people using drugs in public places and more than pay for themselves by reducing the need for criminal justice and emergency medical services. It has been particularly successful in Canada.
The scientific consensus demonstrating the benefits of these facilities has yet to result in one such facility being opened anywhere in the United States. It’s time already.
8. Heroin-assisted treatment. Conventional treatments do not work for many people addicted to opioids and want to stop taking them. That’s why more than a half dozen countries in Europe and Canada have developed a second-line option: heroin-assisted treatment.
With this treatment, pharmacological heroin is administered under strict controls in a clinical setting to those who have failed to succeed with other treatment options. Virtually every published evaluation of heroin-assisted treatment has shown extremely positive outcomes: major reductions in illicit drug use, crime, disease and overdose; and improvements in health, well-being, social reintegration and treatment retention.
The hundreds of billions of dollars spent on the drug war has nothing to prevent the dramatic increase in addiction and overdose fatalities. Indeed, the drug war has fueled the number of people who die from an overdose, while filling our prisons with people who shouldn’t be there. Candidates’ words are good. But we need action.
Tony Newman is the director of media relations at Drug Policy Action, the C4 arm of the Drug Policy Alliance
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