Why 2020 Is a Banner Year for Drug Decriminalization—And What It Means For Public Health

For those of us who came of age in the 1980s and 1990s, anti-drug messaging was a constant. There were the PSAs with stars like Ally Sheedy, Kirk Cameron, and Pee-wee Herman delivering dramatic monologues slipped into our after-school specials (many of which had their own anti-drug messaging; one about angel dust, starring Helen Hunt, remains imprinted in my brain. Then there was the endless D.A.R.E. merchandise; the “this is your brain on drugs” fried egg commercial; and, of course, the earnest speeches by Nancy Reagan, a figurehead in the failure that was the racist war on drugs. The message was simple and always the same: just say no.

This week, with the passage of key drug-related measures in a diverse swath of states, it’s become clear that the majority of Americans are more than ready to just say yes. Arizona, Montana, and New Jersey all voted to legalize cannabis for recreational purposes; in Mississippi, the passing of initiative 65 will establish a medical cannabis program. South Dakota became the first state to simultaneously legalize recreational and medical cannabis; in DC, the use of entheogenic plants (aka shrooms) has been decriminalized. In Oregon, a pair of groundbreaking measures passed with broad support—110 will decriminalize all drugs (including heroin and cocaine, when in possession of small amounts) and 109 will legalize access to psilocybin for medicinal purposes. “These victories definitely send a message about what Americans in this country want,” says Kassandra Frederique, executive director of the Drug Policy Alliance, about the seismic shift in public perception and a shift toward legalization that is widely bipartisan. “It signifies that this isn’t a red state issue or a blue state issue, it’s a common sense issue,” adds Hadas Alterman, a partner at Plant Medicine Law Group, a newly launched firm whose mission is to expand equitable access to plant medicine.

Evolving from criminalization to a more public health-focused approach certainly feels like a move rooted in common sense, particularly in the U.S. where drug possession is the most arrested offense. “For too long we’ve accepted jails and prisons as stand-ins for health services, despite years of data showing us that this approach just furthers the circumstances that lead someone to problematic drug use,” says Frederique. “Decriminalization approaches [like Oregon’s Measure 110] turn that on its head by removing the harm of the criminal justice system and providing connection to services that address the full range of people’s needs, whether that be evidence-informed treatment, harm reduction, housing, employment, or other health resources.” In Oregon, the connection between decriminalization and public health improvement is direct: As Vox explains, money saved from law enforcement and incarceration costs will go towards a new drug addiction treatment program overseen by the Oregon Health Authority.

These decriminalization measures also address another major roadblock for those seeking help: stigma. “The public health-based approach of decriminalization centers human dignity and connection,” says Natalie Lyla Ginsberg, policy and advocacy director at MAPS, an organization focused on developing medical, legal, and cultural contexts for the beneficial uses of psychedelics, including cannabis. “In contrast, decades of a global war on drugs built on a punishment-based paradigm of criminal justice have led to sharp rises in drug-related deaths, problematic substance abuse, drug contamination and adulteration, and the strength of drug cartels.”

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