We have been through this before as a nation – during the crack epidemic of the late ’80s and early ’90s, and the previous heroin crisis of the ’70s – and we have valuable lessons to draw upon when approaching today’s challenge.
One lesson is that the reactionary “tough on crime” rhetoric led us astray. It resulted in policymakers enacting ineffective and overly punitive drug policies, many of which resulted from knee-jerk reactions to media sensationalism of crime or political opportunism.
Today, almost half of all federal inmates are in prison for drug crimes and 1 in 5 state prisoners are serving sentences for drug crimes. They are part of the world’s largest and most expensive prison population, which since 1980 has increased by more than 800 percent. In the last 40 years, federal and state governments have spent more than $1 trillion on the “war on drugs.”
What we now know is that drug use should be treated as a public health issue, rather than just a criminal justice issue. It’s easy to let political self-interest lead policymakers to enact harsh, punitive policies following high profile events like the heroin-related death of Oscar-winning actor Philip Seymour Hoffman. It’s also clear that simply incarcerating drug users doesn’t work.
Research by the Justice Department shows two-thirds of drug offenders leaving state prison will be re-arrested within three years. In addition, nearly half of released drug offenders will return to prison.
Each prisoner costs taxpayers an average of $30,000 a year, money that could be better spent on drug treatment programs with a stronger record of success. Studies have found that every dollar invested in drug treatment saves taxpayers more than $18.00 in crime-related societal costs, and that treatment reduces crime, recidivism and other societal costs 15 times more effectively than law enforcement alone.
The Obama administration has acknowledged this truth. Last April, drug czar Gil Kerlikowske said that his office would support a broad effort to make health care a larger part of the solution to drug issues. “We’ve relied far too long on the criminal justice system.” Despite the administration’s stated commitment, however, Obama’s budget and his drug policies continue to focus on drug enforcement.
The administration must make a stronger effort to prioritize treatment programs as a solution to drug crises, including the current heroin epidemic. In addition, Congress should continue its efforts, through legislation like the bipartisan Smarter Sentencing Act, to reduce the use of draconian mandatory minimum sentences for drug offenders. These policies perpetuate the worst aspects of the drug war by locking up low-level drug offenders for long periods, possibly the least efficient use of taxpayer money to combat drug use.
As illegal drug use again becomes a focus of public policy, it is vital that we don’t make the same mistakes that created mass incarceration in America. Decades of experience have given us the tools to do better. It is incumbent on policymakers, from the White House to state legislatures, to apply these lessons.
Try giving it away for free: From Jason Smith at TheRealEdition.com.
Heroin is sweeping the country. There’s no denying that. Rx drugs — specifically, the opiate variety — paved the way for what became a very healthy appetite for all things opiate in the United States. So now what?
I believe that too often, the desire to “fight drug addiction,” while well-intentioned, is mislabeled. Under the “fight addiciton” umbrella, there are really two separate fights that require very different resources:
1. Prevention and education, to stop the next generation of addict.
2. Treatment for the current addict.
Those two require very different approaches with different resources, and often times, when the government throws money at “fighting drug addiction,” they send money to No. 1. Money to schools and communities is sexy, something tangible that politicians can show in campaign videos. A classroom of small children learning about the dangers of drug abuse makes a great campaign commercial.
Videos of a heroin addict kicking in a rehab facility is, decidedly, much less sexy, receiving funds accordingly.
Drug addiction affects far more than the addict using the drug. Family and friends have to suffer along with the addict, who will steal their shit when the opportunity presents itself, to buy drugs from someone who is also destroying his or her community by perpetuating the drug trade. Drug cartels from Mexico, in the meantime, are playing chess while the U.S. government plays checkers, having splintered into smaller, more difficult groups to control, compared to when there were just five major cartels. There are now 43 smaller, more deadly cartels operating, each fighting for the right to feed America’s insatiable heroin appetite.
The cartels subcontract out their street-dealing to street-gangs, who damage communities, perpetuating crime so long as so much money is involved.
This is the result of a 40 year “War on Drugs.”
It has FAILED.
My solution: Let’s just give the stuff away.
