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February 1, 2022
Different perspectives one year after Measure 110 took effect decriminalizing low-level drug possession in Oregon
Via an email with this press release from the Drug Policy Alliance, I received a reminder that today marks one year since the effective data of Measure 110, Oregon's ballot initiative decriminalizing personal possession of all drugs. The DPA release suggests there is much to celebrate on this anniversary:
While the robust support infrastructure is still getting off the ground, early results show over 16,000 people have already been able to access services. Additionally, there has been a nearly 60% decrease in the amount of people who have been arrested for any drug offense (approximately 3,700 drug offense arrests in the first 10 months after decriminalization took effect compared to over 9,100 arrests in the same 10-month period of 2020....
According to the first round of data from the Oregon Health Authority (based on grant reports from the Access to Care grants that went out last spring and summer — representing the initial $31.4 million previously mentioned — to 67 organizations and 11 tribes and tribal organizations), the funding has been used to:
- Provide grant funding to 67 harm reduction, treatment, housing, peer support and recovery organizations across 29 counties
- Provide funding to 11 Tribes and Tribal organizations through Tribal set aside
- Provide services to 16,000 people, 60% of which engaged with harm reduction services
- Hire 115 staff to provide a variety of health, harm reduction, treatment, housing and recovery services
- Purchase 12 vehicles to provide mobile health and harm reduction services
- Purchase three housing units - one motel, one duplex, and one gender and culturally-specific recovery house, plus 10 tiny houses
- Secure four leases on new facilities
- Purchase 154,535 harm reduction supplies
- Pay for four 24-hour peer support and crisis phone lines
This Filter article reports on the one-year anniversary in a somewhat similar vein under the headline "One Year on, Oregon Drug Decriminalization Is Boosting Harm Reduction and Housing":
Housing is another particularly important need that Measure 110 is helping to address. “Not everyone’s going to get into residential treatment and not everyone needs residential treatment,” [Tera Hurst, executive director of the Health Justice Recovery Alliance] said. “Some people actually have better outcomes if you’re able to house them in their community and offer these ‘wraparound’ services.”
Hurst acknowledged Oregon’s huge task of setting up the behavioral health resource network in 2022. But advocates like her are also on the defensive — already, state lawmakers are making plans to take money allocated for expanding services and spend it instead on more police.
Challenges and battles remain, therefore. But thousands of people in Oregon, whether receiving services or avoiding arrest, have already felt benefits from Measure 110. And with major funding soon to be rolled out, many more positive impacts are expected in 2022.
But some other media sources have a somewhat different perspectives on how things are going in Oregon. This local press piece, headlined "As Meth and Fentanyl Tighten Their Grips on Oregon, the State Scrambles to Implement Treatment Services: Measure 110 will provide a massive infusion of new money but overdose deaths are skyrocketing," provides some sobering statistics:
The good news, Oregon State Medical Examiner Dr. Sean Hurst recently told lawmakers, is that the jump in Oregon’s alcohol-related deaths in 2020 flattened in the first half of 2021. The bad news: Drug overdose deaths, particularly those involving fentanyl and methamphetamine, soared to new highs.
Deaths attributable to meth jumped from 2019 to 2020, and are on pace for a bigger increase in 2021, Hurst told lawmakers Jan. 13. Though slightly less numerous, fentanyl-related deaths are rising much faster: They more than doubled from 2019 to 2020 and are on pace to rise steeply in 2021. Together, medical examiner figures show, the two drugs will account for the deaths of more than 1,000 Oregonians in 2021 — that’s nearly three per day. “Substance use disorder is prevalent and it’s everywhere,” says Tony Vezina, chairman of the Oregon Alcohol and Drug Policy Commission.
Hurst presented his dismal news on drug deaths as the state races to implement Measure 110, the 2020 ballot measure that forced two major policy shifts. It decriminalized the possession for personal use of many hard drugs, including heroin, meth, cocaine and some opioids. Measure 110 also shifted funding from Oregon’s cannabis taxes — well over $100 million a year — to fund new referral and treatment services for substance use disorder....
The idea was that those cited for possession could avoid a fine by calling a phone number on their ticket; that connection would open a gateway to evaluation and services—and get up to $100 of their fine waived. Data collected by the Oregon Judicial Department from February 2021 through Dec. 31, however, shows that avenue has not worked. Police wrote 1,826 tickets last year for hard drugs (nearly two-thirds for meth) but few — only 55 for the whole year — prompted users to telephone the number for services.
