The day I thought Donald Trump might really win was several months ago when I attended a gathering of people who had or had had family members in prison and were interested in humane drug policy. One of the leaders of the group, said he wasn’t buying Kamala. “A prosecutor is a prosecutor is a prosecutor,” he said, “She ain’t fooling us,” he said which was greeted by many “Here. Here’s.”
I was stunned. I guess I can understand a family’s inherent dislike of a prosecutor, someone who put one of your loved ones behind bars. Still, just based on public statements, it seemed the alternative was likely to be closer to send them all up the river, put ‘em behind bars and throw away the keys than the more moderate drug policy we have seen under Biden/Harris.
Well, the people have spoken. I am grateful the election was not close so there was no chance of an election steal from either side. No controversy. Fair and square. Let’s have a peaceful transition of power and all root for the United States and our people.
I preface this all to speculate how drug policy will change under President-elect Trump.
I hope that we will continue to move toward a model based on public health solutions rather than law enforcement. It is hard to find a street level law enforcement official who still believes we can arrest ourselves out of this mess. We cannot return to the all out failure of the 50 years war on drugs that filled our prisons and cemeteries. Trillions wastes, lives ruined and our drug supply in this age of fentanyl is far more toxic than it ever was under Richard Nixon when the war was first declared in the 1970’s,
Here’s what I hope.
The US will continue to expand access to buprenorphine and methadone, which have been proven to save lives but reducing cravings and helping people stay off more dangerous illicit opioids. This expansion should include patients in prison, many pf whom are in jail due to the substance use disorder and who are at high risk of overdose and death on their release,
The US will continue to support harm reduction, including widespread naloxone availability, syringe exchange and the development of overdose prevention sites. “Dead people don’t recover,” is a message that even conservatives can understand. While harm reduction meets people where they are at, and supports even those who have no intention of ever seeking recovery, the more effective message to those unfamiliar with harm reduction is that it keeps people alive until they are able to find a path.
I fear the movement toward legitimizing overdose prevention sites where people can use drugs safely under the eyes of care workers rather than using alone in alleys and dark parks and behind locked bathroom doors, may be threatened. Even under President Biden, these centers were never embraced, although the few that opened in New York City were not shut down and many unofficial sites were allowed to operate without legal interference.
If law enforcement is to play a larger role under the new administration, focus should be on stopping the flow of precursor chemicals from China rather than jailing street level dealers, many of whom have substance use disorder themselves, and sell only to keep themselves out of drug withdrawal.
In the last year, there have been promising signs that the death toll is truly starting to decline. Let’s build on that progress. No retreat. People first. Common sense public health solutions. Not demagoguery.
Here’s my seven-point plan.
- End the war on drugs and the war on people who use drugs.
- Recognize the drug use disorder as a public health problem, not a criminal one.
- Reallocate funding to harm reduction, and medical treatment, including offering suboxone or methadone to all who meet the conditions.
- Create a safe supply alternative by legalizing possession of small amounts of opioids and authorizing the production and regulation of pharmaceutical grade heroin and/or fentanyl for users enrolled in public health programs.
- Establish overdose prevention centers where users can use under watch of a trained worker with naloxone at hand and ability to refer patients to treatment and advise of safe use practices and access to social services.
- Create and support safe use alone applications to allow monitoring and rescue of patients who overdose when using alone.
- Make naloxone available at little or no cost to the public.
If we are serious about stopping the deaths, we need to change our failed approaches of the past. Organize! Collaborate! Speak out!