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The biggest mistake we make when discussing drug policy is that we keep talking about drugs. That creates a debate that merely ping-pongs between calls for more rehab and calls for more prison. 

Even amid a presidential campaign, when standing out is a good idea, few people in either political party transcend this artificial divide to ask the real question: Why, in one of the most abundant countries in the world, do nearly twenty million people have what’s recognized as a substance use disorder? 

Behavioral science has already provided the answers. We know that genetics, metabolism, adverse childhood experiences, chronic stress from such factors as poverty, and mental illness put some people at high risk for drug abuse. 

“Substance use disorders in the United States are often lumped into other diseases of despair, such as suicide and alcoholism,” explains Dr. Blake Fagan, addiction specialist at the Mountain Area Health Education Center in western North Carolina. “People who have no job prospects or health insurance are more likely to have problems.”

“So often, problematic drug use is bound up with hopelessness and broader societal and economic challenges.”

There is no doubt that problematic drug use has profound negative consequences for people and communities across the country. The United States has the highest share of population with substance use disorders and the highest rate of drug overdose death in the world. Although overdose deaths have fallen slightly, provisional data from the Centers for Disease Control and Prevention shows 68,500 fatalities in 2018, more than the Vietnam and Iraq wars combined.  

Examples of sensible drug policy initiatives include universal health care, education, affordable housing, and legally guaranteed living wages. On the surface, such proposals might not seem related to substance use. But effective drug policy would seek to reduce exposure to factors that increase the risk of substance abuse, such as trauma, stress, and instability.

“So often, problematic drug use is bound up with hopelessness and broader societal and economic challenges,” says Maria McFarland Sánchez-Moreno, executive director of the Drug Policy Alliance. “Yet instead of supporting people who are struggling, our society has compounded the problem with punitive approaches—the war on drugs.

“[We] punish people involved with drugs, not only through arrests and incarceration, but also deportations, evictions, loss of child custody, and barriers to jobs and education that keep entire families and communities trapped in a desperate vicious cycle.”

True drug policy reform means societal change, which includes challenging the racial inequalities that emanate from our criminal justice system. Drug policy reform cannot be colorblind because the criminal justice system is not colorblind. The racist outcomes of current drug policy are well documented: Black people account for just 12.5 percent of drug users in the United States, but 33 percent of those incarcerated for drug crimes, despite similar rates of drug use and sale compared to white people. 

Many people of color in this country are caught in the catch-22 of conflicting economic and drug policies. First, failing educational systems, housing and employment discrimination, and lack of job opportunities in minority neighborhoods drive people to use drugs to cope with marginalization or to sell them for survival. Then police sweep into neighborhoods, snatching up people who are the most vulnerable and easiest to catch.

Our prisons are disproportionately full of people of color due to policies such as mandatory minimum sentencing, three-strikes laws, and strict probation requirements, including court fees that people released from prison are unable to pay. The system needs to stop stacking the deck against people charged with drug crimes.

To redress the ongoing effects of decades-old tough-on-crime policies, current or future drug policy changes—such as marijuana legalization—must be made retroactive for the millions of people stuck behind bars for activities that are now legal. And as legalization efforts sweep the country, we must ensure that the benefits of new marijuana businesses are accessible to those most harmed by criminalization.   

Since 1970, the United States has spent an estimated $1.5 trillion to wage its so-called war on drugs, yet rates of drug use remain stable. Many politicians, and even police, publicly admit the drug war has failed, but propose only piecemeal reforms. Some offer drug treatment access, overdose prevention programs, syringe exchange, diversion programs, drug courts, even safe consumption sites where people can legally use drugs, a proposal that federal courts in Philadelphia recently greenlighted

We can and should do all of these things, but they are not enough. Millions of people are snatched up every year by the criminal justice system for nonviolent drug crimes. Even with the best harm-reduction and diversion programs, millions more will continue to be arrested, with people of color being disproportionately impacted. If we are serious about reform, we must get straight to the root of the matter and decriminalize and regulate personal possession of all drugs.

Decriminalization means no longer treating the possession of drugs for personal use as a crime. Regulation means controlling the content of our drugs, where they are sold, and to whom—as we do now with other potentially harmful substances like alcohol and tobacco. These policies would not eliminate problematic drug use, but could lessen many harms, such as mass incarceration and overdose deaths from an unregulated supply.

Neill Franklin, a thirty-four-year veteran of the Maryland State Police and Baltimore Police Department, thinks this is an issue that Democratic contenders for President should be taking up.

The current crisis is the result of decades of inequitable economic policy, racism, and the tendency to blame complex problems on easy scapegoats.

“All candidates, regardless of party, should be focusing on decriminalization of personal possession of all drugs,” Franklin, who now serves as executive director of Law Enforcement Action Partnership, a nonprofit group that advocates for criminal justice reform, says in an interview. “Doing so would relieve a substantial burden on the justice system, allow police to focus on what really matters, and prevent millions of people from becoming unnecessarily involved in the justice system.”

Many people fear that decriminalization would increase problematic drug use. They argue that incarceration is necessary to prevent even more people from abusing drugs. But these fears run counter to the experiences of countries like Portugal, which decriminalized the personal possession of all drugs in 2001. 

That country did not become a mecca for drug refugees, as fear-mongers predicted. While drug experimentation has increased in Portugal since decriminalization, drug-related death rates have plummeted to one-fifth the European Union average. HIV infection rates have dropped by 96 percent, and drug use initiation among youth aged fifteen to twenty-four, a high-risk population, has declined as well.

There is no silver bullet to achieve drug policy reform. The current crisis is the result of decades of inequitable economic policy, racism, and the tendency to blame complex problems on easy scapegoats. The solutions will be equally complex and interconnected, which is why we must step back and see the whole picture. Drug policy reform is not about drugs. It’s about people. It’s about how we treat each other. It’s about granting the freedom to decide what to put into our bodies. 

If decriminalization and regulation of drugs in the United States seem unlikely in the near future, we should remember that a few years ago, marijuana legalization wasn’t considered a realistic goal. Now, eleven states and the District of Columbia allow recreational use, with more on the way. 

The current presidential debates are practically defined by goals that have only a slim chance of getting through Congress—single payer health care, free higher education, universal basic income. We should add the decriminalization and regulation of drugs to this list. If we start the conversation right, the impossible might just become the inevitable. u


[1] Drug & Substance Abuse Addiction Statistics ➤[2] MAHEC ➤[3] Drug Use - Our World in Data ➤[4] Drug Use - Our World in Data ➤[5] CDC: Drug Overdose Deaths Finally Dropped in 2018 | Time ➤[6] This Overdose Awareness Day, US overdose deaths are at record highs - Vox ➤[7] Criminal Justice Fact Sheet | NAACP ➤[8] A Chart That Says the War on Drugs Isn't Working - The Atlantic ➤[9] Judge Rules Planned Supervised Injection Site Does Not Violate Federal Drug Laws : NPR ➤[10] Law Enforcement Action Partnership | Advancing Justice and Public Safety Solutions ➤[11] Portugal’s radical drugs policy is working. Why hasn’t the world copied it? | Portugal | The Guardian ➤[12] Want to Win the War on Drugs? Portugal Might Have the Answer | Time ➤[13] Want to Win the War on Drugs? Portugal Might Have the Answer | Time ➤[14] Portugal’s radical drugs policy is working. Why hasn’t the world copied it? | Portugal | The Guardian ➤[15] Want to Win the War on Drugs? Portugal Might Have the Answer | Time ➤[16]