[ To reduce stigma and improve the addiction crisis, drug policy
must be liberated from the idea that without criminal penalties, no
one would ever quit drugs. In fact, arrest, incarceration and having a
criminal record can exacerbate drug problems. ]
TREATING ADDICTION AS A CRIME DOESN’T WORK. WHAT OREGON IS DOING
January 26, 2022
The New York Times
_ To reduce stigma and improve the addiction crisis, drug policy must
be liberated from the idea that without criminal penalties, no one
would ever quit drugs. In fact, arrest, incarceration and having a
criminal record can exacerbate drug problems. _
Morgan Godvin, who is in recovery, is part of a council in Oregon
overseeing how funding for addiction treatment is distributed.,
Ricardo Nagaoka for The New York Times
Morgan Godvin arrived at the Multnomah County Inverness jail in Oregon
in June 2013. She had volunteered to be locked up during a drug-court
appearance for felony heroin possession. Like many Americans, she
believed that incarceration would help her recover. But when she
requested her prescribed addiction medication, the nurse “just
laughed,” she said. Ms. Godvin was denied the gold
standard treatment [[link removed]] for
opioid use disorder and was left to kick cold turkey.
Almost 10 years later, after having served four years for various
drug-related convictions, Ms. Godvin is putting her painful experience
to use. She’s been in recovery since 2015 and now sits on a state
council [[link removed]] helping
to oversee Oregon’s sweeping decriminalization of drug possession,
which passed as a ballot measure by a 58 percent majority vote in
2020. The idea is to have the people most harmed by the war on drugs
— like those with addiction and people of color — help lead a
Today, people like Ms. Godvin who are caught in Oregon with
personal-use amounts of heroin, methamphetamine or other drugs receive
the equivalent of a traffic ticket, which carries a $100 fine. The fee
can be waived by undergoing a health screening in which treatment may
be recommended but not required. Selling or carrying quantities beyond
those allowed for personal use can still result in prison time.
By decriminalizing personal-use drug possession, Oregon has become the
first state to acknowledge that it is impossible to treat addiction as
a disease and a crime simultaneously. This kind of model is urgently
needed in the United States, where street fentanyl
[[link removed]] is
the leading cause of death among people ages 18 to 45, and where
sending people to jail for using drugs has failed to prevent the worst
addiction and overdose crisis in American history.
Criminalization supercharges addiction stigma, and stigma is one of
the biggest obstacles
[[link removed]] to
recovery. Stigma is such a major roadblock that most
organizations working to combat addiction
[[link removed]] have
large initiatives focused on addressing it. “I think the biggest
killer out there is stigma,” former U.S. Surgeon General Jerome
Adams once said
[[link removed]] in a
speech about opioid addiction. “Stigma keeps people in the shadows.
Stigma keeps people from coming forward and asking for help.”
Try as experts might to destigmatize addiction through conferences and
calls for the use of more respectful language, stigma and a
criminalization approach to drugs cannot be divorced. One of the
fundamental goals of making drug possession into a crime is, after
all, to deter this behavior by shaming and punishing lawbreakers.
To reduce stigma and improve the addiction crisis, drug policy must be
liberated from the idea that without criminal penalties, no one would
ever quit drugs. Because far from spurring recovery, arrest,
incarceration and having a criminal record can exacerbate drug
problems. Ms. Godvin’s story is a case in point.
“Within about nine months of the first time I was in jail, my
injections spiraled so much worse,” she said. Another arrest had
gotten her fired from her job. This is despite the fact that research
shows that being unemployed worsens
[[link removed]] addiction,
[[link removed]] improves
the odds of recovery.
Further, because possession of even a tiny quantity of drug residue
was a felony in Oregon at the time of Ms. Godvin’s arrests, she had
to give up her dream of becoming a paramedic.
