Nora Volkow, the director of the National Institute on Drug Abuse (NIDA), has written an essay for the journal Health Affairs that’s titled “Addiction Should Be Treated, Not Penalized.”
In the essay, the head of a top federal drug agency has laid out the case against incarcerating people over low-level drug offenses and looking at the issue as a public health matter.
While Volkow does not explicitly endorse decriminalization, she says the current system leads to disproportionate enforcement against communities of color and can actually increase the risk of overdose deaths.
“Drug use continues to be penalized, despite the fact that punishment does not ameliorate substance use disorders or related problems,” she writes. “Imprisonment, whether for drug or other offenses, actually leads to much higher risk of drug overdose upon release.”
“We have known for decades that addiction is a medical condition—a treatable brain disorder—not a character flaw or a form of social deviance,” Volkow continued in the essay.
“Yet, despite the overwhelming evidence supporting that position, drug addiction continues to be criminalized. The US must take a public health approach to drug addiction now, in the interest of both population well-being and health equity.”
The essay was published by Health Affairs late last month and republished on NIDA’s website this past Friday.
The NIDA head pointed out how people of color have been “disproportionately harmed by decades of addressing drug use as a crime rather than as a matter of public health.”
“The damaging impacts of punishment for drug possession that disproportionately impact Black lives are wide ranging. Imprisonment leads to isolation, an exacerbating factor for drug misuse, addiction, and relapse,” the director said. “It also raises the risk of early death from a wide variety of causes.”
Volkow also explains that being arrested for marijuana possession “can leave the individual with a criminal record that severely limits their future opportunities such as higher education and employment.” She believes law enforcement trend hurts black people more than white people despite comparable rates of consumption.
“This burden reinforces poverty by limiting upward mobility through impeded access to employment, housing, higher education, and eligibility to vote,” she said. “It also harms the health of the incarcerated, their non-incarcerated family members, and their communities.”
The NIDA is “redoubling its focus on vulnerabilities and progression of substance use and addiction in minority populations,” she said. “We are exploring research partnerships with state and local agencies and private health systems to develop ways to eliminate systemic barriers to addiction care.”
The agency is “also funding research on the effects of alternative models of regulating and decriminalizing drugs in parts of the world where such natural experiments are already occurring.”
“People with substance use disorders need treatment, not punishment, and drug use disorders should be approached with a demand for high-quality care and with compassion for those affected,” she added. “With a will to achieve racial equity in delivering compassionate treatment and the ability to use science to guide us toward more equitable models of addressing addiction, I believe such a goal is achievable.”
