America finds itself in the midst of what some call an “epidemic,” as tens of thousands of people are losing their lives every year due to overdosing on illicit or prescription drugs, while many more are using, misusing and potentially growing dependent or addicted to such drugs.
According to the Centers for Disease Control and Prevention, more than 50,000 Americans lost their lives last year to drug overdoses, more than 33,000 of which were attributable to prescription and illicit opioids, which have come under particular scrutiny in recent years. It should be noted that opioid overdoses are commonly linked to drug mixing, like drinking alcohol while using opioids.
During a December interview on CNN, Sen. Joe Manchin of West Virginia invoked the opioid problem to call for, of all things, “a war on drugs.” Considering it has been 45 years since Richard Nixon already declared such a war, that we’ve already spent $1 trillion fighting it and have yet to arrest and bomb our way to a drug-free society, doubling down on such a “war” is unlikely to be the solution.
On the campaign trail, Donald Trump repeatedly suggested his glorious border wall would keep the drugs out. Considering that prisons and jails are incapable of keeping drugs out, it is highly unlikely a wall along part of the southern border of a nation with thousands upon thousands of miles of coastline and borders will do much better.
Politicians tend to prefer simplistic solutions, and tend to launch ill-advised crusades against things. This has been seen in the dominant narratives over opioids, which have been particularly demonized in recent years, and the response of well-meaning government officials whose good intentions have mostly made things worse.
Opioids, a class of drugs including opium derivatives likes morphine and semi-synthetic drugs like hydrocodone and oxycodone, have been used for thousands of years to treat pain and other ailments, and are generally safe. Millions of people across the country are prescribed them every year, and, according to a Cochrane review published in 2010, less than 1 percent of people prescribed them become addicted.
But in the past 25 years, prescriptions for opioids have skyrocketed. This has panicked policymakers and government bureaucracies tasked with combating the scourge of drugs. The Office of National Drug Control Policy has championed a prescription drug monitoring program, while the Drug Enforcement Administration has made a point of cracking down on doctors and the CDC advises doctors to prescribe fewer painkillers.
“Unsurprisingly, these responses have been wholly ineffective at reducing rates of opioid use or overdose,” argues the Drug Policy Alliance in a recently released action plan. Instead, what has been achieved is pushing many opioid-dependent people to heroin.
Though the vast majority of heroin users never become dependent, according to the National Institute on Drug Abuse, there are many risks associated with prescription opioids. Much of this is due to heroin’s illegality, including widely varying degrees of purity and the common presence of adulterants like fentanyl, which itself is generally safe in therapeutic doses and contexts.
Hence, while heroin use has steadily increased over the past decade, deaths associated with it have ticked up even faster. Despite a decrease in estimated heroin users between 2014 and 2015, heroin overdose deaths rose from 10,574 to 12,990 during that time period. This is likely a result of the heroin supply becoming less safe.
All of this speaks to the ineffectiveness of our current approach to drugs. We’ve had 45 years to see how imprisonment, treatment with the threat of imprisonment and a litany of local, state, federal and international drug agencies and task forces work. They don’t.
We would probably be better off dissolving the DEA and reallocating its multibillion-dollar budget to harm reduction and treatment. Decriminalizing personal possession and use of drugs should also be considered, as criminalizing drug users and addicts alike has failed to encourage treatment and better choices.
If we want to curtail the problems associated with the use of heroin, we should probably look more to the use of things like syringe exchange programs, supervised injection facilities and heroin-assisted treatment.
We might want to take a step back from prosecuting doctors or having government bureaucrats tell them how to do their jobs. We also should do a better job of educating the public about the actual dangers of drugs, which are real, but often misrepresented.
We don’t need another war on drugs, we just need smarter approaches.