Impact Health

Criminalizing Addiction Sets a Dangerous Obstacle to Effective Treatment

Rather than treating it as a crime, would policies considering drug addiction as more of an illness galvanize public health perceptions?

by Kimberly Lawson
Jul 25 2017, 8:00pm

When it comes to addressing "the worst drug addiction epidemic" in US history, Attorney General Jeff Sessions has raised some serious concerns as the individual enlisted to lead that fight. In May, barely three months into his tenure as head of the Department of Justice, Sessions ordered federal prosecutors to pursue harsher punishments against criminals, including low-level drug offenders. In issuing his memo, Sessions essentially rolled back an Obama-era policy that sought to make punishments actually fit the crime more fairly.

With this, and rumblings that the attorney general plans to release a report soon linking marijuana use to violent crime and recommending harsher sentences for growers, sellers and smokers, Sessions' tough-on-crime stance has a clear message: People who do drugs need to be locked up.

Instead of acknowledging the public health ramifications of drug addiction—or even how complex abuse and dependence is—Sessions' advice is to "Just say no." But many experts believe rather than treating addiction as a crime, as the attorney general has made clear he intends to do, policies should consider it more of an illness.

"People start using substances for many different reasons: to feel good, to cope with physical or emotional pain, to relieve anxiety related to past or present traumatic events, etc.," Margie Skeer, an associate professor of public health and community medicine at Tufts University School of Medicine, told VICE Impact. "The human brain is wired to respond positively to reward, and drugs provide a level of reward that is much greater than rewards like having sex or eating good food."

"Treating addiction as a crime hurts almost everyone."

According to Skeer, addiction sets in when people are physically dependent on a drug and will do almost anything to get it. "It's not because they are weak or because they lack will power—it is because their brain essentially tells them that they have to.," she said. "Treatment allows the brain to recover and get back on track to not need the drug all of the time."

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Criminalizing addiction often makes things worse because people do not get the treatment they need, Skeer says. Moreover, the people who are most impacted by harsher drug laws are usually people from marginalized communities. According to the NAACP, blacks and whites use drugs at similar rates, but the imprisonment rate of blacks for drug charges is almost six times that of whites.

"Laws criminalizing drugs were born from racism and discrimination," Skeer said. "When certain groups of people were seen as a threat (including black, Chinese, and Mexican populations, to name a few), drugs that were associated with these groups of people became illegal. People could not be jailed for being a certain race, but they could be jailed for using drugs."

"Treating addiction as a crime hurts almost everyone," she continues. "People who are addicted to drugs need to be treated, not locked up."

One somewhat controversial pathway to helping people deal with addiction is harm-reduction services, such as syringe exchange programs or supervised injection facilities. Not only do these programs help reduce the spread of blood-borne illnesses, such as HIV and hepatitis C, Skeer says, but they also reduce the risk of overdose and minimize the chances of a person being accidentally stuck with a discarded needle.

Plus, she told VICE Impact, "When people are connected with harm-reduction centers, their chances of getting connected with psychosocial support, healthcare services, and even more so addiction treatment goes up dramatically."

"People who are addicted to drugs need to be treated, not locked up."

While there are other methods of treatment out there—including medication-assisted treatment, therapy and self-help programs—Skeer says it's important to have an array of options because addiction is so complex.

"The reasons people start using drugs are multifaceted, their experiences while addicted to drugs are multifaceted, and so treatments for addiction should be multifaceted," she said. "In the same way that different people need options when they have an injury to recover, people who are addicted need options to try to find the treatment that is most effective for them."

To find a harm-reduction center near you, check out this list of local resources compiled by the Harm Reduction Coalition, and you can learn more about Opioid addiction over at Tonic here.