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Treating Some Drugs Like Food Regulations Could Radically Alter Long-Term Addiction

If we want to end overdose deaths we need to radically rethink our drug policies with new solutions like drug checking services and supervised consumption sites.
Photo via Dan Toulgoet.

This is an opinion piece by Derek Rosenfeld, manager of social media and media relations for the Drug Policy Alliance.

Kellyanne Conway is a political consultant with no background in public health, and yet she is the person who is leading the Trump administration’s response to the opioid overdose crisis. Her lack of experience and inability to effectively address this crisis was on full display when she jokingly told a forum of young people: “eat the ice cream, have the french fry, don't buy the street drug.”

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This ridiculous line of advice came up while Conway was trying to underscore the dangers of fentanyl.

“On our college campuses, your folks are reading the labels, they won't put any sugar in their body, they don't eat carbs anymore, and they're very, very fastidious about what goes into their body. And then you buy a street drug for $5 or $10, it's laced with fentanyl, and that's it,” Conway said at a forum hosted by the White House.

If we decriminalize drugs and move towards a public health framework it will be easier to expand medication-assisted treatment services that have been proven to work.

I really want to underscore the importance of something Conway said. She points to “the labels” college students are reading as an example of how people can make choices when they know what it is they’re consuming – and how to avoid things they don’t want, like sugar or carbs. Because ice cream and other foods are regulated, they are required to come with a label that tells you what is in it. But when someone goes to buy cocaine, MDMA, heroin, meth, or something else that’s illegal, they don’t know what they’re getting. Almost none of the people who use heroin are seeking fentanyl, and they aren’t prepared to protect themselves from its risks. This is why I think Kellyanne Conway actually inadvertently made the case for legalizing drugs.

The whole reason there are labels on food and (legal) drug products is because of the Pure Food and Drug Act of 1906, which was passed deliberately to prevent the manufacturing and sale of adulterated foods and drugs. If Kellyanne Conway is concerned about the dangers of potentially-adulterated illicit drugs, then regulation and labeling is one clear answer.

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I’m not saying drugs like cocaine, heroin and meth should all be available to buy at the corner store so long as they have a label. But in some countries it’s totally legal for a person who has struggled with long-term heroin addiction and has been unable to stop using to visit a heroin-assisted treatment (HAT) clinic, where legal, pharmaceutical heroin is used to help people titrate their use. These countries do not have thousands of people dying from overdoses like we do.

Whether legal or illegal, the effects of taking almost any drug are predictable when you know its purity and proper dose. If you take two Advil, for example, you know what to expect vs. if you take twenty because the label says each pill is 200 mg and the proper dose is 400 mg for an adult. You can also be confident that the pills aren’t cut with other drugs because Advil is legally regulated.

If we’re going to end overdose deaths we need to radically rethink our drug policies. We need to move away from Trump’s calls for harsher penalties, longer prison sentences, “Just Say No” commercials, and the death penalty, and move towards policies grounded in science and harm reduction.

Conway also said, “Most of America suffers from information underload when it comes to the horrors and the dangers and, really, the toxicity and lethality of fentanyl.” But then all she said was that it’s synthetically produced, it comes into the U.S. in a couple of different ways, and it’s got “50 times the potency of heroin and 100 times the potency of morphine.” Conway is seemingly trying to scare young people into not using drugs, and we know that “Just Say No” campaigns are a failure.

Here are some real and helpful facts about fentanyl. And here’s an explanation for why there is virtually no heroin without fentanyl in many places. Hint: it’s because of prohibition.

If we’re going to end overdose deaths we need to radically rethink our drug policies. We need to move away from Trump’s calls for harsher penalties, longer prison sentences, “Just Say No” commercials, and the death penalty, and move towards policies grounded in science and harm reduction. If we decriminalize drugs and move towards a public health framework it will be easier to expand medication-assisted treatment services that have been proven to work and we can open ourselves up to new solutions like drug checking services and supervised consumption sites.

We’ve been waging a war on people who use drugs for nearly 50 years and it has put us in the situation we’re in now, where tens of thousands of people are dying every year of drug overdoses. The evidence shows harm reduction is the answer – all we need to do is push ourselves to do something new.