Advocates of Measure 110 say it will take time for the benefits to become apparent, as was the case in Portugal, which decriminalized hard drugs in 2001 and saw its overdose death rate plummet — but only after services were in place.
Tera Hurst, executive director of the Oregon Health Justice Recovery Alliance (and no relation to the medical examiner), says voters signaled they wanted an explicit shift away from treating people with substance use disorders as criminals and to instead direct energy and money toward treatment. She says it’s unsurprising that citations are not driving drug users to seek help. She and other advocates did not expect they would. Even arrests rarely motivated users to seek treatment, they say — most go only when they are ready.
This other local press stories also set forth distinct perspectives on drug-related challenges in the Beaver State:
"Oregon is No. 2 in nation for addiction, last on access to treatment"
"Oregon’s drug decriminalization measure fails to fund treatment"
February 1, 2022 at 06:16 PM | Permalink
Comments
Where's Bill Otis' response to this? The voice of Mr. Otis, who has regularly and vociferously argued against drug legalization and/or decriminalization laws, is eerily absent in the face of empiracal data that flies in the face of his previously stated positions. I would find it difficult to believe that outspoken Mr. Otis has lost the courage of his convictions when presented with this illuminating information. Perhaps one of Bill's friends can ask him to comment.
Posted by: Where's Bill? | Feb 3, 2022 6:32:58 PM
What exactly are the empirical "data that flies in the face" of anti-legalization/decriminalization laws?
The linked articles say there have been fewer arrests while drug overdose deaths have skyrocketed. Is your implication that letting people die is better than jailing them?
I'd guess the family members of dead addicts will disagree.
Posted by: Oregonian | Feb 4, 2022 3:14:45 PM
Oregonian --
Just saw this from the Harvard School of Public Health (https://www.hsph.harvard.edu/news/hsph-in-the-news/drug-overdose-deaths-hit-record-high/):
DRUG OVERDOSE DEATHS HIT RECORD HIGH
"More than 100,000 Americans died from drug overdoses between May 2020 and April 2021—the most ever recorded in a single year—according to the Centers for Disease Control and Prevention.
"The number of drug overdose deaths was up almost 30% from the 78,000 deaths in the prior year, and was nearly three times that of traffic accident deaths and twice that of gun deaths during the same period.
"Most of the deaths were due to opioids, fueled by the powerful drug fentanyl, which is often added to illegal drugs to enhance their potency."
But if the easier availability of drugs contributes to a record number of deaths, hey, look stuff happens! And if the death toll falls disproportionately on black people, hey, look, that happens too!! What's important is the ideology, and if the ideology has some costs here and there, well, just as in rape cases, it's all most unfortunate, but her skirt was too short and she should have known better.
Posted by: Bill Otis | Feb 6, 2022 11:00:51 PM
Bill, there is a sound basis in both ideology and science that these overdose deaths are fueled by prohibition, not by efforts to end prohibition. During alcohol prohibition in the 1920s, it is estimated that tens of thousands of persons died from alcohol poisoning because of the unsafe nature of bootleg alcohol. With a legal and safe supply, alcohol poising deaths are much rarer in modern times. Advocates of drug reform reasonably hope that providing a safer supply of opioids and other drugs could reduce the high number of overdose deaths being driven by fentanyl which has polluted the illicit drug market.
Perhaps if the federal government would support states that want to explore alternatives to drug prohibition, we could have a laboratory of democratic efforts to explore alternative paths on these challenging issues. That's among the reasons I think it important to keep a close eye on Oregon's experience with decriminalization and other local attempts to find a sound way out of this public health crisis. It seems that the ideology of many on the right are troubled by a federal one-size-fits-all response to COVID, and anyone adopting a local control ideology in other public health settings ought to be supporting of local efforts to find a better drug policy path.
Posted by: Doug B. | Feb 7, 2022 8:42:57 AM
Doug --
"...there is a sound basis in both ideology and science that these overdose deaths are fueled by prohibition, not by efforts to end prohibition."
That must be why, as steps toward legalization have progressed over the last couple of years, in Oregon and around the country, overdose deaths have skyrocketed, in Oregon and across the country.
Oh........wait............
The data matter. Where access becomes easier, more drugs will be consumed. Where more drugs are consumed, more overdose deaths will ensue. This is both the logic and the lived experience of it. Drug users are simply never going to live with the limits, on amount and potency, that the government will impose in order to get the electorate to approve legalization legislation. So they do not, and are not going to, live within whatever the standards are, and will find ways to evade them, which they are ingenious at doing. As I once said in a debate with the very distinguished Prof. Randy Barnett, drug users don't want a safer high. They want a higher high, and they will keep the black market open and doing a good business in order to get one. So we're going to continue to get exactly what we're seeing, in Oregon and elsewhere, to wit, the morgue filling up.
