“Notably, the War on Drugs costs the U.S. nearly $50 billion per year, while the public health workforce and infrastructure, and in particular substance use and harm reduction services, remain severely underfunded.”
— by Lori Tremmel Freeman, Chief Executive Officer —
Washington, DC, June 17, 2021 — “The War on Drugs was declared on June 17, 1971, expanding the federal government’s role in drug control and the criminalization and incarceration of people who use drugs. After 50 years, we can see that this criminalization approach has failed to reduce substance use, exacerbated the root causes of substance use disorder, driven the disproportionate and mass incarceration of Black, Latinx, and other people of color, and limited access to substance use treatment and harm reduction services. Notably, the War on Drugs costs the U.S. nearly $50 billion per year, while the public health workforce and infrastructure, and in particular substance use and harm reduction services, remain severely underfunded.
“After half a century of the failed War on Drugs, the National Association of County and City Health Officials (NACCHO), representing the country’s nearly 3,000 local health departments, is calling for a public health approach to substance use and its harms. This would involve scaling up evidence-based harm reduction and health services and eliminating legal and other barriers that impede these strategies. Local health departments (LHDs) often provide harm reduction services—including syringe services programs, naloxone training and distribution, drug checking services, and overdose prevention sites—enabling them to meet people who use drugs where they are, address the immediate harms they face, and build trust that can support their overall and long-term health. However, LHDs and their local partners need significantly more funding from all levels of government—including an elimination of the ban on the use of federal funding for syringes by Congress—to scale up harm reduction services. The removal of legal barriers, including the decriminalization of syringes and other equipment, could make it easier for local health departments to build trust with people who use drugs and provide them with the tools they need to protect themselves from overdose and infectious diseases. There is also a need for increased investments in substance use treatment, including medications for opioid use disorder, and HIV and viral hepatitis services for people who use drugs.
“The current approach focused on the criminalization of substance use exacerbates the root causes of substance use as a criminal record can serve as a barrier to housing and employment. Additionally, this approach contributes to stigma, deters people from seeking services, and can directly impede access to harm reduction services and substance use treatment, which are difficult to obtain in correctional settings. Consequently, the decriminalization of minor drug offenses would reduce the harms associated with the War on Drugs and increase access to health and social services. Notably, Oregon has recently decriminalized possession of small amounts of drugs, which is anticipated to reduce racial inequities in drug arrests by 95%. Internationally, in Portugal, decriminalization has been associated with an increase in substance use treatment and a decrease in HIV, fatal overdoses, and of course, drug arrests and incarceration.
“For 50 years, the U.S. has focused on criminalizing, rather than treating or reducing the harms associated with substance use disorder. To effectively combat substance use and its harms, the U.S. must shift to a public health approach and invest in substance use treatment, harm reduction services, and other health and social services that improve the health and support recovery for people who use drugs.”
The National Association of County and City Health Officials (NACCHO) represents the nation’s nearly 3,000 local governmental health departments. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information about NACCHO, please visit www.naccho.org.