The Partnership for Drug-Free Kids recently startled me with a blog post titled, "Why You Shouldn't Use the Word Addict." Drug addiction is a disease, the blog explains. People shouldn't be defined by having an illness, so it's better to use first-person language and say "someone with diabetes" rather than "diabetic." The same should go for the word "addict."
In other words, the ad was saying, we shouldn't stigmatize people living with addiction by identifying them based on one condition with which they struggle. I was startled by the blog because stigmatizing drugs and drug users is exactly what the Partnership for Drug-Free Kids did for years under its previous banner, the Partnership for a Drug-Free America.
"This is drugs. This is your brain on drugs." Sound familiar?
The Partnership is best known for aiming anti-drug advertisements at young people during the 1980s and 1990s. Nowadays, these ads are sources of ironic nostalgia on YouTube, where they are routinely mocked and parodied. However, at the height of the drug war, the ads were mainstays on the airwaves, supported first by generous foundations and later by a billion-dollar partnership with federal authorities.
Thanks to the Partnership and its allies, young people like myself learned that smoking marijuana would deflate you like a balloon, and using drugs was like cracking your skull open and frying your brains on a hot skillet. Short on facts but heavy on scare tactics, these ads warned against becoming a "junkie" or an "addict," all while portraying drug users as "criminals" and "losers." This is just the type of stigmatization the Partnership warns against today.
What changed? For starters, the anti-drug ads and the broader "Just Say No" campaign had no discernable impact on rates of teen drug use, and government funding eventually dried up. Social attitudes have grown more liberal, particularly towards marijuana. But there are much more sinister reasons for the anti-drug movement's change in tone.
Radical Ideas Go Mainstream
For decades, US border and law enforcement operations have fueled large-scale violence across Mexico and Latin America. At home, harsh anti-drug laws caused incarceration rates to skyrocket, devastating families and communities of color in the process. Rates of teen drug use are declining, but the nation is reeling from an ongoing crisis of fatal opioid overdoses. The government reports that rising overdose rates have been driven in part by prescriptions signed by medical doctors, a far cry from the lurking street dealers depicted in racist anti-drug ads of the 1990s.
The dominant media took notice as the overdose crisis reached into whiter, wealthier neighborhoods. Suddenly, the Obama administration and lawmakers in both parties began uttering phrases like "public health issue" and "access to drug treatment" that reformers have repeated for years. What's more, politicians began embracing strategies first developed by grassroots radical organizers working outside of the law.
In the 1980s, gay activists and radical health care organizers took matters into their own hands as HIV/AIDS spread through neighborhoods in New York City and other urban areas. They knew the virus spread when heroin users shared syringes because there weren't enough around. They also knew that opioid dependency can be very difficult to treat, and that an abstinence-only approach would not eradicate use. So, they organized street-level services where used syringes could safely be exchanged for new ones, despite laws against possessing drug paraphernalia. They treated drug users as neighbors and human beings, not the desperate burnouts conjured up by anti-drug campaigns.
These early harm reduction activists eventually teamed up with forward-thinking public health workers, and over the next 30 years, syringe exchange became an international gold standard for controlling rates of HIV and hepatitis C infection. Despite endorsements from public health offices across the globe, Congress retained a ban on funding syringe exchanges until 2009, when Democrats were finally able to lift it. After regaining a majority, Republicans put the ban right back into place.
In 2014, an outbreak of HIV infections among injection opioid users in a rural, white community in Indiana made international headlines, thrusting the so-called "opioid epidemic" into the national consciousness. Despite pushback from then-Gov. Mike Pence, GOP lawmakers from areas in Indiana and nearby Kentucky with high rates of opioid misuse began embracing syringe exchange. Within months, Congress lifted the ban on federal funding.
There is more to harm reduction than syringe exchange. For example, activists were training each other to administer the lifesaving overdose treatment Naloxone long before lawmakers began making it easier to access the drug. For decades, harm reductionists have also handed out condoms and Band-Aids and referred people to treatment programs. Some harm reduction activists are drug users themselves, dedicated to keeping the people around them and their own bodies as safe as possible. Harm reductionists -- along with many public health professionals and legal reformers -- see drug misuse, dependency and overdose as health issues, not crimes.
It has taken countless tragedies to get this point across to policymakers, but activists and reformers are not losing hope. Giving up is not an option. Each year, cops in the US make 1.2 million arrests for drug possession, and on any given night there are 133,330 people behind bars for simply possessing drugs, including 63,000 who are stuck in jail because they can't afford bail, according to the Drug Policy Alliance. Behind these numbers lie overwhelming racial disparities. For example, Black people make up 13 percent of the population and use drugs at similar rates as whites; in fact, white people are actually more likely to use cocaine and heroin. However, Black people make up 29 percent of those arrested for drug violations and 35 percent of those locked up in state prison for possession only.
