What are the Different Types of Drug Policies?
Drug abuse and deaths are at an all-time high in the U.S. right now. In 2021, approximately 107,000 Americans died from fatal overdoses, an alarming 49% increase from just five years earlier. 46 million people currently struggle with the disease known as Substance Use Disorder, and the total economic impact is estimated to be $442 billion annually.
In the last 20 years, drugs have killed more Americans than in both World Wars, the Korean War, the Vietnam War, Desert Storm, and the War in Iraq COMBINED. Overdoses are this country’s leading cause of accidental death – more than gun homicides, suicides, or even traffic deaths.
With all this in mind, it’s no wonder the White House has called the overdose epidemic a “national health emergency” and the “worst drug crisis in American history.”
All of this means that the government at every level has an obligation to create policies that address this crisis in ways that protect its citizens.
Let’s take a closer look at what steps local, state, and federal governments are taking.
Drug Prevention Policies
“Given the impact of substance misuse on public health and the increased risk for long-term medical consequences, including substance use disorders, it is critical to prevent substance misuse from starting and to identify those who have already begun to misuse substances and intervene early.”
What are Drug Prevention Policies?
The best way to curb abuse rates, eliminate overdose deaths, combat crime, and otherwise address the drug epidemic in America is simply to stop people from using drugs in the first place.
According to the U.S. Surgeon General, the goals of drug prevention science include:
- Understanding the factors that increase the risk that a person will misuse substances – genetics, environment, mental illness, trauma, etc.
- Identifying protective factors against substance abuse – social support, mental health treatment, community involvement, etc.
- Designing targeted interventions and programs to steer people away from substance abuse, especially those most at risk.
Why are Drug Prevention Policies Necessary?
According to the 2020 National Survey on Drug Use and Health, first-time drug use is a serious problem in the United States. Look at how many people initiated the use of various substances in 2020:
- Marijuana: 2.8 million
- Hallucinogens: 1.4 million
- Prescription Painkillers: 1.2 million
- Prescription Tranquilizers: 950,000
- Prescription Stimulants: 734,000
- Inhalants: 678,000
- Cocaine: 489,000
- Prescription Sedatives: 343,000
- Methamphetamine: 153,000
- Heroin: 103,000
One of the reasons for such rates of first-time drug use is that fewer people believe that occasional drug use doesn’t pose any great risk.
- For example, in 2015, over 36% of people thought that smoking marijuana once or twice a week was dangerous, but by 2020, that number had dropped to a little more than 27%.
- Cocaine: Over 87% (2015) versus less than 85% (2020)
- Heroin: Over 94% (2015) versus 93% (2020)
While these declines in perceived risks are problematic across the board and show the need for increased drug awareness and prevention efforts, they also highlight the specific problem presented by the marijuana industry and its pro-legalization campaign.
Lobbyists push the false narrative that marijuana is harmless to further their agenda, to the point that many people are not even aware of the many hazards and long-term consequences of cannabis use.
Unfortunately, this mistaken public perception evidently carries over and softens the public’s perception of other dangerous substances.
Examples of Drug Prevention Programs
The good news is that there are many defensive strategies available to combat substance abuse at the federal, state, local, community, and even individual levels:
- Awareness Campaigns – To educate Americans about the dangers and consequences of substance abuse.
- Prescribing Guidelines – To help healthcare providers dispense potentially-misused medications in the safest manner possible.
- Prescription Drug Monitoring Programs (PMPs) – To track the prescribing of medications that carry a risk of misuse.
- Drug Scheduling – To restrict public access to medications that can be abused and ban outright substances without proven medical value.
- Mental Health Services – To address co-occurring mental illnesses that contribute to substance abuse, such as anxiety, depression, bipolar disorder, psychosis, or PTSD.
- Expanded Access to Treatment – treatment programs customize brain and environmental health.
- Recovery Housing – To provide stable, transitional, and drug-free housing for individuals in recovery.
Stopping substance use before it ever starts is also the most cost-effective way to combat the drug crisis in America, especially through early interventions targeting young people. Every $1 invested in prevention programs can return up to $65 by reducing costs associated with active Substance Use Disorder.
Drug Promotion Policies
On the other end of the spectrum are what can only be called drug promotion policies. These are laws that actually normalize the behavior of using drugs and make it easier for people to purchase and use them.
