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Tess Borden, ACLU and Human Rights Watch, tborden@aclu.org
Maria McFarland Sanchez-Moreno, Human Rights Watch, mcfarlm@hrw.org
Alexandra Ringe, ACLU, aringe@aclu.org
The massive enforcement of laws criminalizing personal drug use and possession in the United States causes devastating harm, Human Rights Watch and the American Civil Liberties Union (ACLU) said in a joint report released today. Enforcement ruins individual and family lives, discriminates against people of color, and undermines public health. The federal and state governments should decriminalize the personal use and possession of illicit drugs.
The 196-page report, "Every 25 Seconds: The Human Toll of Criminalizing Drug Use in the United States," finds that enforcement of drug possession laws causes extensive and unjustifiable harm to individuals and communities across the country. The long-term consequences can separate families; exclude people from job opportunities, welfare assistance, public housing, and voting; and expose them to discrimination and stigma for a lifetime. While more people are arrested for simple drug possession in the U.S. than for any other crime, mainstream discussions of criminal justice reform rarely question whether drug use should be criminalized at all.
"Every 25 seconds someone is funneled into the criminal justice system, accused of nothing more than possessing drugs for personal use," said Tess Borden, Aryeh Neier Fellow at Human Rights Watch and the ACLU and the report's author. "These wide-scale arrests have destroyed countless lives while doing nothing to help people who struggle with dependence."
The organizations interviewed 149 people prosecuted for using drugs in Louisiana, Texas, Florida, and New York -- 64 of whom were in custody -- and 217 other individuals, including family members of those prosecuted, current and former government officials, defense attorneys, service providers, and activists. The organizations also did extensive new analysis of data obtained from Texas, Florida, New York, and the FBI.
Among those interviewed was "Neal," whose name, like that of some others, was changed to protect his privacy. "Neal" has a rare autoimmune disease and is serving five years in a Louisiana prison for possessing less than 0.2 grams of crack cocaine. He said he cried the day he pled guilty because he knew he might not survive his sentence.
Another is Corey, serving 17 years in Louisiana for possessing half an ounce of marijuana. His 4-year-old daughter Charlee, who has never seen him outside prison, thinks she visits him at work. A third is "Nicole," who after being held pretrial for months in a Houston jail, separated from her three young children, finally pled guilty to her first felony. The conviction, for possessing heroin residue in an empty baggie, meant she would lose her student financial aid, job opportunities, and the food stamps she had relied on to feed her children.
"Do they realize what they are doing to people's lives in here?" said "Matthew," from the Hood County jail in Texas. "Because of my drug addiction, they just keep punishing me... They never offered me no help. I have been to prison five times, and it's destroyed me."
"Matthew" was sentenced to 15 years for possession of an amount of methamphetamines so small the laboratory could not even weigh it. The lab result simply read "trace." His prior convictions were mostly out-of-state and related to his drug dependence.
"While families, friends, and neighbors understandably want government to take action to prevent the potential harm caused by drug use, criminalization is not the answer," Borden said. "Locking people up for using drugs causes tremendous harm, while doing nothing to help those who need and want treatment."
Four decades after President Richard Nixon declared a "war on drugs," rates of use have not significantly declined. People who need treatment often find it is unavailable, and criminalization tends to drive people who use drugs underground, making it less likely that they will get care and more likely that they will engage in unsafe practices that make them vulnerable to disease and overdoses.
All states and the federal government criminalize possession of illicit drugs for personal use. The majority of states make possession of small amounts of commonly used drugs such as cocaine, heroin, and methamphetamines a felony. Each year, the organizations found, state law enforcement agencies make more than 1.25 million drug possession arrests -- one of every nine arrests nationwide.
Despite officials' claims that drug laws are primarily used to combat drug distribution, four times as many people are arrested for possessing drugs as for selling them. Half of those arrested for possession are charged with nothing more serious than possessing marijuana for personal use. In 2015, according to data analyzed by the groups, police made 14 percent more arrests for simple marijuana possession than for all violent crimes combined.