The way to cut down on overdose deaths is to make drugs harder and more costly to get, hence to cut back on their use. This is why almost the entire world, in vastly different legal systems and cultures, from the USA to Africa to the Middle East to Asia, keeps drugs illegal (and has punishments for them more severe than ours).
Posted by: Bill Otis | Feb 7, 2022 2:45:54 PM
What "steps toward legalization" have there been regarding fentanyl, Bill? We tightened opioid supply by going after the pill mills, and that contributed toward a turn to street heroin and then fentanyl invaded. The modern uptick in overdose deaths produced by opioids seems to be a story, not of steps toward legalization, but what's called the "iron law of prohibition": https://filtermag.org/infographic-the-iron-law-of-prohibition/
Time will tell if decriminalization efforts in Oregon, based on a model with great success in Portugal, can and will prove effective here in the US. (Notably, Oregon has more than 1% of the US population but seemingly less than 1% of its overdoses, so it may be doing better than average. But the data is limited and reforms take time. As this post highlights, I am eager to see if that state can have real success with a less punitive model, though what Oregon is doing is not "legalization" by any sensible definition.)
Meanwhile, the federal government and others have mostly blocked harm reduction approaches which seems to hold more promise than the prohibition regimes we keep trying. I think it remains to be seen whether experiments with other drug control models can do better in the US, but I have a hard time finding examples of prohibition models working well in the US (and these approaches have many casualties beyond those just in the morgue). Can you give any examples of prohibition models working well in the US? I can cite to alcohol and marijuana prohibition working poorly AND the 100,000 deaths you note as prohibition's failures. Where are the success stories in the US?
Posted by: Doug B. | Feb 7, 2022 3:11:25 PM
Doug --
"What 'steps toward legalization' have there been regarding fentanyl, Bill?"
Did I say there've been steps toward legalizing specifically fentanyl? That's odd, I can't find that. Could you quote me? But, on the other hand, you have said in the past that you favor the legalization of ALL drugs, fentanyl, heroin, meth, LSD, the whole deal. So in fact you favor legalizing fentanyl, yes? No? Do you think more plentiful fentanyl will bring us a healthier country?
"Time will tell if decriminalization efforts in Oregon, based on a model with great success in Portugal, will prove effective."
Actually, there's already been quite a bit of time, slightly more than 20 years. You'd think we could get some good data over two decades. And in fact, the White House examined the data about Portugal and was not so enthusiastic. Now I know, what we can expect from Orange Bad Man's White House? Only it wasn't Orange Bad Man. It was Barack Obama, who, partly for reasons outlined in this short paper, never came close to recommending drug legalization to Congress, on Portugal's model or anything close to it. https://obamawhitehouse.archives.gov/ondcp/ondcp-fact-sheets/drug-decriminalization-in-portugal-challenges-and-limitations
Yes, it's all true! I'm almost as much of a Puritan prude as Barack Obama. Oh, the shame!
And while we're at it, why haven't Portugal's neighbors, the ones with an up-close view for quite a while now, adopted Portugal's regimen? Just too dumb?
"Meanwhile, the federal government and others have most blocked harm reduction approaches which seems to hold more promise than the prohibition regimes we are trying now."
The only federal government I'm aware of is the one headed by Joe Biden in the Executive Branch and Chuck Schumer and Nancy Pelosi in the legislative branch. And for all their frantic activity to pass this and pass that, I haven't seen their drug legalization bill. Does the administration and the leadership have a Portugal-type legalization bill out there that I've missed? Or are they prudes too?
"Can you give any examples of the prohibition models working well in the US? I can cite to alcohol and marijuana prohibition working poorly AND the 100,000 deaths you note as prohibition's failures. Where are the success stories?"
The 331,000,000 who are still with us, despite decades of pro-drug propaganda. Here's the deal: The massive majority of people in this country don't take hard drugs, don't want their kids taking them, don't want them to become more accessible and oppose legalizing them by huge margins (just like almost all the rest of the world, which I note you decline to address. Is that because people in Africa, the Middle East and Asia are so much less advanced than we are? That would be news to me, but I'm all ears if that's what the drug lobby thinks).
