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A leading voice in the substance use treatment community is calling for a balanced approach in national policy as a new administration and new Congress in Washington consider measures to reduce still troubling opioid overdose rates.
In a detailed letter to congressional leaders in early February, the American Society of Addiction Medicine (ASAM) urged supporters of the proposed Halt Lethal Trafficking (HALT) Fentanyl Act not to lose sight of the difference that expanded use of evidence-based substance use treatment can make in reducing overdose deaths. The HALT legislation passed in the House on Feb. 6 and awaits action in the Senate.
ASAM President Brian Hurley, M.D., M.B.A., argued in his organization’s Feb. 3 letter that a punishment-first approach to low-level drug offenses could actually worsen problems around drug use and trafficking. “Research has shown that mandatory minimum sentences do not deter drug use — either before or after incarceration — and can spend tax dollars with little to no impact on drug use, drug-related arrests, or overdose rates,” Hurley wrote.
He continued, “Moreover, a meta-analysis of research studies found that incarceration not only fails to prevent drug use, it may even increase the likelihood of reoffending.”
The HALT legislation would permanently classify fentanyl and fentanyl-related substances under Schedule I; this authority had been extended to the Drug Enforcement Administration on a temporary basis but is scheduled to expire in March. House leaders say the legislation would give law enforcement and the courts a much-needed tool to combat the presence of fentanyl in the drug supply.
ASAM would like to see Congress include in the HALT legislation a policy direction stating that “while the legislation may facilitate prosecutions and seizures of fentanyl-related substances, increased and sustained congressional efforts are needed to address the demand side of our national addiction and overdose crisis if the primary goal is to save lives,” Hurley’s letter stated.
Hurley suggested that substance use treatment represents the most effective use of public funds targeting low-level drug offenders whose activities are supporting their addiction. He cited historical data showing that every dollar spent on substance use treatment saves $4 to $7 in criminal justice and related costs.
ASAM would like to see Congress build on the emergence of evidence-based medication treatments for opioid use disorder (OUD) by offering drug makers incentives to develop new products, in a market that most pharmaceutical companies have traditionally avoided. ASAM also believes Congress should remove legal barriers that have caused some pharmacies to resist stocking supplies of buprenorphine for OUD.
ASAM’s comments are seeking to remind policy-makers that all components of a strategy to combat illegal drug activity, addiction and fatal overdose are important to achieving critical policy goals.