Black people use drugs at similar or even lower rates than white people, yet data the groups analyzed shows that Black adults are more than two-and-a-half times more likely to be arrested for drug possession, and nearly four times more likely to be arrested for simple marijuana possession. In many states, the racial disparities were even higher - 6 to 1 in Montana, Iowa, and Vermont. In Manhattan, Black people are nearly 11 times as likely as white people to be arrested for drug possession.
This racially disparate enforcement amounts to racial discrimination under international human rights law, said Human Rights Watch and the ACLU. Because the FBI and US Census Bureau do not collect race data for Latinos, it was impossible to determine disparities for that population, the groups found.
On any given day, at least 137,000 men and women are behind bars for drug possession. Tens of thousands more are convicted, cycle through jails and prisons, and spend extended periods on probation and parole, often burdened with crippling debt from court-imposed fines and fees.
People interviewed for the report were prosecuted for small quantities of drugs -- sometimes fractions of a gram -- that were clearly for personal use. The report's analysis of new data suggests that in 2015, nearly 16,000 people in Texas were sentenced to jail or prison for possession of under one gram of substances containing commonly used drugs -- enough for only a handful of doses in many cases.
State legislatures and Congress should decriminalize personal use and possession of all drugs, Human Rights Watch and the ACLU said. Federal and state governments should invest resources in programs to decrease the risks associated with drug use and provide and support voluntary treatment options for people struggling with drug dependence, along with other approaches.
Until full decriminalization is achieved, officials at all levels of government should minimize and mitigate the harmful consequences of current laws and practices. The groups provided detailed recommendations to state legislatures, police, prosecutors, and other state and local government entities, as well as the federal government.
"Criminalizing personal drug use is a colossal waste of lives and resources," Borden said. "If governments are serious about addressing problematic drug use, they need to end the current revolving door of drug possession arrests, and focus on effective health strategies instead."
"Every 25 Seconds: The Human Toll of Criminalizing Drug Use in the United States" is available at:
https://www.hrw.org/node/294820/
Video:
https://media.hrw.org/index.asp?ID=EBMUE<=ENG&showEmbargoed=true
For more Human Rights Watch reporting on the United States, please visit:
https://www.hrw.org/united-states
For more Human Rights Watch reporting on criminal justice, please visit:
https://www.hrw.org/united-states/criminal-justice
For more ACLU reporting on criminal justice, please visit:
https://www.aclu.org/issues/mass-incarceration
The following are quotes from people interviewed for the report, with all names changed to protect their privacy.
"When you're a low-income person of color using drugs, you're criminalized -- that means demonized, marginalized, stigmatized.... When we're locked up, we're not only locked in but also locked out. Locked out of housing.... Locked out of employment and other services. Locked into a class that's underclass -- you're a fixed class; you're not a person anymore, because you had a drug."
-- Cameron Barnes, New York City, arrested repeatedly for drug possession by New York City police from the 1980s until 2012
"You get thrown in here. You don't have any contact with the outside world. I'm waiting on everybody else. Everything is crumbling."
-- Breanna Wheeler, speaking from jail in Galveston, Texas, where she was detained pretrial for methamphetamine residue in a baggie. A single mother, she eventually pled to her first felony conviction and time served so she could return home to her nine-year-old daughter
"I've been in here for four months, and [my job] was the only income for my family.... [Their] water has been cut off since I've been in here. The lights were cut off.... Basically that's what happens when people come here. It doesn't just affect us, but it affects everyone around us."
-- Allen Searle, speaking from jail in St. Tammany Parish, Louisiana, where he had been detained pretrial for almost a hundred days
"You're starting life over. You can't expect to be absent from society and just walk back in. You've lost everything - your job, apartment, whatever you had before you're going to lose that.... Because I caught this felony, I was on the street for five years. I had never been homeless before.... [Y]ou walk out of those [prison] gates and you're on your own."
