Treat Addiction As A Medical Disorder - Not A Crime

The following is part of a thought-provoking article by Maia Szalavitz in The New York Times:

By decriminalizing personal-use drug possession, Oregon has become the first state to acknowledge that it is impossible to treat addiction as a disease and a crime simultaneously. This kind of model is urgently needed in the United States, where street fentanyl is the leading cause of death among people ages 18 to 45, and where sending people to jail for using drugs has failed to prevent the worst addiction and overdose crisis in American history.

Criminalization supercharges addiction stigma, and stigma is one of the biggest obstacles to recovery. Stigma is such a major roadblock that most organizations working to combat addictionhave large initiatives focused on addressing it. “I think the biggest killer out there is stigma,” former U.S. Surgeon General Jerome Adams once said in a speech about opioid addiction. “Stigma keeps people in the shadows. Stigma keeps people from coming forward and asking for help.”

Try as experts might to destigmatize addiction through conferences and calls for the use of more respectful language, stigma and a criminalization approach to drugs cannot be divorced. One of the fundamental goals of making drug possession into a crime is, after all, to deter this behavior by shaming and punishing lawbreakers.

To reduce stigma and improve the addiction crisis, drug policy must be liberated from the idea that without criminal penalties, no one would ever quit drugs. Because far from spurring recovery, arrest, incarceration and having a criminal record can exacerbate drug problems. . . .

over 80 percent of jails and prisons do not allow the use of methadone and buprenorphine, the only medications proved to reduce the death rate from opioid use disorder. Research shows that experiences like being denied medication while locked up deter people from seeking further help. Studies also find that drug incarceration increases the risk of overdose, suicide and disease. States with more drug arrests also do not have less drug use­­­.

Such data has led Dr. Nora Volkow, the director of the federal government’s National Institute on Drug Abuse, which funds most of the world’s addiction research, to advocate decriminalization to improve drug policy. This is the first time I’ve heard such unequivocal support from that agency.

“The research is unequivocal that putting someone who is addicted into prison or jail actually exacerbates their condition and puts them at much greater risk for relapse,” she said. . . .

It is too early to evaluate the effectiveness of Oregon’s approach. The new law went into effect last February, and about 90 percent of the funding for recovery services will reach providers only in the next few months. But in 2021 drug possession arrests dropped by about 75 percent compared with the number in 2019. . . .

Portugal, which is a model for Oregon’s changes, decriminalized drug possession in 2001 and expanded treatment. Heroin addiction rates, H.I.V. infections and overdose deaths declined there, while youth drug use rates stayed the same as in comparable countries with no policy change. American politicians would be singing hosannas if U.S. crime and drug use rates ever fell to the low levelsnow seen in Portugal.

As a result, Massachusetts and Vermont now have decriminalization bills under consideration, and activists are working toward a California initiative in 2024.

Supporters of these efforts know that if America wants to solve the overdose crisis, it must start treating addiction as the medical disorder that it is. The first step is to follow Oregon’s lead and stop treating it as a crime.