Over the course of covering drug policy for over three decades, I have
heard hundreds of similar, or even worse, stories. While some people
in recovery say prison helped them kick drugs, more describe dreadful
conditions, ineffective treatments and traumatic experiences.
For example, over 80 percent of jails and prisons do not
[[link removed]] allow
the use of methadone and buprenorphine, the only medications proved to
reduce the death rate from opioid use disorder. Research shows that
experiences like being denied medication while locked up deter
[[link removed]] people from seeking
further help. Studies also find that drug incarceration increases the
risk of overdose
[[link removed]], suicide
[[link removed](17)30430-3/fulltext] and disease
[[link removed]]. States
with more drug arrests
[[link removed]] also
do not have less drug use.
Such data has led Dr. Nora Volkow, the director of the federal
government’s National Institute on Drug Abuse, which funds most of
the world’s addiction research, to advocate decriminalization to
improve drug policy. This is the first time I’ve heard such
unequivocal support from that agency.
“The research is unequivocal that putting someone who is addicted
into prison or jail actually exacerbates their condition and puts them
at much greater risk for relapse,” she said.
During Oregon’s decriminalization campaign, some of the strongest
[[link removed]] opposition
came from people in recovery who thought that criminal penalties
should not be removed until a new treatment system was already in
place. Some argued
[[link removed]] that
the threat of prison is essential to motivate recovery.
But anecdotal claims about positive effects of incarceration are
belied by the data. And in Oregon, the organizations that are
receiving state funds to expand care recognize the challenge. To
succeed, they must reform or replace rehabs that use a punitive
approach and do not recognize that being treated like a criminal is an
obstacle to seeking help.
Larry Turner Credit...Ricardo Nagaoka for The New York Times
Fernando Peña Credit...Ricardo Nagaoka for The New York Times
“We’ve got to meet people where they’re at,” said Larry
Turner, the president of Fresh Out, a prison re-entry program in
Portland that primarily serves Black people. Mr. Turner is himself in
recovery. His organization offers meals, housing, support groups and
other aid. While some of the services (housing, for example) require
abstinence, others do not. The idea is to attract people into recovery
by building relationships, not making them feel bad about themselves.
“We support all paths to recovery,” said Fernando Peña, executive
director of Northwest Instituto Latino in Portland and also a person
in recovery. Like Fresh Out, Mr. Peña’s group offers a variety of
options to help people move toward recovery, from offering clean
needles to abstinence support.
It is too early to evaluate the effectiveness of Oregon’s approach.
The new law went into effect last February, and about 90 percent of
the funding for recovery services will reach providers only in the
next few months. But in 2021 drug possession arrests dropped by about
75 percent compared with the number in 2019.
[[link removed]] that
the police aren’t issuing many citations for possession, and few who
are cited are making the phone call to get the required treatment
evaluation. Supporters, however, argue that reducing arrests and
incarceration itself aids recovery and that creating a better system
“People who use drugs will no longer be quite as set apart from
society,” Ms. Godvin said, “which immediately improves health
problems, reduces stigma and increases their access and willingness to
participate in services.”
Portugal, which is a model for Oregon’s changes, decriminalized drug
possession in 2001 and expanded treatment. Heroin addiction rates,
H.I.V. infections and overdose deaths declined
[[link removed]] there,
while youth drug use rates stayed the same as in comparable countries
with no policy change. American politicians would be singing hosannas
if U.S. crime and drug use rates ever fell to the low levels
[[link removed]] now
seen in Portugal.
As a result, Massachusetts and Vermont now have decriminalization
bills under consideration, and activists are working toward a
California initiative in 2024.
Supporters of these efforts know that if America wants to solve the
overdose crisis, it must start treating addiction as the medical
disorder that it is. The first step is to follow Oregon’s lead and
stop treating it as a crime.
_Maia Szalavitz writes about addiction and public policy. She is the
author of, most recently, “Undoing Drugs
The Untold Story of Harm Reduction and the Future of Addiction.”_