YOUR VOICE

Drug Use and the Criminalization of Vulnerable Communities

The “War on Drugs” was initiated in June of 1971 when Richard Nixon dramatically increased the scope of federal drug control policies. As part of that initiative, he expanded the penalties for drug offenses through mandatory sentencing that ultimately served to enshrine generational trauma into families and communities that historically (and continually) have been the subject of racist and suppressive government policies. That legacy continues to this day despite the recognition that government-sanctioned oppressive and discriminatory approaches to drug use continue to ignore the impetus of that use: unmet mental health needs grounded in the disenfranchisement of vulnerable communities through the restriction of meaningful participation in the economic, social, and political opportunities of this country. It is time to address this historic inequity and end the criminalization of drug use. Coupled with investments in proven methods of reducing harmful substance use, we can end the “War on Drugs,” begin a “War on Health Inequity,” and propagate evidence-based methods to address the mental health challenges and general health inequities our communities face. As a matter of historical grounding, the use of mind and body altering substances by humans has been part of various cultures for thousands of years. These substances have served roles in medicine, religion, spirituality, and simply as commodities in socially approved ways. Psychologically and biologically active substances are part of our environment, adapted to human and animal biology, and do not intrinsically have moral properties. Rather, modern industrial societies have assigned moral and legal properties to their use for various reasons. In the United States, biologically harmful substances, such as alcohol and tobacco, have remained a protected class of drug use, despite the enormous health costs and impact on communities. At the same time, other less harmful or arguably unharmful drugs, including those with legitimate medicinal purposes, have been classified as illegal to use and/or declared to have no legitimate medical purpose. These facts expose the true intent of drug use criminal penalties. The “War on Drugs” eventually became recognized as a deliberate effort at incarcerating increasing numbers of Black Americans, as well as an effort to shift public impression of the counterculture movement that began in the 1960s. This was not the first time drug laws were used to target a particularly vulnerable minority group. The first anti-marijuana laws in the 1910s and 1920s were directed at Mexican migrants and Mexican Americans. In the 1870s, the first anti-opium laws were directed at Chinese immigrants. Drug laws have become a political tool for tapping into the social anxiety of voters around perceived threats to the white majority. Today, despite representing only 13% of the U.S. population, Black people are 25% of those arrested for drug use and possession, even though Black and white people use and sell drugs at similar rates. The “War on Drugs” has also created an illicit drug trade that has led to an overdose epidemic due to illicitly manufactured fentanyl and fentanyl analogues. Finally, drug use addiction and disorder are serious concerns that are public health issues, not criminal justice issues. Most drug abuse is rooted in untreated mental health disorders. Other aspects of the drug trade are rooted in the inability for historically suppressed members of our society to access the cultural, societal, and economic advantages felt by privileged communities. Countries like Portugal have demonstrated that decriminalizing drug use (20 years ago) and re-investing those criminal justice dollars into treatment for mental health disorders decreases drug use rates, drug overdoses, and saves substantial amounts of money. Now is the time for change in Minnesota—for the medical community to adopt evidence-based, scientifically supported policy changes around drug use decriminalization and shift that focus from criminalizing vulnerable communities to investing in their health and well-being.

By Ryan Greiner, MD and Mark Nupen, MD

Citations: • Felix, S., Tavares, A., Portugal P. “Going after the Addiction, Not the addicted: The Impact of Drug Decriminalization in Portugal.” Institute of

Labor Economics. Accessed https://ftp.iza.org/dp10895.pdf. • Vicknasingam B, Narayanan S, Singh D, Chawarski M. Decriminalization of drug use. Curr Opin Psychiatry. 2018 Jul;31(4):300-305. doi: 10.1097/

YCO.0000000000000429. PMID: 29746420. • Drug Policy Alliance. “It’s Time for the U.S. to Decriminalize Drug Use and Possession.” Accessed https://drugpolicy.org/sites/default/files/documents/Drug_Policy_Alliance_Time_to_Decriminalize_Report_July_2017. pdf.