Oakland, CA, Monday, June 28, 2021
It is time to end the War on Drugs.
Serena Clayton, Ph.D., Executive Director
CA Bridge mobilizes medical providers to treat people with opioid use disorder with evidence-based care. We do this to improve the health and well-being of the many people who use drugs. But we are also well aware that much of what determines a person’s health is rooted in broader social determinants of health, such as income, housing, community, racism, and other factors that live well outside the walls of our health care facilities. When it comes to substance use disorder, our country’s drug policies are critical social determinants of health.
If we want to improve the health of our patients, we need to do more than provide treatment, we need to speak up for drug policies that promote public health.
This June marks the 50th anniversary of the War on Drugs. This “war,” launched by President Nixon, marked an era of drug policy that has focused on the criminalization of drug consumption, previously considered a personal choice or even openly promoted in commercial products. The War on Drugs gained political momentum over the last 50 years with devastating effects. According to the Sentencing Project, there was more than a ten-fold increase in the number of people incarcerated for drug offenses between 1980 and 2018. These are not primarily drug dealers or producers. In 2019, 86.7% of arrests were for possession, compared to 13.3% for sales or manufacturing.
What do we know about the impact of the War on Drugs on health?
Drug use did not go down. Actually, self-reported use of illegal drugs increased between 1990 and 2014, as did the availability of heroin, cocaine, and methamphetamine.
Mortality from drug overdoses has only gone up. Between 1980 and the present, there has been a continual increase in the number of people dying from drug overdoses. Stepped-up law enforcement as a policy has not kept people safer, and in fact drug law enforcement has been shown to increase overdose mortality, while having no benefit in a reduction in drug market violence.
Incarceration has negative health consequences and increases risk of overdose. More than half of all prison and jail inmates have mental health problems and are more likely to have high blood pressure, asthma, cancer, arthritis, and infectious diseases, such as tuberculosis, hepatitis C, and HIV. Upon release from custody, former inmates are at exceptionally high risk of death from a drug overdose which is the leading cause of death during this time period.
Criminalization has increased racial disparities. While people of all races use drugs at equal rates, people of color, particularly Black Americans, are much more likely to be arrested and incarcerated. Not only are these contacts with law enforcement detrimental to the individual, they have a multi-generational impact on children’s physical and behavioral health as well as stability and socio-economic status.
If we care about health, it’s time for a new approach
It is now clear that substance use disorder is a disease that is treatable with medication. Of course, this disease has a behavioral component, but so do many other chronic diseases — none of which we would ever dream of criminalizing. As a program focused on saving lives and improving the health of people who use drugs, CA Bridge is taking a critical first step by making treatment more accessible and promoting a stigma-free culture. But we need to do more. We need to speak out for policies that stop criminalizing a disease. We want our patients to seek care without fear of arrest. Incarcerating people with a substance use disorder for their chronic medical condition is not a rational, just, or effective intervention.
Join the movement of medical professionals committed to improving the health of our patients. You can help by speaking up about changing drug policies to promote public health and by donating to the CA Bridge Advocacy Fund to help with this effort.