"2 Steps Forward, 1 Step Back": Will Obama's New Opioid Proposal Continue the Failed War on Drugs?

March 30, 2016
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Guests

Maia Szalavitz

journalist who’s covered addiction for almost 30 years. Her recent piece in The Guardian is headlined "Curbing Pain prescriptions Won’t Reduce Overdoses. More Drug Treatment Will." Her book, Unbroken Brain: A Revolutionary New Way of Understanding Addiction, will be out next week.

Michael Collins

deputy director of national affairs at the Drug Policy Alliance.

President Obama has unveiled a series of steps aimed at addressing the epidemic of opioid addiction in the United States. In 2014, a record number of Americans died from drug overdoses, with the highest rates seen in West Virginia, New Mexico, New Hampshire, Kentucky and Ohio. Many states reported even higher death tolls in 2015. We speak with journalist Maia Szalavitz and Michael Collins of the Drug Policy Alliance about Obama’s proposal. "I think the best thing we can say about the proposal is it’s two steps forward and one step back," Collins says. "There is a lot of positives in the announcement—emphasis on harm reduction, treatment, overdose prevention—but at the same time the Obama administration is still beholden to the criminalization of drug users." Watch Part 2 of our interview here.


TRANSCRIPT

This is a rush transcript. Copy may not be in its final form.

JUAN GONZÁLEZ: In 2014, a record number of Americans died from drug overdoses, with the highest rates seen in West Virginia, New Mexico, New Hampshire, Kentucky and Ohio. Many states reported even higher death tolls in 2015. Well, on Tuesday, President Obama vowed to step up the fight against heroin and opioid addiction by treating addiction as a health issue, not a criminal problem. Obama made the comment at the National [Rx] Drug Abuse & Heroin Summit in Atlanta, where he met with addicts in recovery, family members, medical professionals and law enforcement officials.

PRESIDENT BARACK OBAMA: It’s important to recognize that today we are seeing more people killed because of opioid overdose than traffic accidents. Now, you think about that. A lot of people tragically die of car accidents, and we spend a lot of time and a lot of resources to reduce those fatalities. And the good news is, is that we’ve actually been very successful. ... The problem is, here, we’ve got the trajectory going in the opposite direction. So, 2014, which is the last year that we have accurate data for, you see an enormous, ongoing spike in the number of people who are using opioids in ways that are unhealthy, and you’re seeing a significant rise in the number of people who are being killed.

AMY GOODMAN: Dr. Leana Wen, Baltimore City health commissioner, also spoke at the summit. Dr. Wen talked about a patient who was a competitive swimmer and, because of torn discs in her back, was prescribed pain pills and eventually became addicted to heroin. The patient repeatedly sought help in the ER, in the emergency room.

DR. LEANA WEN: It’s one of the most humbling things and worst feelings as a doctor to know that you can’t help them, that what this patient needed, what so many of our patients need, is treatment, addiction treatment, at the time that they’re requesting it. But we couldn’t give it. I mean, we would never say that to someone who has a heart attack. We would never say, "Go home, and if you haven’t died in three weeks, come back and get treated." So that’s what we faced. And I remember that I talked to her this one time about getting into treatment. She really wanted to do it. We set her up with an appointment. But it wasn’t until two weeks later. And she went home that day and overdosed, and came back to us in the ER. We tried to resuscitate her, but we couldn’t save her. And I think about her all the time, because she had come to us so many times requesting treatment—and yet, clearly, there is a difference between how we treat her and how we treat everybody else—because we need to recognize that addiction is a disease. If we treat addiction like a crime, then we’re doing something that’s not scientific, that’s inhumane, and it’s, frankly, ineffective.

AMY GOODMAN: That was Dr. Leana Wen, Baltimore City health commissioner.

We’re joined now by two guests. Maia Szalavitz is with us. She’s a journalist who’s covered addiction for almost 30 years. Her recent piece in The Guardian headlined "Curbing Pain Prescriptions Won’t Reduce Overdoses. More Drug Treatment Will." And she has a new book out; it’s called Unbroken Brain: A Revolutionary New Way of Understanding Addiction. Michael Collins is also with us, deputy director of national affairs at the Drug Policy Alliance.

Michael, let’s begin with you. Your assessment of what President Obama is proposing right now?

MICHAEL COLLINS: I think the best thing we can say about the proposal is it’s two steps forward and one step back. I mean, there is a lot of positives in the announcement—emphasis on harm reduction, treatment, overdose prevention—but at the same time the Obama administration is still beholden to the criminalization of drug users. And we see that in the announcement: There is funding in there for law enforcement, for heroin task force. And we know that that is the epitome of the failed war on drugs. So, as I say, there are parts of the announcement that we like and we applaud, but there are also parts of the announcement that are very disappointing.