-- Charlie West, a former U.S. military medic, describing his reentry after incarceration for felony possession of cocaine in New York City in 2010
"I don't see why [the felony record is] defining. It's not like we're a minority; they're making us a majority. If a matter comes up that is important to me, I can't vote and make a difference in the world.... You don't realize -- the vote -- how important that stuff is until you lose it. I was convicted at 18; I had never been able to vote yet.... I found my voter registration card. I thought, here's a good high school memory of when me and my friend got registration cards. Now I can't use it. I just threw it out."
-- Trisha Richardson in Auburndale, Florida, one of three states to impose lifetime disenfranchisement, convicted of possession of Xanax and methamphetamines
"The felony conviction is going to ruin my life.... I'll pay for it for[ever]. Because of my record, I don't know how or where I'll start rebuilding my life: school, job, government benefits are now all off the table for me. Besides the punishment even [of prison].... It's my whole future."
-- Nicole Bishop, speaking from the Harris County Jail, where she was detained pretrial for heroin residue in a baggie and cocaine residue inside a plastic straw
"Food stamps, you can't get them for a year. So you go dig in a dumpster. My food stamps are for my kids, not me."
-- Melissa Wright, on probation in drug court after pleading guilty in Covington, Louisiana
"Trace cases need to be reevaluated. If you're being charged with a .01 for a controlled substance, ... that's an empty baggie, that's an empty pipe. There used to be something in it. They are ruining people's lives over it."
-- Alyssa Burns, speaking from the Harris County Jail, where she was detained pretrial for methamphetamine residue inside a pipe
"I remember when they said I was guilty in the courtroom, the wind was knocked out of me. I went, 'the rest of my life?' ... All I could think about is that I could never do anything enjoyable in my life again. Never like be in love with someone and be alone with them... never be able to use a cell phone...take a shower in private, use the bathroom in private.... There's 60 people in my cell, and only one of us has gone to trial. They are afraid to be in my situation."
-- Jennifer Edwards, speaking from jail in St. Tammany Parish, Louisiana, about the jury's guilty verdict. Because of her prior drug possession convictions, she faced a minimum of 20 years to life in prison for possessing a small amount of heroin
The American Civil Liberties Union was founded in 1920 and is our nation's guardian of liberty. The ACLU works in the courts, legislatures and communities to defend and preserve the individual rights and liberties guaranteed to all people in this country by the Constitution and laws of the United States.
(212) 549-2666The progressive congresswoman also warned that "an extension with abortion restrictions kills women."
The US House of Representatives is set to vote on extending Affordable Care Act subsidies next week, and Rep. Alexandria Ocasio-Cortez warned Friday that if Republicans let the ACA tax credits expire at the end of the year, "people are going to die."
The New York Democrat spoke to reporters in Washington, DC a day after only four Republicans voted with Democratic senators in an unsuccessful effort to pass legislation extending ACA subsidies, as over 20 million Americans face a surge in health insurance premiums. A GOP bill to replace the subsidies with annual payments to tax-advantaged health savings accounts also failed.
"We have to remember who's in charge of the House, the Senate, and the White House. Republicans have a House majority, they have a Senate majority, and Donald Trump is president of the United States, and JD Vance is vice president of the United States," Ocasio-Cortez said in remarks shared by her and multiple news sources on social media.
House Speaker Mike Johnson (R-La.) "refused to engage" in a debate on the looming healthcare crisis and "kept Republicans home for over a month so that they would not negotiate," she said. Trump and Vance "did the same thing—they stuck their heads in the sand for the entirety of a... government shutdown where we were urging them to come to a solution on extensions of ACA premium subsidies," she continued, calling for a "clean" extension while the GOP sorts out its supposed healthcare plan.
Rep. @AOC on healthcare subsidy proposals: "An extension with abortion restrictions kills women." pic.twitter.com/HOCqHMGemp
— Forbes Breaking News (@ForbesTVNews) December 12, 2025
"People are gonna be kicked off of their insurance. Open enrollment is happening right now, and there are going to be millions of Americans that are affected—that aren't gonna be able to go to a doctor, aren't gonna be able to afford their prescription drugs, because of some petty fight in Washington," the congresswoman said, noting Democratic efforts to force votes on an extension.