Step One: Decriminalization
Typically, this first manifests as a push to decriminalize a specific substance – making simple possession either a minor civic offense or no violation at all.
In 1973, Oregon became the first state to decriminalize marijuana possession, imposing a fine of just $100 for up to an ounce. Significantly, growing, cultivating, manufacturing, and selling marijuana still remained illegal.
Within 5 years, Alaska, Maine, Colorado, California, Ohio, Minnesota, Mississippi, New York, North Carolina, and Nebraska all decriminalized individual possession of small amounts of marijuana. Today, roughly half of all US states and territories have decriminalized cannabis.
Supporters of decriminalization argue that there is no reason to make a personal social vice a jailable offense. After all, they say, some people are going to use drugs no matter what, and it isn’t like decriminalization makes them any easier to get.
But that’s not where it ends.
Step Two: Normalization
When the behavior of drug use is no longer a crime, much of the stigma is removed. As a specific example, once marijuana was decriminalized in so many places, a shift in public opinion about the potential harms decreased.
In 1969, less than 13% of Americans favored increased acceptance of marijuana. But today, that number has risen to almost 70%. This is despite the continually-growing mountain of scientific evidence highlighting the dangers of cannabis use.
Why has this happened?
A 2018 study suggests that pro-marijuana media coverage may be the largest factor behind the shift in public perception and opinion. Beginning in the early 1980s, there was a sharp increase in the number of newspaper articles that talked about marijuana in a medical, rather than criminal, context. By the late 1990s, marijuana was rarely, if ever, discussed in terms of substance abuse or drug trafficking, as were other supposedly “harder” drugs like cocaine and heroin.
This is odd because, between 1991 and 2000, the number of marijuana arrests spiked sharply to historic levels, while the number of cocaine and heroin arrests dropped to almost 15-year lows.
So why the seemingly-incongruous reporting?
In a word, lobbying.
How Pro-Marijuana Lobbying Shapes Marijuana Policy
During the first round of decriminalization, one organization stands out for its work of lobbying legislators – NORML, or the National Organization for the Reform of Marijuana Laws. Founded in 1970, NORML aggressively lobbied for decriminalization and even paid for pro-marijuana politicians, doctors, and attorneys to travel to various states to testify.
Today, NORML remains a massive grassroots organization, with over 130 local chapters and an army of more than 550 lawyers. It continues to exert tremendous influence on media stories, legislators, and public opinion.
Other organizations that spend the most on pro-cannabis lobbying include:
- Cannabis Trade Federation
- Marijuana Policy Project
- National Cannabis Roundtable
- National Cannabis Industry Association
In many ways, these entities can be likened to lobbyists for the tobacco and pharmaceutical industries. The parallels are alarming – unethical practices, such as lying to the public about the health risks of marijuana, all in the pursuit of greater profits.
Even renowned drug policy expert Mark Kleiman, the so-called “Pot Czar” of Washington State, said, “The industry has interests that are different from the public interest…”
Step Three: Legalization
Then, it shifts to legalization. This means that not only is possession of the substance allowed, but so is its legal production and sale.
It happens in increments. Once marijuana becomes normalized, thanks to expanded decriminalization, the next step is pushing for legal, medical cannabis. Following the media shift of the 1980s, California became the first state to legalize the medical use of marijuana in 1996. Washington, Oregon, Alaska, and Nevada followed suit in 1998; today, nearly 40 states permit medical marijuana.
But if marijuana’s therapeutic uses really are the point of legalized medical marijuana, then most of those benefits can be realized without the need to get high. There is no need to legalize the consciousness-altering addictive form of the drug when there is a safer alternative.
Predictably, as more states legalized medical marijuana, use became even more normalized, and the needle shifted again.
In 2012, Colorado and Washington became the first states to legalize recreational marijuana. Today, about half of the US allows the cultivation, production, sale, and use of non-medical marijuana.
The Impact of Drug Promotion Policies
But the problem with drug promotion policies is that they legitimize harmful behaviors that negatively affect both the users and society. It also makes the drug more widely available and easier to obtain.
As an example, take a look at what’s happened in Colorado since recreational cannabis was legalized in 2012:
- Among all DUI arrests, citations for the combination of marijuana and alcohol or other drugs climbed from 5.7% in 2014 to 22.7% in 2020.
