With more than a million lives lostIn the United States over the past two decades since the drug-overdose crisis began, more than 103,500 in 2021, some would have us believe that we are at a crossroads — where we either double down on prohibition or institute a purely profit-driven commercial infrastructure that treats drugs like other products.
This thinking creates a false dichotomy between drug-related mass criminalization or a free-for-all. There are many other options. We don’t have to sacrifice our communities to overdose and incarceration in the name of public safety.
We all know that prohibition is ineffective. It has led to mass criminalizationThe United States has a majority of Black and Brown communities. fueled human rights atrocities, economic devastation and mass-scale violence abroad. Deaths have risen rather than falling due to overdoses. This is due in large part to an increase in drug supply. contaminated with fentanyl. Prohibition was also an option erected barriersThroughout the very systems that are supposed to help people, such a restriction on housing, employment, cash assistance, and food stamps.
It’s also fiscally irresponsible, with the Drug Enforcement Administration budget alone costing U.S. tax payers upwards of $3 billion a yearThe U.S. economy is now losing more than $1 trillion annually due to overdose. according to the government itself.
It is understandable that some people are calling for legal regulation of illicit drug use. But not all regulation works the same. The U.S. has had mixed results in effectively regulating substances. Each case study focuses on alcohol, tobacco, prescription drugs, and now marijuana. promisesAnd perilsWe must learn from regulation.
To be sure, Big Pharma’s illegal and fraudulent marketingThe story of prescription opioids is a warning tale. It reminds us that profiting over people will always lead to disastrous consequences. These harms should have been stopped by the Food and Drug Administration. allowed pharmaceutical companies to make claimsThe claim of a reduced abuse potential was proved false.
But in our collective quest to point the finger at a single villain, we’ve ignored the role of drug prohibition and criminalization in compounding and contributing to this crisis. Indeed, death rates skyrocketedPeople turned to illegal opioids when prescription opioids were being restricted. eventually saturated with fentanyl. Even though fentanyl, and other drugs, remain illegal, people won’t know what they are taking or how potent it is. Many will continue to use fentanyl alone or in the shadows in order to avoid police contact. more likely to die of an overdose.
Our government’s inability safely regulate prescription opioids should prompt us to ask questions but not stop us from asking. pursuing other formsLegal regulation. There are many options. what regulation can look like, including state run systems; compassion clubsThere are two types of nonprofits:, which offer safe, judgement-free access to drugs that have been tested to ensure that they aren’t contaminated with harmful adulterants;, which provides access to a safer, regulated supply without any commercial or profit incentive. It is not easy to do this, but it is time for us to face our fears, and have an honest conversation about our options.
We have seen examples in other countries such as SwitzerlandAnd CanadaInclude heroin maintenance programsPeople can get help from, which provides them with information.Dependent on opioids, such as pharmaceutical-grade heroin and hydromorphone. DecadesOf researchTheir effectiveness is supported. In Canada, a “Compassion Club Model” was approved by the city of VancouverIn 2020, piloted. According to the Canadian Drug Policy Coalition, two organizations, The Drug User Liberation Front and the Vancouver Area Network of Drug Users, “obtained street drugs (e.g., crack cocaine, heroin, and methamphetamine) from darknet (online) markets, tested the contents of the drugs, and returned the drugs to the street market in sealed packaging with clearly labeled contents. No deaths have occurred as a result.”
These are some examples can help us determine metrics for successIn a regulated marketplace. It should, at a minimum create a safer supplyDrugs, standardize potency and eliminate contaminants.
But, better regulation models aren’t enough. Education is key. largely been missingBecause of a rigid and unrealistic commitment to abstinence-only ideologies. People are left in the dark due to this and an ever-increasing supply of unadulterated drugs. It is crucial that any regulation model be accompanied by evidence-based drug education, harm minimization, and public awareness. This will allow people to better navigate the risks and keep others safe.
In Baltimore, for example, Bmore POWER (Peers Offering Wellness Education and Resources) launched “Go Slow,” a public awareness campaign that could be seen in mass transit, online and on social media throughout the city, outlining six practical tips people could use to prevent overdose deaths, including: 1.) Take Naloxone, 2. go slow, 3.) never use alone, 4.) If you have to take medication alone, you should have someone else check on you. Talk to your family and friends about what to do in the event of an overdose. Test for fentanyl. This knowledge and these skills could help prevent overdose deaths.
There are even licensing modelsSimilar to what we’ve seen with medicinal cannabis, these models could go further to ensure people have safe access to drugs and have the skills and knowledge to manage their drug use. These models would usually require some training and oversight for customers to obtain a license. They could also include monitoring and referral to the healthcare system.
Success — in any of these models — would also mean people are no longer criminalized for drug possession, and their drug use no longer prevents themAccess to the services and support they require to thrive is not possible. Achieving this would mean that U.S. interdiction efforts abroad are no longer dictating foreign policy.
Regulating is essential to reach these goals. infrastructure that includes health and harm reduction services, voluntary treatment, fact-based education and supportive services. We believe that it must limit, if not eliminate, all commercial interests.
We don’t have all the answers, but we know it’s time to ask the hard questions.
Although it is difficult to have a conversation about drug regulation and/or prohibition, we owe it ourselves to do so honestly and with the full support of those who use drugs. We have made many mistakes that have led to our society’s downfall. We’ve buried our loved ones in caskets and alive in cages, we stepped over them while they were suffering on the street, and we’ve failed to invest in vulnerable communities. We lost our loved ones because of policy choices we made and because of conversations we were too afraid to start.