Today, doctors wishing to prescribe the 21st century’s version of methadone — Suboxone — need a special license. Let’s do the same thing with heroin.
It’s time we have doctors start issuing heroin to heroin addicts. Truth is, they’re going to get it anyway. If we have it issued by doctors, we can implement monthly HIV and Hep-C tests, issue clean needles, and present treatment opportunities to addicts when they come to get their drugs. Look, 9 times out of 10, the addict will want their drugs. But what about that 1 time? You think their street dealer is going to go through the process of testing and treatment opportunities?
It’s all about risk reduction.
By doing this, we immediately take the cartels out of the picture. No addict is going to continue to rob, cheat, steal, and connive, to buy from a dealer when they can jump through a few painless hoops and get it for free from a doctor.
What we’re doing is creating a controlled environment and destroying the uncontrolled environment of the street game at the same time.
Monitoring abuse will help fight the problem: From Brandon Duncan, at RecoveringMe.com.
In response to the surging drug epidemics seen across the country, national agencies and health experts are now developing an enhanced system for monitoring drug trends. In August 2014, the National Institute on Drug Abuse (NIDA) will start funding the National Drug Early Warning System (NDEWS), which will provide more intensive monitoring of local drug use trends and allow experts to act more quickly to address outbreaks of drug abuse before they spread to other areas. The system will also take advantage of social media platforms to provide information and education to people living in areas where addiction outbreaks are occurring.
Current ways of tracking trends in drug use have been too slow to adequately respond to the fast-growing opioid drug and heroin epidemics. The new system will be more tech-focused, scanning social media and other web platforms to identify new trends in drug use. Health experts will then send rapid response teams to the regions where the drug outbreaks are happening, assessing the health epidemics and working to contain them. The system will also create online networks of addiction professionals who can more easily communicate and coordinate efforts to reverse the surges in drug use and overdose deaths.
Removing stigma from addicts and families is crucial: From Lauren A. Rousseau at the American Bar Association.
There is a plague stalking the young people of our nation, and its name is heroin. Between 2007 and 2013, the number of annual heroin users almost doubled, from 370,000 in 2007 to 680,000 in 2013. The federal Center for Disease Control and Prevention released statistics on January 12, 2015, showing that overdose deaths linked to heroin increased 39 percent in 2013 over 2012, and that 8,257 people died of heroin-related deaths.
The number of drug overdose deaths overall in 2013 increased by 6 percent, raising the number to 43,982. This means that every day in this country, 119 people die from a drug overdose. Another 6,748 are treated in emergency rooms—there is an overdose-related hospitalization in this country every 13 seconds. Drug overdose is now our leading cause of accidental death, exceeding traffic fatalities and gun deaths. And 75 percent of these drug overdoses involve opioids. Heroin is an opioid, as is a whole host of prescription pain medications—Vicodin, Hydrocodone, and OxyContin, to name a few. …
Although the medical community has recognized addiction as a disease since 1956, society and government policy have largely treated it as a moral failing. Our current approach—much of which centers on criminalization and incarceration—costs our nation in excess of $360 billion a year. Only a small fraction of this goes to prevention and treatment services; a recent national survey found that only one in nine people struggling with addiction receives treatment.
The documentary film, “The Anonymous People,” directed by Greg William, explores the emergence of a new recovery advocacy movement focused on eliminating the stigma associated with addiction and increasing access to treatment. In response to the heroin epidemic, this movement is accelerating. Grassroots organizations are springing up across the country hosting public awareness events, rallies, even “die-ins” to protest the increasing number of overdose deaths.
And governments are responding. As of December 2014, 28 states had adopted legislation broadening access to naloxone, a drug that can reverse opioid overdoses, permitting distribution to police, EMTs, and in some cases, families of opioid addicts. At least 22 states have enacted “Good Samaritan” laws providing legal protection against drug charges to persons calling 911 for someone who is overdosing. These laws are important because people who are with an overdose victim often use drugs themselves and are afraid to call 911 for fear of prosecution.
There are things Congress could do to help: From Kyle Simon, at The Hill.
