The United States declared war on drugs in 1971 with a declaration by then-President Richard Nixon characterizing drug abuse as "public enemy number one" and vowing to "fight and defeat this enemy." The result? Fifty years of pouring vast sums of money, time, and other resources into fighting drugs with still no path to victory. If anything, the “enemy” in this war has evolved into new, more potent drugs that are still sold on the streets, resulting in the death of hundreds of thousands of users.
A worldwide coronavirus pandemic has worsened the current opioid addiction crisis. Reports of 81,230deaths from drug overdoses in a recent 12-month period cast doubt on whether the tactics being used to fight the war on drugs should continue. For example, the most recently available data regarding imprisonment shows that 46%of the inmates in federal prisons are there for drug offenses. To put that into perspective, the second-highest percentage is for weapons offenses at 20%. Incarceration has obviously not worked, so what is the solution?
Oklahoma hit hard
As deaths from drug overdoses in the U.S. rose by 28.3% last year, Oklahoma experienced an increase of almost 21%, which may be even higher as delayed reports of death investigations during the period become available. One factor in the rise in deaths has been a wave of counterfeit pills being sold on the streets.
The counterfeit pills that have appeared in Oklahoma appear similar in size, shape, and color to oxycodone, but appearance is where the similarity ends. The pills contain lethal levels of fentanyl. State law enforcement officials state-reported seizing almost 96,000 of them during the first six months of 2020. Law enforcement seized another 4,700 in Chickasha, Oklahoma.
What can be done?
A 2018report by the Pew Charitable Trusts organization challenges the reliance on criminal prosecution and incarceration to address the drug crisis. It found no correlation between imprisonment rates and drug problems experienced by states. Oklahoma was second out of all states in the country regarding its rate of imprisonment for drug offenses. Still, as mentioned previously, it recently posted a 21%increase in lethal drug overdoses.
The Pew report recommends developing a strategy to combat the drug crisis that combines enforcement of criminal laws to target trafficking operations with sentencing initiatives focusing on diversion of nonviolent offenders away from incarceration and into programs promoting drug treatment options. It also stresses the need to improve initiatives to identify those individuals with risk factors indicative of substance use disorders.
These recommendations are in line with a policy statement from the U.S. Department of Health and Human Services. The agency announced a shift in its focus toward prioritizing the improvement of drug treatment and recovery services, supporting more research into pain and addiction, the development of better pain management practices, and continued support for making opioid antagonists, such as Naloxone, that reverse the effects of an opioid overdose readily available.
A majority of states have passed so-called "good Samaritan drug laws" to remove the fear of arrest that may prevent a person who witnesses a friend experiencing a drug overdose from calling 911 to report it. The laws differ from state to state regarding the extent of the immunity from prosecution granted, though.
There have not been enough studies done to determine with any degree of certainty the effectiveness of good Samaritan drug laws. Still, one criticism of the implementation of the laws has to do with education or, more accurately, the lack of it.
The failure of state governments to allocate money toward public education targeting populations most vulnerable to drug overdoses may have weakened the impact the laws could have on overdose mortality rates. Another criticism is the lack of uniformity in the scope of the protection afforded by the laws because each state has its own.
Rethinking how the war is fought
Criminalizing a substance abuse disorder with laws that prosecute drug users and overuse prison sentences instead of alternative options is only one of the policies that public officials need to change to stop the fifty-year losing battle in the war on drugs.
Another example was raised by a spokesman for the Oklahoma Bureau of Narcotics, who was recently quoted as attributing the demand for counterfeit opioids to an inability of people to get pain medications through their physicians. Part of the difficulty people have getting pain medication through legitimate sources is government policies at the federal and state levels that limit the quantity of opioids doctors may prescribe for a patient.
Medicare and Medicaid guidelines now put limits on the amount of morphine contained in a pill prescribed by a doctor, which could mean that some patients receive doses that do not relieve their pain. Such policies, although well-intentioned, should be reexamined. After all, they likely contribute to the street demand for illicit drugs. Perhaps it is time to change how the battles are being fought.