Lock up ‘dem addicts Now! –

June 29, 2020 – For individuals addicted to opioids or suffering from chronic pain, a war on drugs has never been a prescription for improving wellness. This dominant abstinence‐​based policy model is grounded in the logic of prohibition, and it depends not upon healing but upon shame, isolation, prosecution, and penalty. The better model is “harm reduction,” grounded in connection and care, reason and rights, and human dignity and worth.

International and historical public health efforts have demonstrated that one of the best ways to confront epidemic drug use is addiction maintenance—that is, establishing medically supervised clinics to provide pharmaceutical‐​grade narcotics (often free of charge) in amounts calibrated to maintain the social and physical well‐​being of the drug dependent. In this policy analysis, we survey these international and historical efforts. We look to our own past to examine the roots of the modern American drug war and describe contemporary reforms both within and beyond the opioid crisis. We explain how meaningful change is likeliest to occur: from the ground up, as a product of underground experimentation initiated by and within the most‐​affected communities.

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