Here's the poll on American's views of drug legalization, undertaken by that Right-Wing-Trump-Loving Freak Show, the Huffington Post: https://www.huffpost.com/entry/drug-legalization-poll_n_5162357
Posted by: Bill Otis | Feb 7, 2022 4:36:13 PM
Bill, you link to a Aug 2010 ONDCP two-pager which is (properly) stating that a single 2009 Cato report about Portugal does not conclusively establish that its reforms are ideal. If you really care about data on these matters, here are some more up-to-date accounts of overdoses, drug policies and practices in Portugal and Europe and worldwide:
https://www.emcdda.europa.eu/system/files/publications/11331/portugal-cdr-2019_0.pdf
https://www.emcdda.europa.eu/system/files/publications/13762/TD0221591ENN.pdf
https://www.aei.org/carpe-diem/chart-of-the-day-5/
https://www.hri.global/files/2021/03/29/HRI_Western_Europe_Final2.pdf
https://www.emcdda.europa.eu/system/files/publications/13838/TDAT21001ENN.pdf
If you take the time to review just some of these data, you will see that the US overdose rate is as much as 15x to 30x worse than some Western European countries (and Portugal has some of the lowest overdose rates). And what is most obviously different in all these EU nations, as a matter of law and policy and practice, is that they rely much more broadly on harm reduction (non-punitive) services and rely much less on incarceration and other punitive drug control means than does the US.
And, as you know, Bill, this is not a simply red/blue issue (and nothing really is). Many Progressives pushed alcohol Prohibition and and Milton Friedman famously advocated for full legalization (as did Donald Trump once long ago). A serious look at the data shows less punitive approaches seem to work better around the world than the punitive approaches adopted in the US. But US markets and cultures are unique, so it remains to be seen if what works (imperfectly) around the world could work here. But you are right that our politics seems to greatly limit a willingness to move away from prohibition and punitive approaches despite the poor track records of prohibition.
Because punitiveness seems to produce more harms in the US, I favor exploring alternative approaches. That is why I am pleased Oregon and some localities are exploring alternatives. But those who want to close their eyes to real data are unlikely to learn from modern history and I fear the body count from failed punitive policies will continue to grow.
Posted by: Doug B. | Feb 8, 2022 2:25:10 AM
Doug --
Just very briefly, since I seem to be occupied on another thread fighting off the idea that it would be awful, just AWFUL, to have a bit more truthfulness and candor in the legal profession.
-- The Obama Administration and the current Administration, the two most left wing in history, are not supporting Portugal-style legalization, having had years to study it. Some of Portugal's closest neighbors, while supporting some legalization of pot, don't take the same indulgent approach to harder drugs, and others maintain complete prohibition, as does almost all of the rest of the world. A consensus that broad for that long can't be made to sit in the corner by just repeating the word "data." It reminds me of threads where commenters seemed to think that if they repeated the word "innocence" enough, they could prove that our jails are filled with the innocent.
The opinion of the world, including of almost every non-white country, has to count. It does with me. People in Asia, the Mideast and Africa are just as smart and just as caring as we are and as Europe is.
-- The body count is not a result of punitive policies. It's a result of the illegal (and stupid) decisions of those who choose to take drugs. If they obeyed the law they's stay out of the morgue. They should give it a try. This would not require new legislation. It would require a new attitude, which would be massively in their interest and in ours.
Posted by: Bill Otis | Feb 8, 2022 2:14:30 PM
Portugal has not legalized drugs, Bill, it has decriminalized and generally seeks to help people who use drugs rather than just jail them. That is the approach Oregon is now trying and there is talk the Biden Administration is now open to the harm reduction tool of safe consumption sites which are widely used throughout Europe:
https://apnews.com/article/business-health-new-york-c4e6d999583d7b7abce2189fba095011
https://www.emcdda.europa.eu/system/files/publications/2734/POD_Drug%20consumption%20rooms.pdf
The politics in the US are shifting, slowly, toward more European approaches in part because the US body count is now so high. But the drug war has always been "good politics" in the US, in part because the US has a long history of embracing punitive approaches (see, eg, alcohol prohibition as a constitutional amendment; high modern incarceration rates). And there may be reason to worry, especially in an internet age with ever fewer personal connections and other aspects of modern US culture and capitalism, that no particular policies will dramatically alter the current sad US realities. But trying something different than the punitive status quo seems worth exploring when decades of European experience provides a guide to some reasonable tools to try to lower the body count.
Meanwhile, the extent to which you are eager to spout bromides rather than engage with data (or even be knowledgeable about basic facts) is sadly emblematic of far too many on all sides of debates over drugs and crime.