As NBC News reported Thursday, early enrollment data from several states shows that "more people appear to be walking away from Affordable Care Act coverage or switching to cheaper plans for 2026 compared to this time last year," which "could reflect signs of financial strain for people who can't afford to pay hundreds of dollars more in monthly premiums once enhanced federal subsidies expire at the end of the year."
Demanding that her colleagues in DC recognize the urgency of the issue, Ocasio-Cortez—who supports Medicare for All—said Friday that "I don't understand why they can't just extend these subsidies so that we can save people's lives while they figure out whatever their political food fight is."
AOC also pushed back against GOP efforts to restrict reproductive healthcare in an ACA subsidy bill, saying "an extension with abortion restrictions kills women—so no, I'm going to allow this Republican majority to kill women in this country so that they can try to do whatever their victory lap is. I will not accept women, and the lives of women, as some political cost for them being able to extend these things. Reproductive care is healthcare. Period."
Since the right-wing US Supreme Court reversed Roe v. Wade and GOP-led states further restricted reproductive rights, multiple stories have emerged from places including Georgia and Texas exemplifying how "Republican abortion bans kill women."
After Johnson met with the House GOP's "Five Families" on Friday, he is expected to allow a floor vote to extend the subsidies next week and, according to Punchbowl News, is considering giving moderates an option without abortion funding restrictions.
As Politico reported Friday evening:
[GOP] leaders ultimately expect the extension vote to fail, resulting in skyrocketing premiums for millions of Americans when the subsidies expire at the end of the year.
Instead, according to House Republican leadership aides, Republicans are preparing to roll out a healthcare framework that would allow businesses that fund their own health plans to purchase "stop-loss" policies—which would protect businesses from going bankrupt from just a few unexpectedly expensive insurance claims.
It also would appropriate funds to pay for "cost-sharing reductions" in Obamacare and include some elements of a separate legislative proposal designed to crack down on pharmacy benefit managers—companies that negotiate drug prices on behalf of insurers and large employers.
Like Ocasio-Cortez—who has faced mounting calls to launch a 2028 primary challenge to Senate Minority Leader Chuck Schumer (D-NY) over his handling of the March funding fight and recent shutdown—the upper chamber's top Democrat put the blame squarely on Republicans after both bills failed to advance on Thursday.
"Republicans must answer for why people will lose coverage. Republicans must answer why families see premiums double and triple over the next year," Schumer said. "Democrats' focus does not change. We fought like hell to stop these hikes, and we're going to continue to fight like hell to bring costs down for the American people on healthcare, on housing, on electric rates, on groceries."
"But Republicans are fighting like hell to send those costs right through the roof," he added. "They're fighting like hell to kick people off insurance. They're fighting like hell to cut taxes and give sweet giveaways to billionaires and the ultrarich. January 1st is coming. Republicans are responsible for what happens next. This is their crisis now, and they're going to have to answer for it."
"Palestinian babies freeze to death as shelters and lifesaving humanitarian aid—located just a few miles away—for 1 million civilians is blocked by Israel," noted one journalist.
A second Palestinian infant and a young girl died of hypothermia in Gaza as heavy rains and flooding—whose effects are exacerbated by Israel's genocidal annihilation and ongoing siege of the coastal strip—raised the death toll from Storm Byron to at least 16.
Taim Al-Khawaja—who was several months old—died in the Shati refugee camp in northern Gaza, while 9-year-old Hadeel al-Masri died in a shelter west of Gaza City, according to local officials. Their deaths follow that of Rahaf Abu Jazar, an 8-month-old who died Thursday of exposure after floodwaters inundated her family’s tent in Khan Younis.