As long as so many drugs remain illegal, people who use them will end up in handcuffs and forced rehab, even if rehab is not something they want or need. Those who do need help will face barriers to treatment, including the fear of arrest, housing discrimination, loss of public aid and stigma. Criminal records haunt low-wage workers for the rest of their lives.
The Partnership may have shifted its focus from sensational ad campaigns to educating parents about treatments for teens misusing prescription drugs, but without changes to the law, cops and courts will continue disrupting the lives of people living on society's margins, where drug enforcement is concentrated.
A Roadmap to Decriminalization
The idea that criminalizing drug users causes more harm than good is no longer considered radical. The World Health Organization, the American Public Health Organization and dozens of global leaders have all called on governments to end criminal penalties for possessing drugs for personal use, and to focus their efforts on public health solutions to society's drug problems instead. The time to decriminalize drugs is right now, and many reformers see a clear political path to achieving this goal, despite the current political situation in Washington.
Many reformers see a clear political path to decriminalization, despite the current political situation in Washington.
The Drug Policy Alliance, which has built a sphere of influence stretching from the halls of Congress to the grassroots, recently released a report that lays out the case for decriminalization and provides policy makers with clear instructions for pulling it off at every level of government. Tess Borden, who works with drug users at Human Rights Watch and the American Civil Liberties Union, said that this "comprehensive roadmap" to decriminalization should be "required reading" for decision-makers at all levels of government.
"The report makes clear not only that decriminalization is possible, but also that we are closer than we may think," Borden said.
These are strong words considering the rise of Donald Trump and his attorney general, Jeff Sessions, who has turned back the clock on federal efforts to end the drug war. He opposes legal marijuana -- unlike a majority of voters -- and is expected to receive recommendations this week from a special crime task force that has been studying his options for enforcing federal prohibition in states where weed is legal. Advocates fear Sessions will initiate a crackdown, but that would be deeply unpopular, including among some fellow Republicans. In May, Sessions reversed an Obama-era policy urging prosecutors to avoid bringing charges that would subject drug offenders to harsh mandatory-minimum sentencing requirements, a move that was criticized on both the left and the right.
Many activists want Congress to decriminalize drugs nationwide, but most acknowledge that it will be an uphill battle. State and local-level initiatives can be just as effective and even more meaningful because stakeholders, such as drug users and health professionals, can have a stronger voice in the decision-making process, according to Emily Kaltenbach, the Drug Policy Alliance's director for criminal justice reform strategy. Initiatives also have a better chance of succeeding politically.
"The public will is there," Kaltenbach recently told reporters. "People are tired of seeing their families locked up or enmeshed in the criminal justice system."
Legislation decriminalizing possession of marijuana and other drugs has advanced in state legislatures and city councils across the country, and some jurisdictions are considering establishing safe spaces for injection drug users. Seattle practices "de facto" decriminalization: Police are ordered not to arrest people for drug possession, and to direct them to treatment services instead. (However, it should be noted that this is not an end in itself; law enforcement's role in responding to problematic drug use should ultimately be dramatically reduced, and police must be held accountable for their role in the drug war.)
There are challenges. Many parts of the country lack adequate public health and drug treatment programs, and Republicans in Congress are eager to siphon off Medicaid dollars that support them. The legacy of abstinence-only drug education lingers in schools, and young people continue to experiment with drugs without an understanding of how to minimize the risks. Selling drugs that are not legally regulated would remain a crime under most decriminalization schemes, allowing law enforcement to continue their war with international cartels and target members of low-income communities of color for arrest.
Decriminalization provides a space to untangle these problems, a crucial step towards a future where people can legally and safely access drugs if they choose to and receive health care if they need it. There are already plenty of models for what legalization could look like -- marijuana is now legally regulated in several countries -- and decriminalization makes them easier to explore. As a society, we must answer tough questions about how to shape access to powerful drugs like opioids and amphetamines that are currently available both on the street and with a prescription; but in the meantime, we must stop jailing people for using them. In this way, decriminalization is a crucial step toward ending the entrenched stigma against drugs and people who use them.
"The stigmatization of drug-involved people, especially those who are poor and are racialized, is what drug criminalization is built upon," Kaltenbach said.
Society is still healing from the anti-drug propaganda that proliferated during the height of the drug war, when treating individuals who use drugs as whole people deserving of dignity, health care and human rights was considered a radical act. As it turns out, the radicals were right.