This is a popular narrative: the overdose crisis took a humanistic, "public health" approach
This narrative is almost completely false, if you define "public health" as being driven by evidence, compassion and focus on prevention
What actually took place looks very different 🧵
This narrative is almost completely false, if you define "public health" as being driven by evidence, compassion and focus on prevention
What actually took place looks very different 🧵
"We can't arrest our way out of this problem" became a mantra of overdose crisis response. Leaders from all sectors, incl CJ, readily served it up, highlighting contrast with hyper-punitive and racist drug crises of the past (e.g. crack)
Theory vs reality
Theory vs reality
Harsh penalties were core policy response to overdose, inc "drug-induced homicide" laws, whereby accidental drug ODs refashioned into murder
These laws surged quickly across the US, negating the "we can't arrest our way out" rhetoric
These laws surged quickly across the US, negating the "we can't arrest our way out" rhetoric
While public was hearing "we can't arrest our way out of this crisis," we were doing exactly that
Prosecutions surged. Most ppl charged were friends, family like @MorganGodvin
Ppl of color disproportionately affected
In other words, rhetoric ≠ reality
Prosecutions surged. Most ppl charged were friends, family like @MorganGodvin
Ppl of color disproportionately affected
In other words, rhetoric ≠ reality
It wasn't just drug-induced homicide. Criminal legal system didn't skip a beat criminalizing substance use. Drug arrests over the course of OD crisis did not see a decline, even as more states legalized cannabis
Of course, arrest, incarceration drive ODs
Of course, arrest, incarceration drive ODs
Public health surveillance is crucial to addressing public health challenges, but surveillance that evolved in response to the overdose crisis took a distinctly punitive turn in the form of prescription drug monitoring programs
papers.ssrn.com/sol3/papers.cf…
papers.ssrn.com/sol3/papers.cf…
Would be unfair to single out criminal legal system, when public health/health care doubled down on punitive, disciplinarian measures in addressing ODs instead of proven treatment and harm reduction
Eg: took till 2016-17 to see major scale-up in naloxone
Eg: took till 2016-17 to see major scale-up in naloxone
Funding allocated to address OD crisis was VERY LATE, there was far too little, and a lot of it was wasted on non evidence-based programs
Narrative about OD being "white" prob that "does not discriminate" is popular, but false. OD did cut into every demographic just as COVID-19 is now
But Native Americans were always at highest risk, as were other ppl of color. Econ vulnerability = OD risk
But Native Americans were always at highest risk, as were other ppl of color. Econ vulnerability = OD risk
Health care responses to OD crisis continue to be abysmal, TWO DECADES in
Meds to treat addiction, slash OD risk by 50-80% STILL not accessible
PPL behind bars rarely get Tx
Even HCW barred from agonist Tx
Meds to treat addiction, slash OD risk by 50-80% STILL not accessible
PPL behind bars rarely get Tx
Even HCW barred from agonist Tx
Jarm reduction approaches to overdose are TOTALLY UNDERUTILIZED and marginalized
We're seeing a lot of flexibility in enforcement of laws and regs during covid-19
Not so w overdose
We're seeing a lot of flexibility in enforcement of laws and regs during covid-19
Not so w overdose
