The Biden-Harris administration recently announced that it is committed to transforming the national drug policy by expanding access to evidence-based treatment, harm reduction, and prevention efforts, and by reducing the supply of illicit substances.
A change in drug policy is more important than ever, especially considering that according to Centers for Disease Control and Prevention (CDC), 13% of Americans reported that they had started or increased substance use to cope with the pandemic.
The CDC also found that 81,000 reported drug overdose deaths occurred across the nation between June 2019 and May 2020. The increase in deaths was linked to using synthetic opioids, psychostimulants (methamphetamine), and cocaine. Overdose deaths involving these drugs increased by 38.4%, 34.8%, and 26.5%, respectively. That’s an increase of more than 10,000 deaths over 2019, during which CDC reported 70,630 drug overdose–related deaths, 71% of which involved an opioid.
This succession of preventable deaths is a clear sign that the war on drugs has failed and demands that President Biden go beyond his tentative steps to avert additional loss of life. Luckily, there is already an evidence-based model for combating the overdose crisis being implemented in Canada, called “safe supply.”
Safe Supply: Providing Care for People Who Use Drugs
The safe-supply movement calls for the government to offer a legal, low-barrier access, and federally regulated supply of drugs that have been checked for potency and toxicity so that people can use them without fear of overdose, poisoning, infection, disease transmission, or criminalization and exposure to perilous conditions.
Instead of forcing people who use drugs to look for a reliable dealer, safe supply interrupts potentially dangerous supply lines by allowing people to manage their dependencies in a supervised and protected area. It is also known as “safer supply” to acknowledge that, much like with the efficacy of condoms against sexually transmitted infections (STIs) in relation to safer sex, there will also be an element of risk involved in using controlled substances.
In March 2020, Vancouver’s mayor Kennedy Stewart joined health officials from around the province of British Columbia in lobbying for health professionals to be allowed to provide drugs to people with chemical dependency so that they could ward off withdrawal symptoms while maintaining social distancing and be protected from the threat of using a tainted opioid supply. At the time they made this request, British Columbia was experiencing three drug overdose–related deaths a day.
Additionally, 17,600 Canadians died from drug overdoses between January 2016 and June 2020. According to CATIE, Canada’s leading source of information about HIV and hepatitis C, the primary cause of this crisis was the government’s criminalization of illicit drugs, which failed to reduce use and resulted in an unregulated and unpredictably toxic supply.
The Canadian Association of People Who Use Drugs—a Canadian national organization that advocates for the rights of people who use drugs across the country—had long advocated for a state-sanctioned drug program that went beyond offering treatment. To date, most medical drug-treatment programs focus on administering non-toxic versions of drug formulations in order to wean people who are living with dependencies off of them.
However, many of these offerings lack the physiological effects that many people who use drugs seek. And while the approach has been effective for some, it offers little protection or assistance to people who have no intention of stopping their use. Safe supply recognizes that abstinence is not for everyone and reasons that since some people will continue to use drugs, regardless of the barriers that they face, they might as well do so as safely as possible and without worrying about the threat of police, gang, or judicial violence.
Consequences of a Racist Drug War
Within the United States, that violence has played out over the past 50 years as part of the “war on drugs.” Rather than treat its residents who use drugs with compassion—a central tenet of the safe-supply movement—the federal government has decimated mostly Black and brown communities through brutal police crackdowns and by penalizing drug possession with mandatory-minimum federal sentencing laws. This remains the case, even as such punitive measures have failed to deter drug use or to offer effective treatment.
The prevailing idea has been that incarceration and loss of freedom will reduce illicit drug use, but years of research have shown that states with higher rates of drug imprisonment continue to experience high rates of reported drug use, arrests, and overdose deaths.
As noted in 2018 by Pew Research Center, though Tennessee ranked fifth in the nation for drug-use imprisonment compared to New Jersey, which ranked 45th, their reports on drug use were about the same, with Tennessee ranked 40th among all states and New Jersey 42nd.
Pew’s study on drug use also found that instead of decreasing drug use, imprisonment yields high costs with low returns by increasing the prison population and delivering life-ruining stains on the permanent records of formerly imprisoned people, who, despite having repaid their arbitrary debt to society, are often unable to attain remunerative employment or access to loans, housing, or higher education. This is particularly debilitating for Black people, who have been targeted most by drug prosecution.
As of 2018, Black people made up 33% of the U.S. prison population even though they accounted for only 12% of the entire country’s population.
In its 2017 report on mandatory-minimum penalties for drug offenses in the federal system, the U.S. Sentencing Commission (USSC)—an independent agency created by Congress in 1984 to reduce sentencing disparities and promote transparency—determined that Black people who have been convicted of drug offenses remained subject to mandatory-minimum sentencing at higher rates than white people.
The commission also found that in 2016, the average sentence for drug offenders convicted under mandatory-minimum sentencing laws was 94 months, more than twice as long as the average sentence of those who were not subjected to a mandatory minimum. Additionally, 45.9% of people convicted of drug offenses carrying a mandatory minimum had little to no prior criminal history, while nearly half of all federal inmates were convicted due to drug laws.
Marijuana Decriminalization Is Safe Supply
In recent years, criminal-justice reform has sought to defang drug prosecution laws in recognition of the disproportionate impact that they have on Black communities. This includes the legalization of recreational marijuana, which has taken root in 17 states and Washington, D.C. By doing so, the states have effectively created a safe supply of marijuana and ensured that the arrest rate will drop.
According to Drug Policy Alliance, a national nonprofit dedicated to ending the war on drugs, in 2010, New York City made 50,300 arrests for marijuana possession. Additionally, the city spent $75 million that year arresting mostly young Black people for possessing small amounts of the drug, because even as Black and white people used marijuana at equal rates, prosecution disproportionately targeted Black neighborhoods.
Crystal meth, cocaine, and heroin undoubtedly belong to different classes from marijuana, but people who use them are no less deserving of care and compassion. Rather than force them to operate at the fringe of society, safe supply offers an apparatus that eliminates criminal prosecution and toxic supply lines.
According to a 2020 study involving 42 safe-supply program participants in Vancouver, published in the Journal of Urban Health, safe supply was shown to reduce overdose risk and improve participants’ economic situation. And because it required a medical office to administer drug prescription, the program increased engagement with primary care as well as pain management.
In recognition of these results, in August 2020, the federal government of Canada announced that it was providing Toronto $1.6 million for the Emergency Safer Supply Program and the Downtown East Collaborative Emergency Safer Supply Program to open their first safer-supply sites. Federal officials embraced what they called in a press release “innovative new harm reduction approaches” after Toronto Public Health announced that the city had experienced 130 suspected overdose deaths between January and August 2020.
Additionally, in February 2021, Canada’s Ministry of Health announced that it is providing $15 million in federal funding for the operation of four safer-supply projects in Vancouver and Victoria.
As a show of approval for this move, Canada’s minister of mental health and addictions, Sheila Malcolmson delivered a written statement that expressed pleasure “that Health Canada is working with us to help separate more people from the toxic drug supply.”
Dependencies and criminalization affect more than people who use drugs; they also hurt their families. In consideration for the destruction that the war on drugs continues to inflict upon hundreds of thousands of lives across the U.S., one hopes that President Biden will take a cue from the success of safe supply in Canada.
Within the U.S., the move to legalize marijuana is another clue that it is time to decommission the war on drugs so that people with dependencies or who use drugs recreationally can pursue their own happiness without fear of prosecution or loss of opportunities.