- Between 2013 and 2019, the number of traffic fatalities where the driver tested positive for cannabis jumped 140%.
- From 2006 to 2019, marijuana poisoning skyrocketed 673%.
- In 2021, children 5 and younger accounted for nearly half of all marijuana poisonings.
- Since 2012, the violent crime rate has risen significantly and is now higher than the national average.
- This is not an aberration because in several states where recreational marijuana is legal – Alaska, California, Colorado, Washington, and the District of Columbia – murders have reached an all-time high.
- By 2014, neighborhoods with dispensaries suffered crime rates that were up to 1452% higher than those without.
- By 2017, Colorado had the highest rate of youth marijuana use in the country – 74% higher than the national average.
A Slippery Slope
But there is another problem with drug promotion policies – what began with marijuana legalization is creating a culture where all drugs are normalized. Look at what is happening now:
For example, Measure 110 was supposed to help people struggling with dangerous substance abuse by issuing citations for possession. These tickets were supposed to steer violators to treatment services, but that simply hasn’t happened.
Less than 1% of those ticketed call the state-provided hotline to arrange treatment services. Worse, between 2020 and 2021, opioid deaths in Oregon increased 58%, far worse than the 17% national increase during the same period.
Especially relevant, Oregon suffers:
- One of the country’s highest rates of past-month and past-year youth marijuana use
- The highest rates of past year painkiller and methamphetamine use
- The highest rate of drug use disorders
- The second-highest rate of mental illness
It does not sound like Oregon needed to make drug use easier.
Currently, Oregon, Maine, and Colorado all allow the recreational use of psychedelic mushrooms, while in Vermont, Nevada, and California, they are approved for medicinal use.
Drug Recovery Policies
Substance Abuse Disorder, the disease commonly known as addiction, is an unfortunate reality for millions of Americans and their families. According to the 2021 National Survey on Drug Use and Health, over 46 million people ages 12 and older met the clinical criteria for a medical diagnosis of SUD within the past year. That represents 16.5% of the population or about 1 out of every 6 people.
These statistics highlight the overwhelming need for professional and specialized medical intervention.
Obviously, the best thing for someone already struggling with SUD is for them to check into an evidence-based rehab program. As with other chronic diseases, it is possible for people to manage their disease with the help of lifestyle changes, medication, and ongoing support.
Barriers to Drug Recovery
Unfortunately, however, in 2021, 94% of individuals with SUD did not receive ANY treatment services. There are three main reasons for this.
- First, as reported by the Substance Abuse and Mental Health Services Administration, the vast majority did not feel they needed professional help.
- Second, despite the fact that addiction is recognized by the scientific and medical communities as a legitimate disease of the brain – and not a personal choice or character flaw – there is still a very real stigma attached to addictive disorders.
The National Institute on Drug Abuse reports that 1 in 8 people with SUD who did feel that they needed help still did not seek treatment because they feared the negative reactions of their family, friends, employers, and community.
- Third, many struggling substance abusers face significant barriers to treatment. For example, they may worry about how to pay for rehab if they do not have insurance.
Other factors that can prevent some people from seeking treatment include a shortage of local facilities, a lack of available inpatient beds, child care, taking time away from work, loss of income, or no personal support system.
Examples of Drug Recovery Policies
Let’s take a closer look at how the right drug recovery policies can help anyone struggling with addiction overcome those barriers to treatment. The good news is there are several policies implemented by lawmakers that can make it easier for people with SUD to get the help they need to live a sober, productive life.
By far, an essential drug recovery policy put in place by the federal government is recognizing drug addiction as a legitimate disability. This move gives people with SUD specific rights and protects them from discrimination.
For example, employers must make reasonable accommodations for people with SUD who are not in active addiction. This includes protecting their privacy, job, position, salary, and duties while the person goes to rehab.
To be clear – you cannot be fired, demoted, or denied advancement because you have a history of substance abuse or because you are in a treatment program. Employers can, however, fire you if you fail a drug test or are currently in active addiction.
Of particular relevance, anyone with a substance-related disability is protected if they participate in a supervised drug rehabilitation program.
Next, the government maintains a regularly-updated directory of substance abuse and mental health treatment programs for each state. This allows substance abusers who are ready to recover to access the available rehab resources in their area. SAMHSA also has a 24/7 helpline for individuals and families in crisis.
