Guard Against

Guard against Failed War on Drugs Approaches

As we seek to implement the above solutions, we must not fall back toward a punitive ‘drug war’ approach that is ineffective, and can actually exacerbate problems. We must stay vigilant and:


Resist criminalization approaches:

Arrests, mandatory minimums, and drug-induced homicide laws: Research consistently shows that neither increased arrests nor increased severity of criminal punishment for drug law violations results in less use (demand) or sales (supply). Increasingly punitive prosecutions and sentences for drug offenses have no deterrent effect and do not keep our communities safer from harm.


Drug courts: It is inappropriate for courts to impose or interfere with medical decisions. Some New York drug court judges routinely require individuals to cease opioid agonist treatment with methadone or buprenorphine, contravening medical judgment and putting people at greater risk of overdose and other health repercussions.


Avoid coercive or narrow approaches:

Involuntary treatment: Holding someone to treat them against their will is very unlikely to result in sustained abstinence. Instead, forced abstinence will rapidly reduce opioid-dependent people’s tolerance, which consequently increases the risk of subsequent fatal overdoses. Involuntary holds carry the risk of killing people. Further, compulsory treatment paradigms are highly susceptible to error and abuse, both as to diagnosis and treatment, as well as to constitutional protections of privacy and due process.


Vivitrol: While open to new medications, physicians and addiction medicine experts remain cautious and few have voiced support for the expansion of Vivitrol (especially in the criminal justice setting) due to the limited research on its long-term effectiveness. This stands in contrast to the well-documented effectiveness of other medication-assisted treatment modalities, such as methadone and buprenorphine. Where offered, Vivitrol should never be the only available or sanctioned option for medication-assisted treatment.


Abstinence-only treatment: Abstinence may lead to good outcomes for some, but it should not be considered the only acceptable goal or criterion of success. Instead, smaller incremental changes in the direction of reduced harmfulness of drug use should be valued. This harm reduction framework helps people who use drugs who cannot or won’t stop completely reduce the harmful consequences of use. Approximately 10% of people who need treatment for substance use disorders actually seek and receive treatment; data shows nearly a quarter of those do not engage with treatment because they aren’t ready to totally stop using.


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