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The Pendulum Swings … Again

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From the floor of Congress to city halls in small towns, the outcry is growing – we must stop deaths from opioid overdose! One would say this is good news; policymakers at all levels are paying attention, regardless of party affiliation, background, or size of the governing body. But if you listen closely to what is being said, the news might not be so great. In fact, one might even hear the rumblings of a new “war on drugs” taking shape.

Yes, the smuggling of fentanyl into the United States has sharply risen which has led to increased overdoses and deaths. And, yes, fentanyl is found in most street drugs today. In fact, the United States Drug Enforcement Administration (DEA) reports that 42% of pills tested for fentanyl contained at least 2 mg of fentanyl, considered a potentially lethal dose. These are facts we must reckon with, but we must be ardent in advocating against a return to failed policies.

Congressmen and women decried the tragedy of deaths from opioids when congress convened for the 2023 session, but whom did they blame for the increase in the supply of this deadly substance? They blamed individuals; the most vulnerable individuals – immigrants seeking refuge from crime-ridden countries with poor economies. Putting the politics of immigration aside, it is important to note where these policymakers believe change should happen to end this crisis. Even though a mere .02% of individuals seeking asylum or crossing the border illegally between legal ports of entry are found to have fentanyl on their person, many lawmakers find it easy to blame the actions of individuals, rather than examining a global failure to address addiction. They believe that if we can just keep “those people” from brining drugs to us, the crisis will be over.

In reality, fentanyl comes into the United States via legal ports of entry by experienced couriers of the illegal drug trade. According to Sanho Tree, Director of the Drug Policy Project at the Institute for Policy Studies, “Most fentanyl is seized at legal border crossings smuggled in all sorts of cargo; not carried on the backs of migrants. Drug traffickers deal with professionals, not amateurs, and they prefer U.S. citizens,” he said.

So why are legislators so apt to believe that, if we can only interdict enough individuals, we can police our way out of this crisis? I believe it begins with a complete disconnect about how addiction works. Lawmakers can’t possibly believe we can arrest and incarcerate a large majority of people buying and selling drugs, yet this concept continues to be enticing to them. This is rooted in the mistaken belief that arrest and incarceration have a significant deterrent value to people who have an addiction. This makes zero sense when put into the context of addiction. A study from 2016, well before the explosive news coverage about opioid deaths, found that 53% of study participants perceived fentanyl presence in their drugs either half, most, or all of the time. Thus, the consideration of possible or even probable death did not deter use. Why then would fear of incarceration significantly impact use patterns?

Nevertheless, in May 2022, Florida passed HB 95 which Increases the mandatory minimum sentence for trafficking fentanyl from three years to seven years for 4-14 grams, and from 15 to 20 years for 14-28 grams. Louisiana passed “Millie’s Law” which says that when a person is convicted of unlawfully distributing heroin or fentanyl, or a mixture containing either, which is the direct cause of serious bodily injury, the person will face a prison sentence of five to 40 years and the offense is classified as a crime of violence.  Kentucky recently passed a law increasing mandatory prison time for those found guilty of bringing fentanyl into the state with the intent to sell or distribute and last March, Wisconsin enacted a law making “manufacturing, distributing, or delivering” any amount of fentanyl a felony. Clearly frustrated lawmakers have thrown their hands up in despair and are falling back on old ways that failed to work in the 1980s.

For those in the profession for as long as I have been this is a familiar feeling, a terrible sense of Déjà Vu. As the opioid/stimulant epidemic shows no signs of cresting it is incumbent on professionals and people in the recovering community to find their footing; wake up to the dangers of the new war on drugs, and be vocal at every level. We know that addiction is a public health issue, not a law enforcement problem. We know that more people die from alcohol use disorder every year than from opioid use disorder and that the substance is not the problem. We must unite and educate policymakers because we also know those who do not learn history are doomed to repeat it.

References

  • https://www.dea.gov/resources/facts-about-fentanyl
  • Park, J.N., Weir, B.W., Allen, S.T. et al. Fentanyl-contaminated drugs and non-fatal overdose among people who inject drugs in Baltimore, MD. Harm Reduct J 15, 34 (2018). https://doi.org/10.1186/s12954-018-0240-z
President & CEO at CCAPP | 800-564-5927 | + posts

Pete Nielsen is the President and Chief Executive Officer for the California Consortium of Addiction Programs and Professionals (CCAPP), CCAPP Credentialing, CCAPP Education Institute and the Behavioral Health Association of Providers (BHAP), and Publisher of Counselor Magazine

CCAPP is the largest statewide consortium of addiction programs and professionals, and the only one representing all modalities of substance use disorder treatment programs. BHAP is the leading and unifying voice of addiction-focused treatment programs nationally.

Mr. Nielsen has worked in the substance use disorders field for 20 years. In addition to association management, he brings to the table experience as an interventionist, family recovery specialist, counselor, administrator, and educator, with positions including campus director, academic dean, and instructor.

Mr. Nielsen is the secretary of the International Certification and Reciprocity Consortium, and the publisher for Counselor magazine. He is a nationally known speaker and writer published in numerous industry-specific magazines. Mr. Nielsen holds a Master of Arts in counseling psychology and a Bachelor of Science in business management.

Pete Nielsen LAADC, CADC II, CAI, SAP

Pete Nielsen is the President and Chief Executive Officer for the California Consortium of Addiction Programs and Professionals (CCAPP), CCAPP Credentialing, CCAPP Education Institute and the Behavioral Health Association of Providers (BHAP), and Publisher of Counselor Magazine CCAPP is the largest statewide consortium of addiction programs and professionals, and the only one representing all modalities of substance use disorder treatment programs. BHAP is the leading and unifying voice of addiction-focused treatment programs nationally. Mr. Nielsen has worked in the substance use disorders field for 20 years. In addition to association management, he brings to the table experience as an interventionist, family recovery specialist, counselor, administrator, and educator, with positions including campus director, academic dean, and instructor. Mr. Nielsen is the secretary of the International Certification and Reciprocity Consortium, and the publisher for Counselor magazine. He is a nationally known speaker and writer published in numerous industry-specific magazines. Mr. Nielsen holds a Master of Arts in counseling psychology and a Bachelor of Science in business management.

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