Finally, SAMHSA helps people affected by substance abuse connect with the long-term support they will need if they are to safely and successfully regain their sobriety.
Harm Reduction Policies
By definition, a “harm reduction” policy does not address the person’s SUD, because it is not a form of treatment. The goal is not recovery or even sobriety. Instead, the goal is to minimize the damage caused by active addiction, both to the individual and to the community.
With overdose deaths at an all-time high – and still climbing – some are of the opinion that since there will always be people who abuse drugs, and since so many of them are resistant to seeking treatment, the only option left is to reduce the harms associated with drug abuse.
- Fatal overdoses
In other words, the goal is to keep the person alive and as stable as possible until they are ready to recover.
Examples of Harm Reduction Policies
Some claim the act of administering Narcan while a person is overdosing is a form of harm reduction. The Every Brain Matters community knows administering Narcan is providing First Aid. This emergency medication works by reversing an opioid overdose. This is important because roughly 70% of all drug deaths involve opioids – heroin, prescription painkillers, and, most often, fentanyl.
Expanded access to Narcan saves lives.
Also, there are so-called “overdose prevention centers,” which are supervised drug consumption sites. People bring their own drugs and may avail themselves of any of the supplied paraphernalia – alcohol wipes, syringes, pipes, straws, etc. They can use their drugs of choice without fear of arrest.
Proponents claim needle exchange programs reduce the risk of spreading diseases like HIV, AIDS, or hepatitis. In fact, a 2015 study found that these kinds of programs reduce the incidence of HIV by 74% over a 10-year period. However, these types of programs are not always accepted in communities, and critics say they only normalize the behaviors of using drugs and are contributing to America’s drug crisis.
When the nation’s first such facilities recently opened in Manhattan’s Washington Heights and East Harlem neighborhoods, they claimed they stopped over 150 overdoses within the first three months. Still, overdose deaths continue to rise in other cities with needle exchange programs, and many view these sites as enabling rather than helping.
Though some IV drug users return used needles to these programs, others do not, leading to environmental harm. It’s becoming common for residents to complain or even be exposed to leftover containment needles in neighborhoods and parks.
Opioid Replacement Therapy
Heroin and other opioids are considered the most addictive drugs in the world, complicating recovery. Cravings can be so intense as to overwhelm even the best of intentions, so the person relapses repeatedly.
One way to combat this and to reduce the harm of active addiction is through Opioid Replacement Therapy (ORT), where a less-dangerous opioid medication is prescribed as a substitute for the illicit drug.
In this way, the person’s opioid cravings are safely satisfied while the risks are minimized. The long-term goal of ORT is to slowly taper the dosage until the person can quit completely.
The immediate goal is to help the person achieve a degree of stability so they can keep a job, maintain relationships, and live as normal a life as possible. And while counseling and other forms of addiction treatment are not mandatory to receive ORT, if the patient wants help, they can be connected to resources.
The two most commonly prescribed ORT medications are methadone and buprenorphine.
Criticisms of Harm Reduction Policies
The biggest criticism of harm reduction is that it does nothing to address the underlying disease directly. Not only does the person stay locked in active addiction, but they also have very little external motivation to change.
Opponents of harm reduction strategies say that it fails because it is a defeatist philosophy – that society is helping the person stay addicted instead of doing everything possible to prevent them from doing drugs or helping them to recover if they are already dependent.
Former Drug Enforcement Administration official Jim Crotty says, “The goal can’t simply be to keep people alive. If you believe, like me, that doing drugs is very destructive, then the goal has to be to stop doing drugs.”
The Bottom Line About Drug Policies
At Every Brain Matters, we know that marijuana alone causes both users and society great harm. Regular use of marijuana opens the door and can pave the way for more drug use. We oppose policies that work to promote, normalize, and commercialize more drug use. Besides, legal drugs harm the most because they are used the most. Regulating alcohol and nicotine has not been all that successful, and we are fools to think we will successfully regulate marijuana. As a country, we must urgently focus only on drug prevention policies and recovery policies.
Harsh criminal sentences for simple marijuana possession of products with low THC content is not a solution either. However, denying a person some type of accountability that deters them from self-destructive behaviors that impact their community is not a solution; often, it blocks their opportunity to a pathway of healing. We must discourage the use of marijuana, not encourage use.
Grass Roots: The Rise and Fall and Rise of Marijuana in America by Emily Dufton