Drug Addiction in America: How Government Policies Are Changing the War on DrugsAnna Ciulla
Not long ago, “Just Say No” was the famous rallying cry of America’s drug abuse efforts, as part of a larger national War on Drugs. These two slogans (“Just Say No” and “the War on Drugs”) probably best epitomize the U.S. government’s approach to addiction and substance abuse in the 1980s and early 1990s: a popular campaign to teach school-aged children about the dangers of drugs and how to “just say no” accompanied an aggressive federal crackdown on the drug trade characterized by stiff criminal penalties for drug addicts.
By the year 1994, this War on Drugs was incarcerating more than one million Americans each year, according to an article in the New England Journal of Medicine. There researchers cited an eightfold increase in the federal budget for the control of illicit drugs, with more than two thirds of the total set aside for “increasingly harsh criminal laws.” Meanwhile, rates of illicit drug use continued to rise, prompting the Global Commission on Drug Policy to declare fatefully, “the war on drugs has failed,” in a 2011 report.
Today, as the number of Americans who abuse illicit substances still continues to rise, according to the latest survey by the National Institute on Drug Abuse, slogans like “Just Say No” and “War on Drugs” have largely given way to an emphasis on treatment for drug addiction. Or so changing public views and developing government policies, their origins dating back as early as the 1940s, would suggest. This article highlights these key policy developments, with a view to showing how shifting frontlines in America’s fight against drugs spell renewed hope for the millions of Americans with substance use disorders and their families.
Drug Addiction and Changing Public Views
Recent advances in brain research and addiction science, among other trends, are changing public views about drug addiction and, in turn, state and federal drug policies. In 2014, more than two thirds of all Americans (67 percent) said the U.S. government should focus on treatment—not prosecution—of users of illegal drugs like heroin and cocaine, according to a national survey by the Pew Research Center. In the same survey, an even larger majority of Americans (76 percent) supported the ending of jail sentences for those caught possessing small amounts of marijuana. And the number of Americans who supported a move away from mandatory state sentences for non-violent drug offenders was double the number of Americans who opposed the move.
With these changing public perceptions, America’s drug policy landscape is also shifting, as evidenced by fresh federal legislation to curb an alarming rise in deaths from opiate and heroin overdose in recent years. The Comprehensive Addiction and Recovery Act (CARA), which the president signed into law this summer after the bill received strong bipartisan support in both houses of Congress, lays out a number of provisions to treat opiate and heroin addiction as a public health crisis. Notably absent from the new federal law are punitive measures for heroin users. On the contrary, CARA aims, by its own description, to “shift resources towards identifying and treating incarcerated people who are suffering from addiction, rather than just punishment as is often the case currently.”
The same tenor (of a less punitive, treatment-oriented approach to drug addiction) pervades CARA’s other goals. These are to:
- Expand law enforcement and first responders’ access to the drug, naloxone, which can reverse the otherwise-lethal effects of a heroin or opiate overdose and has reportedly reduced overdose deaths in some places by two-thirds
- Improve prescription drug monitoring programs in order to prevent abuse and “to help at-risk individuals access services”
- Prohibit inquiries by the Department of Education (DOE) into past conviction(s) for the possession or sale of illegal drugs as a criterion for receiving federal financial aid
Naloxone for Heroin Overdose
One provision of the new federal law CARA is itself an interesting case study in how government policies are changing the so-called war on drugs from times gone by. In the year preceding CARA’s expansion of naloxone for heroin overdose, 14 states expanded access to the life-saving drug, so that by February 2016, a vast majority of U.S. states—some 41—reportedly had laws on their books encouraging the administration of naloxone. These “Narcan” or “Good Samaritan” laws have provided civil or criminal immunity to healthcare providers or lay responders (illicit drug users included), who administer naloxone in cases of suspected overdose.
Changing Government Policies Re: Drug Addiction: Key Milestones
The mandated expansion of naloxone is but one policy development in the larger story about changing U.S. attitudes and policies in response to drug and alcohol addiction (which is itself the reflection of a growing trend to treat drug addiction as a disease). The below timeline highlights four of the most important milestones in this general policy trajectory toward recognizing the benefits of addiction treatment:
- 1940-1945 — Recovering alcoholics in the group “Alcoholics Anonymous” (AA) were reportedly recruited at DuPont, Remington Arms and other companies to spearhead the first modern industrial alcoholism programs—the first forerunners of what today are known as “Employee Assistance Programs” (EAPs).
- 1962 — The U.S. Supreme Court made the landmark ruling to recognize drug addiction as a disease rather than a criminal act, in the Robinson v. California decision.
- 1966 — The passage of the Narcotic Addict Recovery Act increased federal involvement in and support for the development of addiction treatment services.
- 1972 — The Drug Abuse Treatment Act became law, leading to the creation two years later of the National Institute on Drug Abuse, the lead federal agency charged with advancing the study of addiction and its treatment.