The Essential Role of Treatment in Effective Drug Policy

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Drug policy debates often revolve around opposing views of prohibition and decriminalization. Both sides present strong arguments but frequently neglect the need for a system that addresses the growing demand for addiction treatment and recovery services.

Prohibition: The Dangers of Modern Drugs

Prohibition advocates emphasize the dangers of today’s potent drugs. For instance, synthetic opioids like fentanyl, which are over 50 times stronger than heroin, have led to more than 55,000 overdose deaths in the last year, according to the Centers for Disease Control and Prevention. Strict control of these substances is deemed necessary to safeguard public health.

Decriminalization: The Case for a New Approach

Reformers criticize the inefficacy of the “war on drugs,” advocating for approaches based on evidence, health, equity, and human rights. Despite extensive investments in interdiction, drugs have become more affordable, potent, and readily available. Advocates urge treating drugs as a public health concern instead.

Challenges in Implementation

Prohibition and reform are hindered by insufficient treatment and recovery options. Past regulations have led to unexpected shifts in drug production. For example, U.S. controls on ephedrine redirected methamphetamine production to Mexico, bolstering drug cartels. Restrictions on prescription opioids forced many patients to turn to heroin and fentanyl.

Decriminalization efforts, like Oregon’s Measure 110, hit roadblocks due to inadequate treatment support. The law reduced criminal penalties but failed to sufficiently expand treatment options. A $100 fine replaced legal penalties, but most individuals ignored it, and few completed health assessments.

Addressing Infrastructure Challenges

Both approaches face the obstacle of inadequate treatment infrastructure. Enhancing this system involves two key elements: personnel and facilities.

There’s a shortage of professionals in the addiction treatment field, including counselors, social workers, and healthcare providers. By 2025, more than 40% of the U.S. population lived in regions lacking mental health professionals, particularly in rural and carceral settings. To address this, competitive pay, streamlined education and licensing, stable funding, and robust peer support are crucial.

Additionally, the U.S. lacks enough behavioral health and substance use treatment facilities. Many counties face shortages, with 80% lacking opioid treatment programs. Wyoming, for example, has none. Expanding facilities and services is critical, particularly in underserved communities.

The Need for Comprehensive Investment

Investments in personnel and infrastructure are foundational to transforming the drug treatment system. These measures are essential for effective drug policy, regardless of one’s stance on prohibition or reform. Expanding treatment services is crucial for meaningful drug policy progress.

Jim Crotty served as deputy chief of staff for the U.S. Drug Enforcement Administration. He is an adjunct professor at American University’s School of Public Affairs and a board member for United Against Fentanyl and End Overdose.