The Second Boat Strike Is Moot Because The First Was Illegal

We have heard a lot about the second strike against an alleged narcotics-carrying boat on September 2nd. Congress want the full tapes of the bombings released, and Secretary Hegseth is refusing to release them. The question seems to be whether a war crime was committed - the execution of helpless shipwrecked victims.

I believe that whole question is a moot one for two reasons. First, we are not at war. Second, the first strike was illegal.

What would we think if Border Patrol officers blew up a vehicle trying to enter the U.S. and killed everyone in it because it was suspected that the vehicle contained illegal drugs?

What would we think if the DEA/Police blew up a suspected drug dealers house/apartment killing everyone in it?

The answer is obvious. The officers would be arrested and charged with murder. We operate under the rule of law in this country. We arrest suspected criminals, give them a fair trial respecting due process protections, and let a jury decide their guilt or innocence. Labeling them as "narco-terrorists" would not change that.

Why then would we think it's different in international waters? They are suspected criminals - not terrorists or enemy soldiers. Calling the bombings an act of war and labeling the victims as terrorists changes nothing.

Our Navy and Coast Guard are fully capable of seizing and searching the boats, and if contraband is discovered, arresting the people on the boats. They would than be given a fair trial and either convicted or found innocent. That is the law. That is what has always been done. Killing them with a trial and proof of their guilt is illegal - it is murder. 

And that is true even if ordered done by a president.

Nearly Half Of Voters Believe Trump Is Spreading Misinformation About Tylenol

 

The chart above is from the Change Research Poll -- done between September 28th and October 6th of a nationwide sample of 1,596 registered voters, with a 2.6 point margin of error.

GOP Discovers A "Magic Elixir" To Cure Dementia

 

One of the lies that Trump has told is to say President Biden is feeble and incoherent. That lie was blown out of the water by Biden's excellent State of the Union speech. Now Trump has talked his way into two debates with Biden, and he's scared that Biden will beat him like a drum. So, to explain how Biden could be both incoherent and verbally astute, Trump is now saying that Biden is being given a shot of some magic drug to make him appear astute and coherent - and his GOP sycophants are now repeating the ridiculous claim.

Here's how Dana Milbank reports it in The Washington Post:

Rep. Byron Donalds’s medical education consists of a bachelor’s degree in finance and marketing from Florida State University. But the Florida Republican played a doctor on TV over the weekend, telling Fox News host Maria Bartiromo that, after examining President Biden, he suspects the president is receiving a secret medication that makes him appear to be sharp-witted and totally on the ball.

“The American people need to understand if they’re giving him some injection so that he can actually look like he’s coherent,” Donalds said.

Dr. Donalds seemed not to have considered the obvious possibility that Biden looks like he’s cogent and clear because he is cogent and clear. Still, the good doctor’s diagnosis raises some key questions that must be considered:

There is a shot that cures incoherence in one dose? How can I get some? Why has nobody thought to give it to Kevin McCarthy all these years? And why, for that matter, doesn’t Dr. Donalds, who seems to think he should be Donald Trump’s running mate, inject his prospective boss with the stuff? Just last week, Trump’s attempt at saying “carried out by radical Democrats” came out as “carried owby rgbgb tdai.”

Donalds was obviously trying to please Trump, who had just announced he would “demand a drug test” of Biden before going on the debate stage. (Another VP aspirant on Bartiromo’s show Sunday morning, Sen. Tim Scott of South Carolina, also loyally endorsed the demand for a drug test.) “He’s going to be so jacked up for those debates, you watch,” Trump predicted. Apparently, Trump realized he had set expectations for Biden a bit too low when he said the incumbent “can’t talk” and “can’t put two sentences together,” so he was attempting to come up with an alternative explanation for when Biden proves to be thoroughly compos mentis. That’s how Trump explained Biden’s energetic delivery of his State of the Union address in March: “He was high as a kite.”

A group of House members calling itself the “GOP Doctors Caucus” is debasing itself to substantiate Trump’s fabrication. A few days before Donalds offered his diagnosis to Bartiromo, Rep. Greg Murphy (N.C.), a co-chair of the “caucus,” told the Fox anchor that he had proof that Biden was drugged. “I absolutely believe that from a medical viewpoint,” said Murphy, speaking like a neurologist, although he is, in fact, a urologist. “I actually have a little bit of good knowledge that that had captained — that that had happened,” he added.

