Will legalizing heroin help?
Prohibition didn’t end alcoholism, just as current law can’t kill addiction
In the past decade, American drug policy has transformed the unthinkable into the commonplace, most notably with marijuana. Moving beyond the decriminalization of simple possession to a regulated network from farm to sales, marijuana is soon to be the new alcohol: seductive and potentially dangerous to some, manageable by most and always to be kept away from children. Business as usual, minus the community and family-destroying street violence caused by its former illegal status. Witness Rep. John Boehner's "evolution."
There has also been a sea change in our relation to those addicted to opioids. From punishable villains, they are increasingly seen as victims of their genes, personalities or circumstances. Today police officers are justly proud of helping rather than hunting street addicts, using harm reduction techniques from needle exchange to Narcan. This effective, non-punitive approach heals police-community tensions. And saves lives.
But the venom once heaped on user and seller alike is still focused on the seller. And hence, there is an intensification of policies meant to target bad traffickers (today’s Al Capones) and to interdict supply lines. Witness President Trump's call for the death penalty.
Help the prey, hunt the predator — a win-win strategy. On its face.
But we never ask how this affects those we wish to help.
A very real, very frightening epidemic of destructive alcoholism helped fuel Prohibition, but alcoholics were not the target of the punishing state. It was not illegal to drink, only to manufacture, transport and sell. Prohibition was what we now call “decriminalization.” Yet this policy threatened life and health because many couldn’t know what was in their drink any more than today’s addicts know what's in their drug of dependence.
It was only when we fully legalized and regulated this dangerous drug that desperate drinkers were no longer burdened by contaminated “bathtub gin” (today’s fentanyl-laced heroin of unknown potency).
We don’t help the addicted by keeping them in “the game,” even as sympathetic victims.
And despite a very real, very frightening epidemic of destructive opioid addiction, we don’t have to.
There are many well-documented examples of a no-nonsense approach that eliminates the criminalization of part of the heroin chain — manufacture, transportation or sale. In 23 nonprofit clinics and two prisons in Switzerland, for example, the government sells affordable heroin of known potency and purity while offering social supports to hard-core addicts, a microcosm of legalized regulation.
Crime, disease, death, unemployment and addiction have all fallen among the very addicts who had been given up on — and feared. While this popular national policy only reaches a minority of the addicted, it gives a working glimpse of a post-prohibitionist approach to opioids.
This approach stresses supportive, nonpunitive treatment, which, like good policing, is based on connection and trust rather than fear and intimidation. Criminalization’s decades of unbroken failure have yielded only chest-thumping sounds bites and exacerbated the problems of addicts who already have multiple problems. It has certainly made no difference in their use or ability to buy such drugs.
Of course, the repeal of Prohibition, current harm reduction methods and the Swiss approach were all met with dire claims that usage would soar, wrong messages would be sent, etc. In fact, the opposite always occurs when we remove the criminal stigma and send a message of supportive hope while demanding personal responsibility on the part of the addicted.
There were alcoholics before, during and after Prohibition, and there will be heroin addicts after we repeal current policies. But they will be able to get — and much more likely to use — treatments that get them past their addiction. We need to step up as responsible adults and oversee heroin’s meaningful regulation — without stigma or promotion. Let us wrest control from street gangs who peddle hard drugs to soft targets. The illicit market may never completely disappear, but it can’t compete with nonprofit clinics providing services and hope to the addicted.
We need to move beyond our addiction to punishment and once again transform the unthinkable into the commonplace.