Posted by: Doug B. | Feb 8, 2022 11:21:38 PM
Doug - What's the overdose rate in Singapore where they cane users and kill dealers? If prohibition causes overdoses, surely Singapore's overdose rate must be through the roof.
Posted by: Oregonian | Feb 9, 2022 3:26:24 AM
Good point, Oregonian, as a useful reminder that I should highlight that there is clearly far more to the story of drug use and impact than just formal legal policies. Singapore seems to have had considerable success with prohibition/punitiveness as a drug control strategy. The experiences and details of drug policy and drug harms in Asian nations generally, and Singapore particularly, are quite interesting and quite distinct from experiences in western nations. I could not quickly find clear overdose data for Singapore, but here are some reports/discussions on these topics:
https://www.rand.org/pubs/research_reports/RR2733.html
https://www.mha.gov.sg/docs/default-source/media-room-doc/home-team-journal-jan-2020-issue17e1a5b21df14567924fbde0000a6c25.pdf
The last article in the second link reviews the Singapore story to make the case that Singapore has had considerable success with prohibition/punitive approaches to drug control. Clearly this approach can work in some settings at some times.
To be clear, Oregonian, I do not mean to argue in all settings that prohibition (or decriminalization or legalization) directly "causes" drug overdose deaths or that the impact of particular policies are entirely predictable or inevitable. For drug use, access and policy impact, set, setting, culture, politics and other factors all seem to play important roles. I surmise Singapore has had relatively good success with punitive approaches to drug control --- including the mandatory death penalty for trafficking large amounts of drugs and physical punishments like caning --- because there seems to be broad public support among the Singapore citizenry for these approaches.
But in the US, there has rarely been widespread support for various forms of prohibition, and the harms/failings of how we fought the "war on alcohol" and the "war on drugs" in our nation can be broadly identified (though they have always been unevenly distributed). We pride ourselves as a nation of freedoms and free markets and individualism, which seem to contribute to prohibitionist/punitive approaches to drug control being generally less successful. But, again, you are wise to highlight Singapore as an example of a nation that has found relative success with this model, and everyone would be wise to remain ever open-minded as to "what works."
Perhaps as Oregon tries out replicating the "Portugal" model of decriminalization another US state might try out the "Singapore" model. I wonder if Gov DeSantis or Gov Abbott might try to make Florida or Texas a vanguard in this respect. I truly wish to be open minded as to how we might try to do better with drug policies and harms in the US, and we should all be open to agreement that we are now not doing very well in the US in this arena by any metric.
Posted by: Doug B. | Feb 9, 2022 9:50:17 AM
Doug - Thanks for your response.
Broadly, we're talking about three different approaches: (1) Decriminalization/treatment (Portugal), (2) Prohibition with serious punishment (Singapore), and (3) Prohibition with lax enforcement (U.S. and most of Europe).
Why is the U.S. "lax"? After all, we sentence repeat dealers/traffickers to long prison sentences and sometimes sentence first-arrest, large-quantity dealers get serious sentences as well. We are lax because our typical approach to drug use and low-level dealing ranges from open toleration (streets of SF & PDX) to minor punishments that fail to deter. Based on my personal experience in a couple of states, punishments for heroin/meth possession (even in repeat cases) is at most a few months in jail, and is often much less. As of a few years ago in the suburbs of Boston, your first heroin possession charge was "free" - cases were automatically dismissed if a defendant *promised* to attend drug education classes, with no follow-up by the DA's office.
It seems intuitive that the Portuguese system could lead to fewer overdoses among drug addicts than the American system. In the U.S., we do just enough to make drugs difficult to obtain (increasing purity), while foregoing serious deterrence policies. There are other problems with the Portuguese system - (1) Portugal has higher HIV rates from needle sharing than Spain/central-Europe (though lower than Italy) and (2) it seems likely that decriminalization will lead to more overall drug addiction than the U.S. system (controlling for cultural variables). That said, you could convince me with controlled studies that decriminalization is better than lax prohibition, particularly in a place like Portland where street-addict drug use has long been decriminalized as a practical matter.
However, the Singaporean system is statistically far superior to either the U.S. or Portuguese system in preventing use and overdoses. Your main objection above seems to be practicality and popularity within U.S. culture. But corporal punishment has a long history in the U.S. (and as far as I know has never been found unconstitutional) and our last President briefly broached the idea of the death penalty for heroin dealers. If Trump actually focused on the issue (highly unlikely), I think he could create a base of support for serious drug deterrence efforts, a least in red states.
