People use drugs for many reasons, including pleasure, healing, spirituality, and cultural practices. We believe that people have a right to put what they want in their own bodies and that people should be able to access a legally regulated and safer supply of drugs where they know exactly what they are getting and at what dose. But, that’s not the current reality.
Right now, people are accessing drugs in dangerous ways due to punitive drug policies that criminalize people for using or possessing drugs. We are dealing with an unregulated, unsafe, contaminated drug supply that is fueling the overdose crisis and killing our loved ones, even those without substance use disorders. The fear of criminalization creates barriers and perpetuates stigma, which stops people from seeking help during an overdose emergency. In the last two decades, people have died in the United States from preventable overdoses. In 2021 alone, 107,600 lives have been lost to overdose.
The failure of our nation and world leaders to decisively act will cost more lives. The evidence is clear that prohibition does not work. It is a deadly and costly failure.
Prohibition has led to the mass criminalization of primarily Black and brown communities in the U.S. It has also fueled human rights atrocities, economic devastation, and mass-scale violence abroad. Rather than decreasing overdoses, deaths have skyrocketed, driven in large part by a drug supply contaminated with fentanyl. Fentanyl is a potent opioid, which has been found in illicit heroin, counterfeit “prescription” pills, and other drugs. Make no mistake about it, drug prohibition created the fentanyl crisis.
The Drug Enforcement Administration (DEA) budget alone costs U.S. taxpayers upwards of $3 billion dollars a year. The current overdose crisis is now costing the U.S. economy more than $1 trillion a year. This is money that can be better spent on the services and social supports people need to thrive and address problematic drug use.
It’s past time we take bold action to save lives. Legal regulation and safer supply can help keep people alive by reducing the likelihood of accidental overdose. Under legal regulation, people who use drugs would know exactly what they are getting, including potency, and could be assured that the substances they are using are not contaminated.
Legal regulation and safer supply must be implemented the right way. This means providing the social and economic circumstances for people to thrive, ensuring big businesses and commercialization are not prioritized, and that we are centering the well-being and health of people.
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Legal regulation and safer supply are not new concepts. We can learn from success and failure of current models—such as prescription medication, vitamins, alcohol, tobacco, cannabis—to create safer supply models and policies that prioritize public health and reduce harm.
Some have pointed to the illegal and fraudulent marketing of prescription opioids as reason why legal regulation and safer supply cannot work, but, in fact, it serves as a critical reminder that putting profit over people is bound to result in harmful consequences for our most vulnerable. Public health and safety must always come before profit.
There is a spectrum of what regulation can look like, including state-run systems, compassion clubs, and non-profits. Other countries have already begun experimenting with different models. Switzerland and Canada, among other countries, offer heroin maintenance programs, which provide people dependent on opioids with pharmaceutical–grade heroin or hydromorphone. Decades of research support their efficacy.
In Canada, a “Compassion Club Model” was approved by the City of Vancouver and piloted in 2020. According to the Canadian Drug Policy Coalition, The Drug User Liberation Front (DULF) and the Vancouver Area Network of Drug Users (VANDU) “obtained street drugs (e.g., crack cocaine, heroin, and methamphetamine) from darknet (online) markets, tested the contents of the drugs, and returned the drugs to the street market in sealed packaging with clearly labeled contents. No deaths have occurred as a result.”
The Drug Policy Alliance is working with experts, including people who use drugs, to explore a range of models for legal regulation that create appropriate access while safeguarding the public’s health.
The unregulated drug supply is contaminated and killing our communities. We need to look toward legal regulation and safer supply as a promising way to lessen the harms that flow from the illicit drug market and to save lives.