Josiah Jones
Edited by Jasmine Renee Iyer, Mac Kang, Roohie Sheikh, and Kira Small
The history of recreational drug use is long and complicated, and with the rise of new drugs like fentanyl as well as steadily increasing abuse and overdose rates, drug legislation has never been more relevant. While the potential dangers of recreational substances are well documented, proponents often defend their use by appealing to individual autonomy and emphasizing the benefits of such substances in controlled settings. In response to the challenges posed by the drug trade, governments worldwide have taken drastic legislative steps to mitigate the detrimental effects of recreational drugs. Two primary approaches to solving this problem have emerged: prohibition and decriminalization. The United States federal government has implemented a hardline prohibition strategy, assertively targeting drug distributors and users alike in an attempt to combat the national drug epidemic. In contrast, many European nations have trended away from prohibition and punitive justice, instead treating drug use as a public health issue rather than a criminal offense. American policymakers' continued reliance on punitive drug policies has not only failed to reduce drug-related harm but has exacerbated the problem, especially when compared to the remarkable success of Europe’s rehabilitative approach. Decades of evidence from countries such as Portugal illustrate how treating drug use as a public health issue rather than a criminal offense is far more effective, underscoring an urgent need for the United States to abandon its outdated strategies and adopt a more humane, evidence-based model when addressing the ongoing drug crisis.
The first major landmark in modern drug legislation, President Richard Nixon’s 1971 “War on Drugs,” was formulated in response to the growing opioid abuse crisis in America. President Nixon called for a worldwide crackdown on the drug trade. The first steps toward this goal were the formation of the Drug Enforcement Administration (DEA), the passing of new drug laws, and the stricter enforcement of existing laws [1]. Subsequent presidents, including Jimmy Carter and Ronald Reagan, escalated the policies for which Nixon advocated [2]. Under President Reagan, FBI drug enforcement spending increased nearly twelvefold between 1980 and 1984 [3]. His Comprehensive Crime Control Act of 1984 substantially increased penalties for the possession and distribution of substances like marijuana and cocaine. Moreover, The Act not only expanded this federal authority in drug enforcement but also instituted mandatory minimum sentencing policies, which narrowed judicial discretion in sentencing and led to a dramatic uptick in incarceration rates for non-violent drug offenses [4]. This legislative shift marked a key moment in the development of the United States’ punitive approach to drug control, entrenching the criminalization of drug offenses.
In 1994, John Ehrlichman, an aide in the Nixon administration, admitted to the true purpose behind the War on Drugs:
“The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and Black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or Black, but by getting the public to associate the hippies with marijuana and Blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.” [5]
Given its explicitly hostile purpose, it is no surprise that the campaign historically has yielded catastrophic results. Despite its publicly stated goal of targeting drug manufacturers and distributors, 82% of United States drug arrests in 2013 were for possession alone [6]. A 2021 study suggests that incarceration for drug possession may even increase the risk of reoffending [7]. In 2013, 68% of incarcerated drug users reoffended within five years [8]. The War on Drugs has caused incalculable harm to those suffering from addiction, stretching beyond the legal sphere into public health. Legislation banning the possession of drug paraphernalia has led to unforeseen negative externalities including rapidly rising disease rates. The American Civil Liberties Union reports that in New York City, over 60% of intravenous drug users are HIV-positive due to the lack of access to sanitary needles. Comparatively, just 1% of intravenous drug users in Liverpool, where sanitary needles are readily available, tested positive for HIV [9]. The Brookings Institute describes the War on Drugs as “a staggering policy failure, advancing few of the claims [it] sought to achieve” [10]. Furthermore, the American Civil Liberties Union cites the fentanyl epidemic, which claims tens of thousands of American lives each year, as compelling evidence of the American government’s inability to generate positive results through its enforcement measures [11].
In light of these failures of the War on Drugs, a shift toward adopting a rehabilitation-based policy strategy is the logical next step. After all, if the American Health Association recognized addiction as a disease in 1987, legal policies no longer should treat those suffering from the disease of drug addiction as criminals rather than as patients [12]. This question today remains largely unanswered, but some governments are taking steps to remedy this incongruity. According to the National Library of Medicine, the European average opioid-related death rate is sixteen per million residents, nearly ten times fewer than the United States’ average of 156 deaths per million [13]. The European Union’s drug policies have tended toward rehabilitation and away from punishment, and more significantly, these policies have yielded successful results.
Certain nations in the European Union have distinguished themselves as particularly successful in limiting drug abuse and overdose. Portugal paved the way as a leader in the fight against drug dependence and fatalities, decriminalizing drugs in 2001 in an effort to reverse skyrocketing overdose rates. While drugs remain illegal, possessing them for personal use now entails “a small fine and a referral to a treatment program -- not jail time and a criminal record” [14]. The results have been astonishing: Portugal’s drug use, overdoses, and new HIV cases have all fallen to less than 20% of the European Union average and the second lowest overall. Czechia, the Netherlands, and Switzerland followed Portugal’s model, reducing penalties for possession and investing in rehabilitation [15]. According to the European Monitoring Center for Drugs and Drug Addiction, Czechia’s overdose rate is 61% lower than the European average, with just forty-four overdose deaths in 2017 despite a population of seven million. Switzerland has experienced even greater success. According to Psychiatry Online, since adopting a rehabilitation-focused approach, Switzerland has seen new opioid use cases drop to almost zero. Switzerland’s methadone rehab programs for opioid users cost approximately $1,750 for six months of treatment, a fraction of the $20,000 cost for six months of incarceration. Crime, overdoses, and the spread of HIV and hepatitis all have fallen dramatically [16]. The evidence is indisputable: Portugal’s drug policy works, however radical it may appear.
The appeal of more effective drug harm reduction, lower incarceration rates, and reduced spending has drawn the attention of a number of the United States’ city and state officials as well. The city of Portland, Oregon, experimented with decriminalization, but the failure to invest in a rehabilitation infrastructure led to worse abuse and overdose rates than before the law was passed [17]. Three years later, Portland reversed its policy. Dr. João Goulão, Portugal’s national drug coordinator, commented on Portland’s policy reversal, stating: “Above all, you have to be consistent in your approach and give it time to provide results…. When you're taking on something as complex as the opioid crisis, you can't really expect to see dramatic changes from one day to the next" [18]. The data is clear: decriminalization, when partnered with rehabilitation, is a proven method for reducing the damage caused by substance abuse. However, this method requires long-term commitment alongside intentional investment in rehabilitation and recovery infrastructure in order to achieve any measurable success. As Portland’s case unfortunately demonstrates, decriminalization alone is insufficient. Decriminalization and rehabilitation must work in tandem.
Solving a centuries-old problem in a handful of years is unlikely, but more than ever before, comprehensive reforms are urgently needed on a global scale. A United Nations report revealed that global drug abuse rose by 23% between 2011 and 2021 [19]. The rise of fentanyl, coupled with steadily climbing rates of drug use and overdose, demands worldwide attention. The international community must continue to research and refine its policies, aiming to reduce the rate and severity of drug-related harm. While a definitive answer to the drug crisis has yet to emerge, Europe’s rehabilitative approach provides a promising blueprint. Portland may have failed to fulfill the promises of its first attempt at reform. However, if Oregon can learn from its mistakes and set an example for other states across America, countless future casualties in this senseless war may yet be avoided. The mounting deaths and costs associated with the War on Drugs call for decisive action, and nations like Portugal offer a vision of a future where an addiction-free world seems increasingly attainable. It is up to world leaders to take the necessary legislative steps to make this hopeful vision a reality.
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