Drug policy reform is long overdue

We may fool ourselves into thinking we’re making progress, but the numbers don’t lie. US drug overdose fatalities have again set world records, with the 2020 death toll up by 30% over 2019, and Maryland ranking in the top five states for overdose deaths per capita.

I can’t say there aren’t good people working hard to deliver the life-saving services aligned with those urged by the world’s leading health organizations. Without the dedication and tenacity of these folks, the death toll would surely be higher. But theirs is the work of Sisyphus, absent deserving his fate, in tirelessly pushing a boulder uphill.

The counterforce that compromises these heroic efforts? Drug prohibition and our dogged determination to treat a public health crisis as a criminal matter. Even though there’s growing awareness that the war on drugs has done more harm than good—costing billions of tax dollars and incarcerating tens of thousands for non-violent drug offenses, while illegal drug trafficking thrives, violence escalates, addiction continues to debilitate, and contaminated drugs ramp up fatalities—the militaristic mentality is our default mode.

Whether it’s fear of political setback or hypocrisy that underlies policymaker’s relentless focus on punitive measures, it’s hard to say. But I can tell you the motivation is not based on science or even on reason, nor is it borne of concern for human well-being, as evidenced by the ease with which we condemn our most vulnerable citizens to a life of misery, often robbing them of what they most need—hope for the future.

We have the highest prison population in the world, a number that has soared since the declaration of the war on drugs. Even more shameful is that Black and brown people are arrested and imprisoned at an alarmingly higher rate than their white counterparts, a reality that destroys families, upends job prospects, and fuels the perpetual cycle of social marginalization, jail time, and poverty.

As we prioritize initiatives and allocate resources accordingly, how do we rank the importance of identifying and addressing what predisposes people to addiction? This is at the heart of the matter, a societal dilemma that warrants a deeper understanding without which meaningful work is doomed.

Also fundamental is acknowledging that a drug-free society is not realistic, and that our years of denial have not only failed on all fronts, but have ceded control to criminals—at our collective peril. We must accept what the data tells us: Cutting the supply only leads to substitution, risking deadly outcomes and neglecting the understanding of addiction needed to care for those who suffer.

Righting the wrongs of the shameful racial disparities—deeply embedded in the criminalization of drug use—and its years of multi-generational devastation deserves much attention and has to change.

For people currently addicted, we must prioritize health care and harm reduction, devoting the resources needed to make a real difference. Simultaneously, we must care for future generations of young people and their parents with substantial investments in coordinated drug education and social programs that are research-based.

As states engage in litigation, suing pharmaceutical companies on behalf of the harm to our citizenry, we should ask: Will settlement money awarded to our states be directed to save lives? Or will it go to double down on law enforcement and the continued harm of mass incarceration? In looking back at the allocation of tobacco settlements, I realize this is a timely question, one that is worthy of demystifying.

If interested, check out The Opioid Settlement Tracker, a website that provides updated information on litigation and stateby-state settlement allocation plans, along with evidence-based policy recommendations for health-centered interventions designed by public health experts at Johns Hopkins University and Harvard University.

To date, we have been our own worst enemy in establishing drug policies. The time has come for policies that are based on science and human rights.

There is no more time to waste.