When it comes to the war on drugs, there’s no need for further research to prove that such criminalization has disproportionately impacted communities of color, a top federal drug official said in a new interview.
National Institute on Drug Abuse (NIDA) Director Nora Volkow has on several recent occasions discussed the harms of the drug war and the need to take an alternative approach, in part by decriminalizing substance misuse and promoting treatment through a public health-focused model.
Now, the official spoke to the scientific journal publisher Springer Nature about a variety of drug policy issues in an interview and authored a new op-ed for Scientific American. The overarching themes again concern the current criminalization and stigmatizing approach to drugs and the need for a policy change.
NIDA Director Dr. Nora Volkow discusses her recent Perspective published in @npp_journal, on how criminalizing drug use disproportionately harms Black communities & exacerbates health disparities with the Executive Editor @SpringerNature.https://t.co/DYYVcB445Y
— NIDAnews (@NIDAnews) August 26, 2021
While there are several possible iterations of decriminalization that could replace the existing system, Volkow said in the interview published last week that one thing is apparent: the war on drugs has had outsized consequences for minority communities, and that alone should be reason to reevaluate the country’s law enforcement-centric policies on drugs.
“It is clear that the United States is currently reckoning with a long history of discriminatory and racist policies, many of which still continue today,” Volkow said. “The War on Drugs was no exception, and by incarcerating Black people at disproportionately high rates, it has had radiating effects into health, economic security and mobility, education, housing, families—areas intrinsically connected with the well-being and success of so many Black and other people of color.”
The top drug science official said that there’s no need for additional studies to shed light on the harms of criminalization.
“In science, we often must say that we don’t yet have an answer, that ‘more research is needed,'” she added. “But the evidence here is straightforward and solid, and needs to inform an urgent conversation.”
That conversation has been happening for decades in advocacy and civil rights circles—and there are legislative efforts that have been introduced and enacted to help repair the harms of the drug war—but it’s a notable call-to-action from the nation’s leading drug official.
In @sciam, Dr. Volkow describes the radical changes needed in the United States to address drug overdose following 2020’s horrific increase in deaths. https://t.co/gEnAumLSW4 #IOAD21 #EndOverdose #OverdoseAwarenessWeek pic.twitter.com/nEFlF8OCXb
— NIDAnews (@NIDAnews) August 31, 2021
Volkow was also asked if she felt there was “consensus” on the need to shift to a public health approach to substance misuse, and she responded that there’s “serious work to do.”
“There is stigma associated with drug use and addiction that is deeply ingrained in culture and society around the world. Many diseases, particularly mental health disorders, are stigmatized,” she said. “As humans, we are taught to fear sickness, and to alienate what is different from us. But this is a losing proposition.”
“We all get sick, we all have needs, and we all benefit from a system that works to treat diseases and conditions with evidence-based care and compassion,” she continued. “Making this cognitive shift will likely be critical to achieving the political will to implement a widespread public health approach.”
She also talked about the record-high drug overdose deaths that the U.S. experienced in 2020 and said that highlighted the need to “re-evaluate how we are addressing drug use.” Volkow said “the science provides some answers as to what is working and isn’t regarding the issue of criminalization.”
Volkow further discussed the overdose epidemic in an op-ed published by Scientific American on Tuesday. She said that record-high overdose deaths in 2020 should tell us “that something is wrong,” and that the data is “shouting for change.”
“It is no longer a question of ‘doing more’ to combat our nation’s drug problems. What we as a society are doing—putting people with drug addiction behind bars, underinvesting in prevention and compassionate medical care—is not working,” she said. “Even as we work to create better scientific solutions to this crisis, it is beyond frustrating—it is tragic—to see the effective prevention and treatment tools we already have just not being used.”
“We must eliminate the attitudes and infrastructure barring treating people with substance use disorders… The science of the matter is unequivocal: Addiction is a chronic and treatable medical condition, not a weakness of will or character or a form of social deviance. But stigma and longstanding prejudices—even within healthcare—lead decision-makers across healthcare, criminal justice, and other systems to punish people who use drugs rather than treat them.”
She added that harm reduction services like syringe exchange programs “need to be a part of any solution to our drug crisis, as these have been shown to reduce HIV and hepatitis C transmission, and help link people to treatment for addiction and other conditions.”
And researchers are evaluating whether “innovative but historically controversial strategies” such as safe consumption sites where people can use illegal drugs under medical supervision can be cost-effective and “reduce deaths and improve health.”
“The risk of incarceration does not deter drug use, let alone address addiction; it perpetuates stigma, and disproportionately harms the most vulnerable communities.”
“Radical change to save lives is long overdue,” Volkow wrote. “It is crucial that scientists help policymakers and other leaders rethink how we collectively address drugs and drug use, looking to the evidence base of what improves health and reduces harms across communities, and funding research to develop new prevention and treatment tools.”
The NIDA director has recently written several other op-eds on this and related issues. And in a podcast interview with Drug Policy Alliance founder Ethan Nadelmann that aired last week, she acknowledged that marijuana legalization has not led to increased youth use despite her prior fears, and she spoke about the therapeutic potential of certain psychedelics that have long been deemed “dangerous” under federal law.
When it comes to cannabis, Volkow has repeatedly stressed that the existing federal regulatory scheme has created significant research barriers. She’s discussed that problem at various congressional hearings. For example, she says the process for scientists to obtain marijuana for studies is “extraordinary cumbersome, and as a result of that, researchers don’t want to get into the field.”
With respect to substance misuse in general, she told Nadelmann that she’s been against criminalization from “day one.”
“One of the reasons why I took this position was because, I say, we can develop the science in such a way that policy changes,” Volkow said.
“I’ve also been openly active in criticizing the policy of incarcerating for crack versus cocaine, which made absolutely no sense,” she said, adding that she tries to address the harms of criminalization during appearances before Congress such as her testimony last month at a Senate Caucus on International Narcotics Control hearing. “There are structural systems in such a way that promote certain behaviors, and science is not enough to change those policies.”