We need to kick our harmful addiction to punishment

We need to kick our harmful and ineffective addiction to punishment – KevinMD – Marc Krupanski |May 3, 2017

As New Jersey Governor Chris Christie takes the lead in crafting the Trump administration’s response to the opioid crisis, he and his colleagues need to understand that we can’t fix the problem until we kick our long-term addiction to the war on drugs and accept overdoses for what they are: a health issue.

Although the majority of Americans who consume illicit drugs do so without addiction, opioid overdose has become a deadly reality.

Expecting the criminal justice system to solve a health crisis does more harm than good.  

A growing number of Americans believe that drug misuse is a health problem. Yet we continue to rely on law enforcement and the criminal justice system to deal with it, despite resounding evidence that punishment does not stop people from misusing drugs.

Treating law enforcement as the primary responder to overdoses encourages punitive responses, like charging overdose survivors and bystanders with drug possession and other offenses.

The widespread adoption of drug courts — praised by former U.S. Attorney General Eric Holder as a way to “strengthen public health and build stronger, safer communities” — is a similarly flawed solution. While some people have found help through drug courts, many of them rely on judges, not doctors, to make decisions about treatment. Drug courts often require total abstinence as a one-size-fits-all solution, sometimes ordering people off of medications like methadone or buprenorphine that are helping them reduce their reliance on heroin. Drug courts can also push people into the treatment system who aren’t dependent on drugs.

People for whom drug-court-ordered treatments don’t work are then punished and pushed back into the criminal justice system, often with harsher prison sentences than they would have received in the first place.

There’s a better way. It’s called harm reduction.

This approach focuses on reducing the negative effects of drug use rather than on punishing people who use drugs in an often-futile attempt to make them stop

In Vancouver, Canada, police have urged drug users to use the city’s supervised injection facility, Insite, to prevent overdoses. In countries as diverse as Kyrgyzstan, Kenya, and Moldova, police have developed operational guidelines to respect the human rights of people who use drugs and advance public health goals like HIV prevention.

If we are serious about preventing overdoses and reducing the harm associated with substance misuse in the U.S., similar programs should be created here. We need solutions that meet people where they are, treat them as human beings, and provide evidence-based services to help them make necessary changes to lead healthier and safer lives

Above all, we need to kick our harmful and ineffective addiction to punishment — so police, health providers, and people who use drugs can work together to save and transform lives

Author: Marc Krupanski is a program officer, Public Health Program of the Open Society Foundations. This article originally appeared in STAT News.
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One thought on “We need to kick our harmful addiction to punishment

  1. Candi Simonis

    This war on “opioids” is actually a war on chronic incurable diseases. A war on chronic pain disease patients who benefit from opioid medications. Medications that enable millions of Americans relief of chronic debilitating pain associated with these diseases.
    100 million Americans have one or more chronic incurable pain Disease. As the CDC, DEA, FDA, Medicaid and Medicare, and numerous other government agencies, are blaming Doctors for the over prescribing of opioid medication. NOBODY, is looking at or reading the statistics from chronic pain disease patients. How about NOT addressing these drugs as dangerous and addictive. When all else fails: physical therapy, exercise, over the counter medications and numerous injections etc, we chronic pain disease patients, are left with one option to help us cope, opioid pain medication. Lets address this medication as lifesaving and medically necessary for the million of Americans with chronic diseases. Chronic pain is a disease. Chronic pain disease patients are now the epidemic. The addiction rate of chronic pain disease patients is .02-.6 %. We do not misuse or abuse our medications.
    No other disease medication is scrutinized. We, as patients, are being denied, dismissed, overlooked and discriminated against, by our physicians, due to all the scrutiny associated with treating chronic pain disease with opioid medications. Our Dr’s are afraid to treat us humanely and adequately. We have a disease that medication is readily accessible to us and we are being denied. We, pain patients, are being discriminated against, due to people who abuse illegal heroin, illegal fentanyl and/or misuse opioid medication and place the blame on everyone but themselves. This is a direct hunt for Doctors who prescribe life saving medication, for pain disease patients, that benefit from them. We have our privacy invaded, we no longer are able to have doctor/patient confidentiality. We now have insurance agencies, pharmacists, and other government agencies in our physicians offices. Monitoring and policing our physicians.
    Though the statistics show a reduction in, medically needed, opioid medications, death rates of overdoses from illegal opioids is rising. This system and laws are obviously not working.
    The specific causes of deaths also needs to be closely investigated. The opioid in the person’s system needs to be specified. Was it an illegal opioid, was it opioid medication specifically for that person, was there other drugs or alcohol involved. All these questions need answers.
    We have a chronic disease. We want to be able to take care of our homes, our children, our selves, as much as possible, but without access to these life saving medications, we are unable to do so. We want to live, not just exist in pain 24/7.
    We need the government agencies to look at the real statistics, not the hand picked. These agencies are not physicians. They are trying to doctor us, patients, without a medical license. They are also trying to police our physicians. This is a war on a disease, medications, physicians and patients.
    The statistics do not differentiate what opioid drug attribute to a fatal overdose or misuse of medication. Was is an illegal drug, heroin, illegal fentanyl, carfentynal, was that person’s legitimate medication? All these questions need answers. The information needs to be addressed.
    We need help. All the headlines, topics and stories on how opioids are bad and how people are abusing, misusing, overdosing, becoming addicted or dying from them. We need to look at the good they do and how they help our disease of chronic pain and the million of Americans who use them for some relief.
    The government needs to put the focus on illegal drugs coming into, being manufactured and distributed in this country, illegal fentanyl, illegal heroin, methamphetamine, cocaine and all other ILLEGAL DRUGS. People who abuse and misuse medication, not prescribed to them, illegal drugs, alcohol, sex, whatever it may be, will always find a way. Put the focus on that. Not the legally and medically necessary medications we patients need.

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