That had captained? Give that man a coherence injection! “You know, maybe we can talk offline and I’ll show you something that I think that proves that,” Murphy offered to Bartiromo.

Even Bartiromo, a reliable Trump mouthpiece, was skeptical. “You’ll show me what?” she asked. Bartiromo’s promised “follow up” on this supposed evidence never came, though she did later repeat for her viewers that “the GOP Doctors Caucus chairman did say, ‘I have experienced this and I know this for sure.’”

Not since then-Senate Majority Leader Bill Frist (R-Tenn.) wrongly diagnosed the brain activity of a comatose woman 20 years ago has a doctor-legislator committed such malpractice. But it was to be expected from the “GOP Doctors Caucus,” which counts among its 19 members five dentists and two pharmacists. Another of its co-chairmen, Rep. Brad Wenstrup (Ohio), is a podiatrist, and he used his extensive knowledge of the human foot to lead the Select Subcommittee on the Coronavirus Pandemic through its attempt to validate various conspiracy theories. Another member of the caucus, Rep. Andy Harris (Md.), proudly prescribed the deworming medicine ivermectin as a covid treatment, and still another, Rep. Ronny Jackson (Tex.), was dubbed the “Candyman” for his liberal dispensing of pills as White House physician.

Trump’s accusation that Biden is using performance-enhancing drugs is a retread; he used the same attack on Biden in 2020 and against Hillary Clinton in 2016. Still, we can’t dismiss Trump’s own medical qualifications, which include his pioneering discovery that covid could be cured by injecting bleach into people’s lungs and his dogged advocacy of hydroxychloroquine as a covid cure, which led people to consume fish-tank cleaner.

And drug use isn’t entirely unknown to our nation’s political leaders. Sen. Markwayne Mullin (R-Okla.) alleged on CNN that his former House colleague Matt Gaetz (R-Fla.) “would brag about how he would crush ED medicine and chase it with energy drinks so he could go all night.” Then-Rep. Madison Cawthorn (R-N.C.) alleged that he had watched some of his colleagues “do a key bump of cocaine right in front of you.” This followed by several years the resignation of Rep. Trey Radel (R-Fla.), who was caught buying cocaine from an undercover federal agent.

At the time, I didn’t believe Cawthorn’s claims of drug-fueled orgies in the House Republican caucus. But now these guys would have us believe that the president has reversed an advanced case of dementia by taking a magical elixir unknown to medical science? They must be high.

Busting Some Myths About The Drug Fentanyl

The newest drug boogeyman for politicians is fentanyl. While it is a dangerous drug, many lies (myths) are being spread about it. The folks at PolitiFact expose some of those myths:

Myth: You can overdose by touching an item containing fentanyl.

This is False. It’s not possible to overdose from touching an item with fentanyl on it, according to medical experts. PolitiFact has previously fact-checked different versions of this claim, including that someone passed out from holding a dollar bill laced with fentanyl.

In 2017, the American College of Medical Toxicology and the American Academy of Clinical Toxicology released a joint statementsaying "it is very unlikely" that skin exposure to fentanyl powder or tablets "would cause significant opioid toxicity."

Fentanyl isn’t absorbed well by the skin; for fentanyl to have a physical effect on the body, it must enter the bloodstream. 

"It's really hard to get fentanyl into your body unless you directly snort it into your nose, directly drink it or inject it with a needle," said Robert Valuck, executive director of the Colorado Consortium for Prescription Drug Abuse Prevention at the University of Colorado. 

When people overdose, their heart rate and breathing slows, and they fall unconscious. 

If simply touching fentanyl could cause symptoms, drug users and health care workers "would be overdosing all the time given that they are constantly exposed," said Dr. Ryan Marino, a toxicologist and emergency room physician who studies addiction at Case Western Reserve University. 

The symptoms people have reported when claiming they’ve touched fentanyl-laced items, such as dizziness, heart rate increases and passing out, aren’t consistent with a fentanyl overdose, Valuck said. 

