America’s New Drug Policy – The New York Times

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For decades, the US has focused on trying to scare people away from drugs, imposing tough criminal penalties and emphasizing law enforcement on addiction treatment.

But major changes are underway.

The old approach failed to stem the overdose crisis that now kills more than 100,000 Americans each year. Policymakers have woken up to the problem and shifted resources, i.e. funding, to treatment. While criminal penalties for drugs remain, many states, led by Democrats and Republicans, have reduced them. Lawmakers now often discuss drugs as a public health issue, not just a criminal justice one.

Some lawmakers have even adopted a radical strategy called harm reduction. The approach focuses on reducing the potential dangers of drugs, not necessarily encouraging users to stop.

Republicans, whose party has historically opposed harm reduction, are among those who support some of these principles. The Republican-controlled Texas House of Representatives voted last month for a bill that would eliminate drug testing for fentanyl, a powerful opioid that is often mixed into heroin, pills and other drugs. Republican strongholds, including Kentucky, Utah and Mississippi, recently decriminalized lane testing.

“My hope is that everyone struggling with addiction has access to quality recovery programs and has the opportunity to achieve and maintain long-term sobriety,” said Rep. Tom Oliverson, Republican of Texas who sponsored the state bill. “But if he dies immediately from an unknown drug, I can’t fix it. No one can.”

The country is undergoing a “determined shift” to harm reduction, said Regina LaBelle, who heads the Office of National Drug Control Policy in the White House under President Biden. In 2015, Congress lifted a ban on funding for needle exchanges, where clean syringes are distributed so people don’t reuse or share infected equipment. And in March, the FDA for the first time made naloxone, an opioid overdose reversal drug, available over the counter.

The modern version of harm reduction began in the 1980s, when the drug problem and the AIDS crisis prompted activists to pursue things other than criminalization.

He helped establish a needle exchange in hopes of stopping the spread of HIV through dirty needles. Critics say needle exchanges encourage drug use and could lead to overdose deaths by removing deterrence to drug use.

Anecdotal evidence refutes these claims. Needle exchange has been shown to reduce infections, according to the CDC In fact, needle exchange programs can reduce overdoses and drug use over time, by acting as a hub that educates people in safe practices and connects them to addiction treatment.

Much of this evidence has been around for decades. But until recently, many policy makers adopted a harm reduction approach.

What has changed? Three things, experts say.

First, lawmakers are desperate to reduce overdose deaths, which have been on the rise for decades and will exceed 100,000 a year for the first time in 2021. Old ideas, like heavy criminal fines, are clearly not enough. Being a member of parliament is an alternative that was once rejected, looking for any solution.

Second, the overdose crisis is now so widespread that many people, including members of Congress, know something is wrong. “Every member of the House and Senate has gone to a constituent who is grieving, burying a child or a sibling or a mother or a father,” said Keith Humphreys, a Stanford University drug policy expert. “It creates an incentive, emotionally and politically, to try things that are unacceptable.”

And the third is the role of race and class. Previous drug crises have disproportionately affected marginalized populations — such as blacks during the crack epidemic of the 1980s and poor whites during the meth epidemic of the 1990s-2000s. Rich, white people don’t have that problem. Stereotypes about drug use develop. A punitive approach, aimed at keeping drugs away from communities that have not yet been affected, is being implemented.

Today’s overdose crisis is hitting white people of all classes more directly, including lawmakers. It’s uncomfortable that policymakers can more easily act — and do it with compassion — when it comes to issues that affect them, often rightly so.

Harm reduction is still far from gaining universal acceptance. Last year, Senate Republicans criticized the potential inclusion of crack pipes in the safe smoking kit of the federally funded program. Some conservative states, such as West Virginia, have restricted or blocked needle exchange programs. Many lawmakers from both parties rejected more controversial ideas, such as supervised injection sites. In Texas, the House fentanyl test strip bill was tabled in a Senate committee, although Governor Greg Abbott voiced support for the idea.

However, there is significant, but uneven movement. Three years ago, fentanyl test strips were banned in 33 states. Today, they are legal or will be at least 37.

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Haiyu Zhang, a student, said the technology allows her to focus on big concepts while algorithms fill in the details. “What makes an artist special is the ability to imagine something new,” he said. “So, while I think that AI tools help us express our creativity, creativity will still be the driving force for the future of art.”

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