More broadly, I think Americans are uncomfortable with serious deterrence because of (philosophical) assumptions about individualism (as you point out) and an aversion to perceived cruelty.
As to philosophical liberal individualism, I think Americans are just wrong. Take Mr. Otis's statement above:
"The body count is not a result of punitive policies. It is a result of the illegal (and stupid) decisions of those who choose to take drugs. If they obeyed the law they'd stay out of the morgue. They should give it a try."
This seems to reflect the philosophical liberal assumption that blank-slate individuals use reason to reach considered decisions. If so, it is wrong. Of course every drug user in some sense "chooses" to begin using drugs. But humans are not blank-slate and they rarely (if ever) use detached reasoning. Genetic and environmental factors drive drug use, just as they drive every other "choice" we make. A 90-IQ white male in a WV holler is more likely to OD from heroin than a 120-IQ asian female in SLC not because of free, rational "choice" but because of genetics and environment.
Put differently, the idea that a free, rational mind "chooses" to use illegal drugs rests on the same philosophical liberal foundation as the idea that we should legalize drugs and allow individuals to "choose" whether or not to use them (and focus on "harm reduction" when they make the wrong choice). Both ideas are wrong because that foundation bears no weight.
I support corporal punishment, the death penalty, and other serious deterrent measures for drug dealing/use not because I think people "deserve" them for making "stupid decisions . . . to take drugs." I support those measures because they would change the environmental factors that lead to mass drug abuse and overdoses. (And, by the way, I also support changes that would improve the economic and spiritual lives of vagrants in SF and welfare addicts in WV and hopefully reduce abuse/overdoses as well).
That brings me to the cruelty of serious deterrence policies like corporal punishment and the death penalty. These polices seem harsh in their application to specific individuals. But I think lax prohibition is truly cruel. We knowingly condemn millions of people to a life of addiction and hundreds of thousands to early death. We fail to punish "low-level" or first-time drug dealing/use and then lock up the unlucky for decades after their 4th or 5th or 6th conviction that is the natural result of drug addiction. Lax prohibition causes and will cause more death and more suffering for addicts and their families than Singapore's ever could.
I'll end with this. Last summer, one of my best friends from high school died from a Fentanyl overdose in Portland at age 37. He was a functioning addict who had a wife and good job, but he had struggled with addiction for over a decade. Maybe he survives under the Portuguese model because he could have found a precise or fentanyl-free dose of heroin. Maybe. But my friend did not *want* to use heroin. He grew to hate it and went through treatment a half-dozen times. But like the strong majority of heroin addicts, treatment was ineffective.
If we had adopted Singapore's model 20 years ago, I believe my friend would be alive. There would be trade-offs. We would have executed perhaps tens of thousands of drug dealers (and hopefully some pharma executives) -- but compare that to the 100k+ overdose deaths last year alone. My friend might have born scars from humiliating and painful corporal punishment -- but if Singapore's success was at all replicated, it is much more likely he would be living with those scars.
We shrink from the "cruelty" of serious deterrence. Much more cruel, however, is our studied neglect of the mass suffering and death we inflict through lax prohibition founded on philosophical liberalism.
Posted by: Oregonian | Feb 9, 2022 3:11:59 PM
So many interesting points here, Oregonian, far too many to engage adequately here. On the politics I will note that, even in deep red states, responses to the deadly opioid crisis has often been to call for more support for users and to assert distinctions between punishing "dealers" and helping "users." Prez Trump himself echoed that kind of distinction when talking about about getting tougher, which reinforces my sense that what you call "serious punishment" remains a political/cultural non-starter. (The fact no single red state is now even talking about moving in that direction, as blue states move to harm reduction approaches, strikes me as also politically telling.)
Politics aside, I will play law professor and ask whether you also think "prohibition with serious punishment" is the right model for other widely used drugs like marijuana and tobacco and alcohol (and even sugar). The health harms from these products typically do not produce immediate overdose deaths --- though there are a few thousand from alcohol each year --- and yet they can often be as addictive and can produce broad public harms to both users and those in their ambit. Are there only certain drugs that you think justify "prohibition with serious punishment" and other drugs that you think can and should be legal/commercialized or at least decriminalized? I ask because in part because I think the US failure over the last 50+ years to focus on the drugs that present the biggest harm risks --- legally, socially, culturally --- contributes to some of our problems.
Posted by: Doug B. | Feb 9, 2022 3:58:37 PM