A coalition of more than 200 drug policy, healthcare, and other community-based organizations on Thursday delivered a letter to U.S. President-elect Joe Biden's transition team, urging the incoming administration to pursue public health solutions to substance use and bring an end to the disastrous war on drugs.
The letter (pdf), sent to Rahul Gupta, team lead for Biden's Office of National Drug Control Policy (ONDCP), advocates for the implementation of policies that prioritize harm reduction rather than prop up criminalization.
"We are urging the administration to abandon criminalization as a means to address substance use, and instead ensure universal access to equitable evidence-based solutions rooted in racial and economic justice and compassion," the coalition wrote.
"We cannot wait another year to address the skyrocketing deaths, harm from the criminal-legal system, and heartbreak in our nation," said the groups. "The time for urgent, bold change is now."
The effort—led by People's Action, VOCAL-NY, the Drug Policy Alliance, and National Harm Reduction Coalition—comes as the U.S. confronts a surge in overdose deaths exacerbated by the federal government's catastrophic mishandling of the coronavirus pandemic as well as the injustice of a trillion dollar-plus drug war that has contributed to the build-up of the world's largest carceral system while doing little to reduce violence and harm.
By sidelining "interventions proven to turn the tide on the overdose crisis and heal the traumas of criminalization," the coalition wrote, the war on drugs has exacerbated preventable overdose deaths and mass incarceration, both of which have disproportionately affected Black, brown, and low-income communities.
Responses to substance use that are based on surveillance and police violence, the groups explained, have "separated families, facilitated deportations, disenfranchised communities, fostered mistrust in healthcare and social services, and perpetuated poverty and stigma." Moreover, the coalition said, "tough-on-crime and prohibitionist policies" have made the country's drug supply "more deadly now than ever."
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"In the past decade alone, overdose has devastatingly killed nearly a half-million people in our country," the coalition wrote. As a result of the pandemic's collision with "the nation's neglected overdose epidemic... preliminary data indicates 2020 will be the worst year on record for fatalities."
As the groups explained: "Impacts from Covid-19, such as physical distancing and wide-ranging unemployment, have led to isolation, stress, and despair among many people, including people who use drugs and people engaged in sex work. All of these factors are increasing overdose risk, and emerging evidence confirms fears that the overdose crisis is worsening during Covid-19."
#PolicyRecommendations! Evidence-based drug policies, backed by science and public health approaches. Commitment to dismantling the drug war and prioritizing harm reduction, treatment, and recovery in ways that don't perpetuate mass incarceration. pic.twitter.com/lFgi7bkA7U
— National Harm Reduction Coalition (@HarmReduction) January 14, 2021
The coalition, comprising stakeholders that represent people who use drugs, people in recovery, and family members impacted by overdose, outlined immediate and longer-term policy recommendations that seek to mitigate the overdose crisis and dismantle the drug war. The proposed solutions include:
- Ground the ONDCP in evidence-based drug policies backed by science and public health approaches;
- Commit the ONDCP to dismantling the drug war, advancing a national drug budget that prioritizes harm reduction, treatment, and recovery, and looks beyond enforcement and supply side strategies that only perpetuate mass incarceration, systemic racism, and the failed drug war;
- Include in fiscal year 2022 budgets and future Covid-19 relief packages dedicated funds to sustain harm reduction providers including syringe service programs;
- Direct the Department of Justice to withdraw litigation challenging the operation of overdose prevention centers (OPCs), refrain from filing new lawsuits against or from prosecuting organizations that operate OPCs, and work with Congress to revise federal laws to permit the operation of OPCs;
- Permanently extend the Substance Abuse and Mental Health Services Administration/Drug Enforcement Agency Covid-19 accommodations for methadone and buprenorphine access (the gold standard for opioid use disorder treatment); and
- Support policies that would eliminate requirements that inhibit practitioners to easily prescribe medication for opioid use disorder, prohibit state Medicaid programs from requiring prior authorization for medication-assisted treatment, and include people directly impacted by the crisis to help decide where resources would be best targeted locally.
"Like the president-elect, we too have watched the nation stigmatize our loved ones for substance use, and, instead of judging, we unconditionally love and support them. And, like the president-elect, we too have experienced the insurmountable grief brought on by the loss of family members," the groups wrote.
"It is our strong hope and belief that ending the drug war that has inflicted incredible harm in communities across this nation, and centering evidence-based solutions to address the overdose crisis, could be a great catalyst for a national transformation," the coalition added.