Congress is finally talking about our nation’s prescription drug abuse and heroin epidemic. Last month, Senate Majority Leader Mitch McConnell (R-Ky.) and Sen. Ed Markey (D-Mass.) requested an official report from the surgeon general on prescription opioid abuse and heroin use. Later this summer, the Department of Health and Human Services (HHS) will bring together officials from across the country to discuss responses to the crisis. …
The problem is clear. So are the solutions.
Since 2009, dozens of not-for-profit health and safety organizations have come together each year to identify prevention, intervention, and treatment strategies to reduce opioid abuse, heroin use and their consequences. More than 30 not-for-profit health and safety groups have vetted and endorsed the 2015 National Prescription Drug Abuse Prevention Strategy.
States at the forefront of reducing prescription drug abuse have taken aggressive action and are seeing results. In Florida, for example, where the legislature enacted strong pill mill laws and prosecutors have cracked down on the physicians who operate them, opioid analgesic-related overdose deaths are down 17 percent.
As we successfully reduce the supply of prescription medications available for abuse, naturally, we must address demand. Among the most obvious and best ways of reducing the demand for substances of abuse is to ensure people with addiction get the treatment they need. This is where the federal government must do more.
Sen. Sherrod Brown (D-Ohio) got it right last year when he stated, “We’ve got a problem when it’s easier for Americans to get heroin than it is for them to get help to break their addiction.”
A federal law enacted before this epidemic took hold prevents physicians from treating more than 100 patients at a time with buprenorphine, an FDA-approved medication for opioid-use disorders. The patient limit established by the Drug Addiction Treatment Act of 2000 (DATA 2000) was intended to prevent diversion and abuse of the medication.
Now, the demand for treatment exceeds capacity, with half of the physicians authorized to provide buprenorphine-assisted treatment forced to relegate patients in need to waitlists. At best, those patients fuel the demand for diverted buprenorphine on the black market — precisely what DATA 2000 attempted to prevent. At worst, they never reach the top of the waitlist.
The Obama administration has had its chance to act, and it has declined to do so. In July 2014, HHS received a petition for rule-making to increase the patient limit for physicians who hold certifications in addiction medicine, and to exclude from the limit women who are pregnant or nursing – an attempt to stem the tide of neonatal abstinence syndrome. Other practical proposals exclude from the limit patients who pose a low risk of diversion or abuse, such as individuals who get implants or injections, are on a low dose of buprenorphine, or have succeeded for two years or more in uninterrupted recovery.
HHS never responded to the petitioners.
In the absence of meaningful executive leadership, Congress must now step in. Carefully expanding access to medication-assisted treatment for opioid-use disorders can reduce overdoses, HIV, hepatitis C and deaths. Enough talk already. It is time for federal action.
Most importantly, action must rest with the individual: From Megan Cairns, at Rare.
Look at the way politicians and commentators focus on the drug as the problem rather than the addict. … In reality, the problem is not the availability of drugs, but the fact that there are people ill enough to stick a needle into their arms and inject a deadly substance into their bodies. …
Politicians on the left make things even worse when they argue that society should accept and even subsidize drug abuse. Government needle exchange programs use taxpayer money to buy needles for heroin addicts, further feeding the addict’s belief that he can never stop. Offsetting the negative consequences of drug abuse is not the government’s job and will only prolong addiction.
As long as it’s providing the needle, the government may as well just go ahead and provide the heroin.
Think nationalized drug dealing is laughable? The government doesn’t. State governments spend millions of dollars a year transitioning heroin addicts to methadone, a drug that contributes to nearly one in three prescription painkiller deaths in the U.S.
Sometimes drug subsidization is subtler. Illicit drug use and dependence are more common among women who receive welfare than women who do not, and almost 20 percent of welfare recipients report recent illicit drug use. But when conservatives propose drug testing for welfare recipients, the left accuses them of “demonizing (welfare recipients) and vilifying public aid.”
Just because someone thinks those who receive public assistance should be clean does not mean he thinks all welfare recipients are drug addicts. If your goal is to destigmatize public aid and push drug addicts into treatment, drug testing welfare recipients actually makes perfect sense.
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