At least five other people were killed when a building in Beit Lahia collapsed amid the storm, and two others were killed when a wall collapsed onto tents housing displaced Palestinians in the Remal neighorhood of Gaza City. According to Gaza's Government Media Office (GMO), at least 13 buildings have collapsed and more than 27,000 tents have been destroyed or left uninhabitable by Byron's winds, rain, and floodwater.
While farmers in neighboring Israel welcomed the torrential rains, which delivered relief from drought conditions, the storm is devastating Palestinians already reeling and weakened from nearly 800 days of war and siege. Israel's US-backed onslaught has left more than 250,000 Gazans dead, maimed, or missing and 2 million more starved, sickened, or displaced. Roughly 1.5 million Palestinians are currently living in tents or other makeshift shelters.
The recent hypothermia deaths evoked horrific memories of the past two winters in Gaza, when more than a dozen Palestinians—most of them infants and children—died from hypothermia caused by exposure. While many Israelis and their supporters abroad point to the relatively mild Mediterranean winters in an effort to deny these deaths, experts note that hypothermia can be deadly at temperatures over 60°F (15°C) in overexposed conditions such as those in Gaza.
Reporting from Gaza, Al Jazeera's Ibrahim al-Khalili said Friday that genocide-ravaged Gazans are now enduring “an added layer of suffering."
“The tents are collapsing. The cold is unbearable. Basically, they don’t have anywhere to go. What is unfolding is devastating,” he said. “It’s not just a storm; it’s a new wave of displacement even after the war has stopped. Many people here told me that a new war has really begun after this flooding, and people are being forced to flee whatever fragile shelters they had.”
Hamas spokesperson Hazem Qassem on Friday called the recent exposure deaths a "continuation of the war of extermination."
“The successive collapses of homes bombed during the war of extermination on the Gaza Strip, caused by the storm, and the resulting deaths, reflect the unprecedented scale of the humanitarian disaster left by this criminal Zionist war,” he said.
Jonathan Crickx, chief of communications for the United Nations Children's Fund (UNICEF), told Agence France-Presse Friday that Gazans are also enduring "absolutely appalling hygiene and sanitary conditions."
"There aren't enough toilets; there are places—I saw some in Gaza City—where large pools of water are essentially open sewers right next to the displacement camps," he added.
While the shaky two-month ceasefire between Israel and Hamas has somewhat eased the Israeli blockade on Gaza, the GMO said Friday that “the occupation continues to close crossings and prevent the entry of humanitarian aid and materials that could provide shelter."
“This includes blocking the entry of 300,000 tents, prefabricated mobile homes, and caravans," the agency added.
The #Gaza Strip has been left flooded by #StormByron, destroying already damaged buildings and causing additional loss of life.MSF is concerned about the upcoming winter and heavy rain.Caroline Seguin, Emergency Coordinator, updates:
[image or embed]
— Doctors Without Borders / Médecins Sans Frontières (MSF) (@msf.ca) December 12, 2025 at 2:02 PM
In a statement Friday, Doctors Without Borders Gaza emergency coordinator Caroline Seguin said that the charity is "very, very worried about the next month with the winter coming and the heavy rain."
"Last year we saw a huge increase in respiratory infections for children, diarrhea as well, and of course all the wounded that are living inside the tents will have big difficulties to heal their wounds and will have probably an increase of infection for the wound of the wounded," Seguin noted. "It's near to be not possible to live in this conditions."
The US is at risk of losing its measles-eradicated status early next year, according to Scientific American.
US Rep. Pramila Jayapal on Friday demanded that the Trump administration "stop lying and follow the science" as an outbreak of measles in South Carolina grew and officials warned that low vaccination rates in the affected area likely mean the crisis will continue worsening.
Since the outbreak began in October in Spartanburg County, near the state's northern border, the highly infectious disease has sickened at least 129 people. The vast majority of people who have been infected have not been inoculated against measles, which is 97% preventable via the measles, mumps, and rubella (MMR) shot—which has been erroneously attacked for years by anti-vaccine activists including Health and Human Services Secretary Robert F. Kennedy Jr.