Dr. Andrew Stolbach, a toxicologist and emergency doctor at The Johns Hopkins Hospital, said first responders who believe these falsehoods might spend time putting on "unnecessary personal protective equipment" or be afraid to touch the person. So misunderstandings like this  can be dangerous because "every second counts" when trying to help someone overdosing on fentanyl, he said. 

"When you're rescuing somebody with an opioid overdose," Stolbach said, "the only one in danger is the person with an overdose." 

Myth: Breathing air in a room with fentanyl can make you sick.

Medical experts said this is false. That’s because fentanyl isn’t volatile, meaning it doesn’t easily become a vapor.

"It doesn't just go up into the air, into your nose where you inhale a lot of it and unintentionally get exposed or get sick," said Stolbach. 

In contrast, being in a room with a substance such as ammonia can cause irritation to the skin or eyes because of its volatility, he explained. 

Stolbach said "never yet, not once" has he seen a plausible case of somebody getting sick from unintentionally being exposed to fentanyl. "It just hasn't happened," he said.

People who come in contact with fentanyl and begin to feel sick could be experiencing a phenomenon known as "nocebo," Stolbach said. They may have heard that coming in contact with fentanyl will make them sick, so they may think they’re sick when they come into contact with the substance. They may start feeling lightheaded or anxious and attribute it to the fentanyl, rather than the anxiety of being around it.

"You don't have to worry about walking down the street and unintentionally getting sick from inhaling somebody else's fentanyl," Stolbach said.

Myth: Fentanyl deaths in the U.S. are increasing because immigrants are smuggling the drug through "open borders." 

This is False. 

The southern border is not wide open. Border protection funding and staffing have remained consistent between the administrations of former President Donald Trump and President Joe Biden, and border laws and policies continue to be enforced. Hundreds of miles of the U.S.-Mexico border has fencing to reduce illegal entries.

Also, most fentanyl is seized at official ports of entry and not between them, where most migrants try to cross the border, U.S. Customs and Border Protection data shows. And in 2022, 89% of convicted fentanyl drug traffickers were U.S. citizens. 

"Drug traffickers deal with professionals, not amateurs, and they prefer U.S. citizens," Sanho Tree, director of the Drug Policy Project at the Institute for Policy Studies, a progressive Washington, D.C.-based think tank, told PolitiFact in 2022. 

U.S. citizens and permanent residents are able to cross the southern border multiple times and know the territory better, Guadalupe Correa-Cabrera, an immigration expert at George Mason University told PolitiFact in August.

Myth: Fentanyl smells like popcorn when it burns. 

This is False. The Centers for Disease Control and Prevention reportsthat fentanyl is odorless and tasteless, and there is no visible way of knowing if or how much fentanyl a pill contains. However, low-cost test strips can determine whether a drug contains traces of fentanyl.

There is no evidence that burning or smoking fentanyl will produce a popcorn-like scent, Dessa Bergen-Cico, public health professor and coordinator of Syracuse University’s addiction studies program, told PolitiFact.

Republican Extremists Now Want To Bomb Mexico

The following is part of an op-ed in The Washington Post by Greg Sargent:

Florida Gov. Ron DeSantis has declared that he’s prepared to authorize drone strikes against drug cartels in Mexico. Bedecked in military-looking garb at the border, he recently vowed to blockade Mexican ports. DeSantis is not alone: Many MAGA-fied Republicans are demanding stepped-up military action against the flow of fentanyl — including inside Mexico, without that country’s assent.

This talk isn’t just insanely reckless. It also exposes a profound absurdity embedded in the MAGA worldview, one that treats migration to the United States as a security problem to be “solved” with maximal force, not a hemispheric challenge that requires international cooperation and diplomacy. . . .

True, Republicans sometimes say they’ll seek Mexico’s permission to wage war on its soil. The idea of more U.S.-Mexico law enforcement cooperation against drug cartels is not inherently problematic. But other times, Republicans tout the threat of waging military action without Mexico’s consent as a badge of their own toughness.

Last week, for instance, DeSantis answered “yes” when an Iowa voter asked whether he’d use drones to “take out” cartels in Mexico. If Mexico won’t help, DeSantis continued, the United States will “do what we have to do.” And his suggestion of naval blockades to prevent precursor chemicals from entering Mexican ports comes with a hint that the action would be unilateral if Mexico “drags its feet.”

