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Nation's Leading Public Health Organization Calls for Drug Decriminalization as Part of Major Overhaul to U.S. Drug Policy

Daniel Robelo

The leading public health organization in the country recently unveiled a clear and comprehensive exit strategy for the failed war on drugs.

With little fanfare, the American Public Health Association adopted a sweeping resolution last November calling for “a full reorientation” of U.S. drug policy “toward a health approach to drug use.”  The resolution condemns the drug war as “an engine of mass incarceration” that has only amplified the harms of drug misuse, such as fatal overdose and disease, while causing or contributing to frightening levels of prohibition-related violence.

As a solution, APHA recommends “ending the criminalization of drugs and…prioritizing proven treatment and harm reduction strategies.”

Established in 1872, APHA is the world’s oldest and most diverse public health association – and the foremost body of public health professionals in the U.S. Now these experts have spelled out what a truly ‘public health’ approach to drugs looks like:

  1. End the criminalization of drug possession and use. Joining other prominent organizations – including Human Rights Watch, International Federation of Red Cross and Red Crescent Societies and Organization of American States – APHA endorses the elimination of criminal penalties for possession and use of all drugs (commonly called decriminalization).
  2. Invest in (and eliminate barriers to) effective treatment and harm reduction services. APHA urges the permanent repeal of all bans on funding sterile syringe access programs, and for voluntary, community-based treatment – including methadone and buprenorphine – to be available to everyone who needs it.
  3. Explore and adopt cutting-edge harm reduction programs – like supervised injection facilities and heroin-assisted treatment – which have proven enormously effective everywhere they’ve been tried. APHA acknowledges the overwhelming evidence in favor of such interventions: they save lives, save money and significantly improve the health of the people they serve – who are often the most marginalized, stigmatized, at-risk and hard-to-reach drug consumers. Its resolution asks legislators to get over their ideological hang-ups and conduct research trials in the U.S – and if the research proves favorable, to implement such programs without delay.
  4. Stop wasting money on drug courts – which are NOT a public health approach. APHA throws cold water on those who think drug courts can somehow fix the drug war’s failures. According to APHA, drug courts are “costly, are no more effective than voluntary treatment, serve very few people…often deny proven treatment modalities such as methadone and buprenorphine…[and] have absorbed scarce resources that could have been better spent on bolstering demonstrated, health-centered approaches.”

    In its blistering critique, APHA writes, “Coerced treatment is ethically unjustifiable, especially when voluntary treatment can yield equal or more positive outcomes.” It recommends “deprioritizing the use (and funding) of non-health agencies, such as drug courts …to deal with people who use drugs, and redirecting resources from criminal justice programs toward public health interventions to improve the health of such individuals.”
  5. Open the debate about regulating drugs. Recognizing that prohibition continues to generate unacceptable levels of violence and corruption, APHA lends its voice to the growing chorus of organizations calling for a vigorous debate about regulatory options for controlling drugs while strengthening public safety and health.

The Drug Policy Alliance has long advocated for this same set of policies – policies grounded in science, compassion, health and human rights. Congress and the states should get to work following this public health roadmap for ending the disastrous drug war.

Daniel Robelo is research coordinator at the Drug Policy Alliance.

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