People are dying at record rates from opioid overdoses, and harm reduction advocates are asking the Biden administration to overhaul how it deals with the crisis.
by Michelle ChenTwitt
Part 4 - Decriminalization
Only about 29 percent of people with opioid use disorders receive specialty drug treatment. Countless others who never make it to treatment end up behind bars.
Tom Smarch recalled how his family was priced out of treatment when his son was thrown into jail at 18. “There was no other place to go,” said Smarch, who has since become an advocate for drug policy reform with Shatterproof. “It was either jail or we would help him with some rehab—but then we didn’t have the financial ability to pay for three months of treatment: $28,000. And so we were stuck between a rock and a hard place.”
While the prevalence of opioid addiction across race and class lines has encouraged public-health-focused approaches to the crisis, drug-war policies have persisted. According to federal data, about 24 to 36 percent of people in prison or jail have a heroin use disorder. Over the past decade, as most states have imposed heavy penalties for fentanyl trafficking, federal convictions on these charges have mostly targeted Black and Latinx people.
During the pandemic, police targeting of people who use opioids has by some accounts intensified. Vincent said that when people were told to shelter at home, the lockdown “was always a reason to be pulled [over], so if you were somebody they wanted to harass, they totally could.”
Lisa Al-Hakim, director of operations of the Seattle-based Peoples Harm Reduction Alliance, is not sure how much will change under the new administration, or with the opioid lawsuit settlements. But her group has always relied on modest private donations and volunteers, not public funds, to distribute syringes and respond to overdoses in the community. Their interventions aim to challenge a drug-policy regime that is based on criminalization rather than healing underlying social problems.
Instead of the War on Drugs, she said, “if we looked into trauma-informed care, if we looked into more mental health services that…were available to people and affordable.… I don’t really think that we would need a giant industry of treatment facilities.… I think that the answer is paying attention to people’s needs in the first place.”
Lisa Wright, director of policy and advocacy with the National Harm Reduction Coalition, which supports decriminalization of opioids, posed the question, “Instead of just locking up people and throwing away the key, what are the ways that we can work together to ensure that we all get to exist, we get our self-determination, we get our autonomy, and we’re not dying in the process?”
For activists like Vincent, the disruption of the pandemic has only affirmed the need for political and medical establishments to listen to people who use drugs—including them in policy discussions, destigmatizing them, and supporting them with life-saving medication. Reflecting on her harrowing experience with tainted opioids, she said, “This is not a story about somebody that wanted to die. This is a story about somebody that didn’t have any desire to get high. I just needed to be well. I needed my opiate use disorder treated. And it was that hard to find anybody to help me treat my opioid use disorder…. It is the medicine that allows me to live and have a normal life. And we deny that to people every single day.”
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