Meanwhile, Sen. Tom Cotton (R-Ark.) has proposed sending in Special Operations forces and said if Mexico doesn’t want to help, “so be it.” Fox News’s Greg Gutfeld wants the United States to “bomb Mexico,” meaning the cartels, even “if Mexico won’t agree.”

As David Frum writes for the Atlantic, such talk addresses a political problem for Republicans. Huge numbers of the opioid epidemic’s victims are rural and White, and a broader domestic crackdown might demonize or criminalize many GOP constituents; threatening Mexico instead spins a tale of “virtuous middle-Americans beset by alien villains.”

But that tale runs into a problem. DeSantis recently said he would reinstate “Remain in Mexico” as the primary way of disincentivizing migrants from seeking asylum in the United States. . . .

It might be argued that “bomb Mexico” talk could exert more pressure on Mexico to restart the policy if the next U.S. president demands it. But, with Mexico’s leftist president, Andrés Manuel López Obrador,regularly lambasting DeSantis’s anti-immigrant policies, GOP war fever will make it politically harder for Mexico to acquiesce, said Bárcena, who was ambassador during “Remain in Mexico” under Trump.

“All cooperation will be less likely if the Republican candidates continue with the threat of use of force,” Bárcena said, as Mexicans will criticize Obrador for “yielding to the U.S.”. . .

But to DeSantis and MAGA, all that matters is whether we are “tough” enough. If we are, migrants will give up. DeSantis’s immigration blueprint says nothing meaningful about root causes of migration or how to address them through multilateral action, dismissing migration as an “invasion” and not a complex phenomenon with profound human rights implications.

Similarly, the fentanyl crisis has myriad complicated causes. As Ryan Cooper writes for the American Prospect, we’d do better to redouble treatment at home and beef up technology at ports of entry — where most fentanyl enters — rather than launch new military adventures south of the border.

But as long as the war-whooping thrills the MAGA masses, that alone counts as mission accomplished.

1/3 Of Adults Didn't Fill A Prescription Because Of Cost

These charts are from an Economist / YouGov Poll -- done between March 4th and 7th of a nationwide sample of 1,500 adults, with a 3 point margin of error.

The Entire U.S. Drug Policy Should Be Overhauled

It has become obvious that the laws regarding marijuana are ridiculous. Marijuana should be legalized nationwide. But the real problem is wider -- all of our drug laws make little sense. We need to rethink all drug laws.

Here is just part of what Maia Szalavitz says about this in an excellent article for The New York Times:

The failure of American drug law, particularly marijuana policy, has long been obvious.

Finally, this October, President Biden ordered the Department of Health and Human Services and the attorney general to review what’s known as the “scheduling” status of cannabis. This legal process could lead to federal regulation of sales for recreational use or a national law that requires a prescription for marijuana. Mr. Biden also recently signed a law to ease onerous restrictions on marijuana research, and legislation is pending to allow cannabis businesses, now forced to use cash, to get access to banks.

Reform is much needed, with more than two-thirds of Americans favoring legalizing and regulating recreational use. Nearly half of Americans can or will soon be able to legally buy marijuana to get high in their state, which conflicts with federal law.

The details of new regulation, however, matter enormously. The current law, the Controlled Substances Act, is antiquated: It makes no scientific sense and grew out of legislation that was often driven by racist and anti-immigrant propaganda. While policymakers consider how to regulate marijuana specifically, they also need to rethink how the U.S. government classifies and controls psychoactive substances in general — not just drugs like marijuana and opioids, but also alcohol and tobacco.

The Controlled Substances Act was initially intended to regulate pleasurable substances that are risky. It has five categories, or “schedules,” which are supposed to reflect varying hazard levels. But it is filled with contradictions.

Schedule I, the most restrictive, bans the sale and possession of certain drugs for recreational use and limits their medical use to research. Those drugs include marijuana, heroin and LSD and most other psychedelics — all of which have wildly different risks. Each also has significant medical benefits.

