The Case for the Federal Decriminalization of Narcotics in the United States

The opioid epidemic is perhaps the most devastating public health crisis facing the contemporary United States. According to the U.S. Department of Health and Human Services, in a twelve-month period that ended in February of 2019, 15,349 people died of an overdose on heroin and 32,656 people died of an overdose on synthetic opioids other than methadone. Over 130 people die of an overdose on opioid-related drug overdoses every day.[1] The magnitude of the opioid epidemic warrants a far greater — and more effective — response than the lukewarm approaches initiated by the government. 

While severe in the United States, the opioid crisis does not exist exclusively within the borders of this country. Worldwide, drug use causes half a million deaths, 70% of which relate to opioids.[2] Although many other countries face this issue, however, the management of the opioid crisis in countries around the world differs. Specifically, some countries — particularly in Europe — champion the decriminalization of opioids, limiting punitive measures in favor of addiction treatment. For example, in Portugal, after the opioid epidemic began to affect society unilaterally, the government invested substantive resources in drug treatment and rehabilitation, treating those suffering from substance abuse disorders rather than punishing them.[3] Given the success of these decriminalization endeavors in Europe and elsewhere, the United States should adapt its legal system to better serve those suffering from substance abuse disorders. 

The opioid crisis began in the United States during the mid-1990s. Pharmaceutical companies, notably Purdue Pharma, heavily advertised prescription painkillers such as oxycodone while falsely assuring the general public and medical community that patients would not become addicted to them. As a result, healthcare providers prescribed these medications at high rates, and before the medical community finally determined that these prescription painkillers were addictive, a large number of patients developed dependencies on their drugs and began to misuse them.[4]

The initial outbreak was only an indication of what was to come; the opioid epidemic in the United States can be divided into three waves. The first is the aforementioned prescription painkiller crisis, which eventually trickled into a second wave, defined by high rates of heroin abuse — in 2011, five people died of a heroin overdose in a population of 100,000. This second wave began in 2010 and continued up until 2013, when a third wave characterized by the abuse of synthetic opioids emerged. In particular, the synthetic opioid fentanyl accounts for a great deal of a dramatic increase in overdoses; synthetic opioids account for more overdose deaths in a population than either heroin or prescription opioids.[5]

In 2017, the U.S. Department of Health and Human Services (HHS) released a five-point strategy to combat the ongoing opioid epidemic nationwide. This plan focuses on the development of better prevention, treatment, and recovery services; the collection of better data on and about the epidemic; the promotion of healthy methods of pain management; the increase of the availability of overdose-reversing drugs, such as naloxone; and the conduction of better research for both clinical practices and general knowledge.[6] What has not been seriously considered on a federal level in the fight against the opioid epidemic, however, is the decriminalization of narcotics in the United States.

The decriminalization of narcotics refers to the removal of punitive legal measures for drug violations, particularly for those minor violations regarding possession for personal use. One point five million drug arrests are made in the United States every year, skewed significantly toward marginalized communities. For example, drug legislation disproportionately targets poor communities and communities of color, bolstered by procedures such as “stop-and-frisk.”[7] Eighty-two percent of drug arrests account for personal possession, while 18% relate to manufacturing or sales. 50,000 people in the United States are incarcerated for small drug offenses, and many more are on probation or in jail.[8]

Decriminalization does not affect the rate of drug use. The World Health Organization found that the United States, known for its emphasis on legal consequences for drug violations, has the highest rate of lifetime drug use.[9] The benefits of decriminalization, however, are multifaceted and widespread. Decriminalization decreases the number of arrests and incarcerations, thereby allowing a government to direct funds to better, more successful methods of long-term treatment. Furthermore, and perhaps most importantly, decriminalization increases the update into drug abuse treatment, allowing an individual to better receive help for their substance abuse disorder.[10]

Portugal is perhaps the most immediate and obvious example of successful decriminalization. In 2001, Portugal decriminalized possession of low-level drugs and consumption of all drugs. The country instead redirected funds and energy to the development of treatment services, including methadone maintenance therapy and access to sterile syringes (particularly helpful with slowing or altogether halting the spread of HIV). Though Portugal has since not observed an increase in drug use rates, it has seen a decrease in drug-related deaths, arrests and incarcerations, and lower rates of adolescent drug abuse. Most importantly, consistent with the model outlined above, far more people now seek treatment for substance abuse disorders in Portugal.[11]

Portugal is far from the only country to enact decriminalization measures. The Czech Republic, Netherlands, Colombia, Argentina, and Germany are among nations that have decriminalized to some extent the consumption or possession of narcotics. All countries that have combined their decriminalization measures to some extent with the increase of treatment resources and development have experienced societal gains. Several prominent public health organizations, including the WHO and American Public Health Association, have openly endorsed the decriminalization of drugs.[12]

The conversation surrounding the decriminalization of narcotics in the United States becomes particularly relevant in light of the state of Oregon’s recent decision. Following the 2020 election, voters in the state of Oregon approved a ballot measure that decriminalizes the possession and personal use of all drugs. Oregon is the first state in the nation to do so. Most notably, this measure extends to street drugs such as methamphetamine, heroin, and cocaine. Offenses regarding possession or personal use may no longer be punishable by incarceration. As Oregon voted toward this widespread decriminalization, on a smaller scale, New Jersey, Arizona, and South Dakota legalized marijuana through their own ballot issues.[13]

There is a reason that, in addition to Oregon, New Jersey, Arizona, and South Dakota, many other states in the United States have decriminalized drugs to some extent. Decriminalization has no real effect on drug use, and instead enables a more effective platform for treatment, addressing the true underlying issue of substance abuse disorders. To truly combat the ongoing opioid epidemic in the United States, decriminalization must be adopted on a federal level. 

References

[1] Assistant Secretary of Public Affairs (ASPA). “What Is the U.S. Opioid Epidemic?” HHS.gov. https://plus.google.com/+HHS. Accessed November 10, 2020. https://www.hhs.gov/opioids/about-the-epidemic/index.html. 

[2] “Opioid Overdose.” World Health Organization. World Health Organization. Accessed November 10, 2020. https://www.who.int/news-room/fact-sheets/detail/opioid-overdose. 

[3] Bajekal, Naina. “Want to Win the War on Drugs? Portugal Might Have the Answer.” Time. Time, August 1, 2018. https://time.com/longform/portugal-drug-use-decriminalization/. 

[4] National Institute on Drug Abuse. “Opioid Overdose Crisis.” National Institute on Drug Abuse, June 10, 2020. https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis. 

[5] “Understanding the Epidemic.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, March 19, 2020. https://www.cdc.gov/drugoverdose/epidemic/index.html. 

[6] (DCD), Digital Communications Division. “5-Point Strategy To Combat the Opioid Crisis.” HHS.gov. https://plus.google.com/+HHS. Accessed November 10, 2020. https://www.hhs.gov/opioids/about-the-epidemic/hhs-response/index.html. 

[7] “Mass Incarceration and Criminalization.” Drug Policy Alliance. Accessed November 23, 2020. https://drugpolicy.org/issues/mass-criminalization. 

[8] “Approaches to Decriminalizing Drug Use & Possession.” Drug Policy Alliance. Accessed November 10, 2020. 

[9] Ibid

[10] Ibid

[11] Ibid

[12] Ibid

[13] Kim, Allen. “Oregon Becomes the First State to Decriminalize Small Amounts of Heroin and Other Street Drugs.” CNN. Cable News Network, November 9, 2020. https://www.cnn.com/2020/11/09/politics/oregon-decriminalize-drugs-trnd/index.html.