As President Donald Trump and Kennedy "push deadly anti-vaccine conspiracy theories, measles is making a comeback across America," said Jayapal (D-Wash.) on Friday. "People will die because of this."
At least three people, including two children, have already died this year in US measles outbreaks
More than 1,900 measles cases and 47 outbreaks have been reported across the country in 2025, compared with 285 cases across 16 outbreaks last year.
In South Carolina, more than 250 people have been exposed to the disease in schools, a healthcare facility, and a church, forcing dozens of unvaccinated children to quarantine for 21 days; some were exposed twice and had to be isolated for two separate three-week periods.
“That’s a significant amount of time,” Linda Bell, the state's epidemiologist, said at a recent press conference. “Vaccination continues to be the best way to prevent the disruption that measles is causing to people’s education, to employment.”
But Spartanburg County's ongoing outbreak is being driven by “lower-than-hoped-for vaccination coverage,” Bell said.
Public health experts consider a 95% vaccination rate to be the level at which the spread of measles can be eliminated in a community. Only about 90% of students in the county had all required childhood immunizations. South Carolina allows religious exemptions for school immunization requirements. Many of the schools where students have quarantined have vaccination rates "well below 90%," the New York Times reported.
Across South Carolina, MMR vaccination rates among schoolchildren has fallen significantly since 2020, from 96% to 93.5%.
Kennedy has been a longtime denier of vaccine science. In 2019, his anti-vaccine group, Children's Health Defense, tried to sue New York state over its vaccine requirement, which is one of just five in the country that doesn't allow for nonmedical exemptions.
In April, Kennedy visited a Texas community where two unvaccinated children had died of measles and acknowledged in a social media post that "the most effective way to prevent the spread of measles is the MMR vaccine."
“Vaccination continues to be the best way to prevent the disruption that measles is causing to people’s education, to employment.”
But during his visit he also promoted, without evidence, two therapeutic treatments that one vaccine expert told NPR are "valueless" in treating measles. In 2023 Kennedy told podcaster Joe Rogan that the vaccine was not linked to a decline in deaths.
He has recently continued fueling overall skepticism about immunizations, with the Centers for Disease Control and Prevention (CDC) panel he assembled advising that newborn babies whose mothers test negative for hepatitis B should not receive a dose of a vaccine for the disease—sparking fear among public health experts that major progress in reducing childhood cases of the disease over the past three decades will be reversed.
In November the CDC website was changed to say a link between vaccines and autism—a theory that has long been debunked—cannot be ruled out. Two months earlier, as measles cases surged in another outbreak around the Utah-Arizona border, Trump called for combination children's vaccines like the MMR to be split up into separate shots—a call made decades ago by Dr. Andrew Wakefield, who lost his medical license over his 1988 study that linked autism to the combination vaccine, which was later retracted.
High vaccine rates allowed the US to declare measles eliminated in 2000, but Scientific American reported Thursday that the current measles outbreaks are bringing the US "toward losing its measles-free status by early next year."
The worsening measles outbreak in South Carolina, said Sen. Ed Markey (D-Mass.), "is yet another horrifying consequence of Trump and RFK Jr.'s Make America Sick Agenda."
Republican Gov. Henry McMaster has urged residents to be vaccinated against measles, but said on Thursday, "We are not going to do mandates on people to go get vaccinated."
Andrew Nixon, a spokesperson for the US Health and Human Services Department, also continued to suggest that vaccination is principally a matter of personal liberty rather than public health, telling the New York Times that people in the affected community in South Carolina should talk to their doctors about "what is best for them."
On Thursday, Senate Health, Education, Labor, and Pensions Committee Ranking Member Bernie Sanders (I-Vt.) said that along with the Republican Party's vote against extending Affordable Care Act subsidies, the Trump administration is raising questions about its push to "Make America Health Again" as it undermines "lifesaving vaccines and spark[s] disease outbreaks."
"The Trump administration," he said, "is endangering the health of the American people."