The remaining four schedules put varying restrictions on medications. But some medically permissible drugs are more dangerous and addictive than some illegal substances — and the recreationally legal drugs alcohol and tobacco can be more dangerous than some prohibited ones and are not scheduled at all.

Initially passed in 1970, when Richard Nixon was president and alcohol and tobacco weren’t seen as drugs at all, the Controlled Substances Act needs a complete overhaul. . . .

Heroin addiction is the deadliest conditionin psychiatry. But neither LSD nor marijuana use kills by overdose, and marijuana doesn’t seem to have significant impact on mortality rates (the effects of LSD on life expectancy haven’t been extensively studied). While both LSD and marijuana are associated with psychotic experiences, lasting psychosis is uncommon. And recent research suggests that cannabis and psychedelics could actually treat some mental illnesses, including addictions. . . .

There’s no science to this system. The Controlled Substances Act was an attempt to justify existing legislation. Many laws prohibiting specific drugs had passed by the 1960s, often propelled by bias and propaganda and without consideration of relative risk.

For example, racist ideas about Black men who used cocaine and Chinese men who used opium helped push the 1914 Harrison Narcotics Act, which prohibited nonmedical use. The 1937 law that banned marijuana was fueled by racism against Mexicans and racist fears about Black jazzmen spreading both addiction and seductive music. . . .

But changing marijuana law isn’t enough. Psychedelics are already presenting similar regulatory issues, with some states already legalizing their use. And it’s unrealistic to think that all of the recreational drugs humans will ever use already exist.

Instead, we should consider creating a new, strict pathway for approval for safer substances that have both recreational and medical uses, like psychedelics — or, for example, some new drug with the benefits of alcohol, but less harm. Without such a path, cartels will continue to be the main innovators, introducing new and often-deadly products to millions without testing or quality control.

Better drug law also demands limits on the marketing and advertising of substances including alcohol, tobacco, cannabis and prescription drugs. As the opioid crisis demonstrated, permitting the marketing of addictive substances can be dangerous, whether aimed at doctors or consumers. Lax rules on commercialization are a disaster.

It’s unclear now how the Biden administration will act on marijuana. But in order to effectively regulate pharmaceutical and recreational drugs, we need new ideas.

A New Use For Psilocybin?

 

Republicans Deny Affordable Insulin To Millions

These two paragraphs are from The Washington Post.

Millions of Americans have Type I Diabetes. For them, insulin is a life-saving drug. But the greedy drug companies have raised the price of insulin many times over the years -- and that price is so high that many cannot afford the needed drug.

Some are trying to ration the bit of insulin they are able to buy -- taking less than the prescribed amount of skipping shots. They hope to make the drug go further. But this is putting their medical condition in jeopardy. And I don't think it's an exaggeration to say some are dying by doing this.

But what choice do they have. The drug companies are not going to lower the price unless they are forced to do it. To them, profits are more important than the lives or health of American citizens. It's greed gone crazy, and it's dangerous.

Democrats in the Senate tried to fix this last weekend. They included a $35 cap on insulin in the Inflation Reduction Act. That would make insulin more affordable to all those who need it. Unfortunately, the Senate Republicans agree with Big Pharma that profits are more important than lives. Using an arcane Senate rule, they stripped the $35 cap on insulin out of the bill -- and then voted down a Democratic effort to put it back in the bill.

The cap remains for those on Medicare. But millions of Americans are not old enough to be on Medicare. They still need the insulin though, and they will still have to pay the outrageous price demanded by the drug companies -- if they can afford it. If they cannot afford it, they could die quickly, or die more slowly by trying to ration the amount they could afford.

Republicans have once again shown that they don't care about Americans -- unless they are rich white men.

Gates Says Pandemic Therapies Must Be Developed Faster

The following is just part of a guest op-ed in The New York Times by Bill Gates. He has a point. We need to be able to develop therapeutic treatments faster when hit by a pandemic. He writes:

Today, drug discovery still relies on a mixture of good science and good luck. Unfortunately, when an outbreak appears to be headed toward a pandemic, there’s no time to count on luck. The next time we’re faced with a contagion, scientists will need to develop treatments as fast as possible, much faster than they did for Covid.

So let’s suppose we’re in that situation: There’s a new virus that looks like it could go global, and we need a treatment. How will scientists go about making an antiviral?

The first step is to map the virus’s genetic code and figure out which proteins are most important to it. These essential proteins are known as the “targets,” and the search for a treatment essentially boils down to defeating the virus by finding things that will keep the targets from working the way they should.

Until the 1980s, researchers trying to identify promising compounds had to rely on slow trial and error to identify the right ones. Today, using 3-D modeling and robotic machines that run thousands of experiments at a time, companies can test millions of compounds in a matter of weeks — a task that would otherwise take a team of humans years to complete.

Once a promising compound is identified, the scientific teams will analyze it to determine whether it’s worth further exploration. Once they’ve found a good candidate, they will typically spend several years in the “preclinical” phase, studying it to determine whether it is safe and triggers the desired response. The first studies will be done in animals. (Finding the right animal is not easy. Researchers have a saying: “Mice lie, monkeys exaggerate and ferrets are weasels.”)

If all goes well in the preclinical phase, the drug will move into the riskiest and most expensive part of the process: clinical trials in humans. With permission from a government regulator — in the United States, it’s the Food and Drug Administration — scientists will start a small trial involving a few dozen healthy adult volunteers. They will be looking to see whether the drug causes any adverse effects and to zero in on a dosage that’s high enough to be beneficial but not so high that it makes the patient sick.

Assuming all goes well once again, it will move on to larger and larger trials. Finally, after three phases, if they believe the drug is safe and effective, the scientists will go back to the regulatory agency and apply for approval. Then — assuming they get the green light — it’s time to start manufacturing.

At this point, a team of chemists will work on finding a consistent way to produce the key part of the drug, known as the “active ingredient.” Then, the scientific team will address the next big question: How to make sure it actually reaches everyone who needs it. Not at all an easy problem to solve.

As you can see, drug development is a complex and labor-intensive science, and each step is fraught with scientific and logistical obstacles — but we need to accelerate the process. The faster researchers are able to produce safe, effective drugs for quick-spreading pathogens like Covid, the more lives will be saved and the more we can reduce the burden on health care systems. Fortunately, there are ways to speed up and streamline the process without sacrificing safety.

One of the keys to ensuring that health care workers have better treatment options in the next big outbreak than they did for Covid will be investing in large libraries of drug compounds that researchers can quickly scan to see whether existing therapies work against new pathogens. Some of these libraries exist already, but the world needs more. We need libraries that cover many types of drugs, but the most promising, in my view, are those known as pan-family and broad-spectrum therapies — either antibodies or drugs that can treat a wide range of viral infections, especially those that are likely to cause a pandemic.

Researchers could also find better ways of activating what’s known as “innate immunity,” which is the part of your immune system that kicks in just minutes or hours after it detects any foreign invader — it’s your body’s first line of defense. By boosting your innate immune response, a drug could help your body stop an infection before it takes hold.

To deliver on these promising approaches, the world needs to invest more into understanding how various dangerous pathogens interact with our cells. Scientists are working on ways to mimic these interactions so that they can quickly figure out which drugs might work in an outbreak.

A few years ago, I saw a demonstration of a “lung on a chip,” an experimental device you could hold in your hand that operated just like a lung, allowing researchers to study how different drugs, pathogens and human cells affect one another. With advances in artificial intelligence and machine learning, it’s now possible to use computers to identify weak spots on pathogens that we already know about, and we’ll be able to do the same when new pathogens arise. These technologies are also speeding up the search for new compounds that will attack those weak spots.

With adequate funding, various groups could take the most promising new compounds through Phase 1 studies even before there’s an epidemic, or at least have several leads that can be turned into a product quickly once we know what the target looks like.

In short, although therapeutics didn’t rescue us from Covid, they hold a lot of promise for saving lives and preventing future outbreaks from crippling health systems. But to make the most of that promise, the world needs to invest in the research and systems we’ll need to find treatments much faster. That’s why my foundation has supported a therapeutics accelerator at Duke University, but broader initiatives will be necessary to make lasting change. This will require substantial investment to bring together academia, industry and the latest software tools. But if we succeed, the next time the world faces an outbreak, we’ll save millions more lives.

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.