JUAN GONZÁLEZ: And, Michael, I’m wondering—I’ve been astounded the past few years now as this—as this new heroin epidemic has spread across the country, the amount of emphasis—even as you say not sufficiently—more on treatment than on incarceration, because I remember back in the '70s when heroin was spreading throughout the inner-city neighborhoods of the United States, and we got the Rockefeller Drug Laws, and we got all of this crackdown on the victims of the heroin epidemic. So you're seeing a whole new dialogue, at least, this time around. And how much of it has to do with the racial composition of who are the folks that are being affected the most at this point?

MICHAEL COLLINS: Well, Juan, I think you’re absolutely right. If anyone ever doubted that the drug war was a war on people of color and the drug war was racist, then, you know, they should look no further than the discussion that’s going on just now, where, as you point out, for years, decades even, communities of color have been affected by heroin, by overdoses and legal handcuffs, not hugs, and now we’re seeing this compassion around white people in rural communities. And, you know, it’s something that I think we have to recognize, that this is very symbolic of the fact that the war on drugs has been a war on people of color. And, you know, while it is positive that the Obama administration and even Republicans are talking about compassion towards drug users, we should bear in mind that there are communities of color who have suffered as a result of the war on drugs, and, you know, we shouldn’t try and escape that.

AMY GOODMAN: A recent article in Harper’s Magazine revisits the start of the war on drugs under President Nixon. The article cites a 1994 interview with John Ehrlichman, who served as President Richard Nixon’s domestic policy chief. He revealed why the war on drugs began. He said, quote, "The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. ... We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did." That a quote from John Ehrlichman, President Richard Nixon’s domestic policy chief. Maia Szalavitz, can you respond?

MAIA SZALAVITZ: Absolutely. I mean, the racism in the drug war goes even further back than that. It starts in 1914 with the Harrison Narcotics Act. And at that time, there were literally headlines in The New York Times about "Negro cocaine fiends" who were causing problems in the South. And the idea was actually that that cocaine made them impervious to bullets. So, the drug war has always not been about fighting drugs, because if we actually wanted to deal with addiction problems, we would see it as a health issue, and we would not be trying to focus relentlessly on supply.

JUAN GONZÁLEZ: Well, Maia, your new book, Unbroken Brain: A Revolutionary New Way of Understanding Addiction, could you talk to us about what that revolutionary new way of understanding the problem, the long-running problem, over the decades, of addiction is?

MAIA SZALAVITZ: Sure. Well, addiction involves learning. And what I’m saying is that we’ve been looking at it all wrong throughout the course of our drug policy, largely because of race. You cannot become addicted without learning, because if you don’t know what fixes you, you can’t crave it and you can’t seek it compulsively. And by leaving out learning, we have misunderstood what goes wrong in addiction. What basically happens is you fall in love with a drug rather than a person or your child, and the relentless pursuit that people have to take care of their kids and be with their loved ones gets turned into that pursuit of drugs. And so, when you look at it that way, you realize that it’s a problem of something that was mislearned, not a problem like Alzheimer’s where this pathology is eating your brain. And that’s a much more hopeful message for recovery, and it’s actually much more accurate about what goes on in the brain during addiction.

AMY GOODMAN: Can you talk about your own experience with addiction, Maia?

MAIA SZALAVITZ: Sure. I became addicted to cocaine and heroin in the '80s when I was at Columbia College. And I had been an incredibly geeky kid for most of my life and was—had a hard, hard time with socializing. And I would always sort of have these obsessive interests—I was really interested in opera or science fiction—and nobody wanted to hear me go on about that, but they did want to hear me go on about drugs, especially if I could provide them. And that made me feel like I had something to bring to the party and that I wasn't this horrible, isolated, bad person who couldn’t connect with people. And so, that was really dangerous for me. I got into coke in the ’80s, when 80—50 percent of all young adults tried cocaine during the ’80s, which is an astonishing figure. So it was very prevalent. And then I got suspended from school, and I thought my life was over. And I thought, "Well, I may as well do heroin now." And that turned out to be my drug of choice, because it actually finally gave me the feeling of safety and love and comfort that I had always been missing.

AMY GOODMAN: And so, then what happened?

MAIA SZALAVITZ: Then I wound up shooting up dozens of times a day. I was selling coke, so I always had it around, and then that always led to heroin. Eventually, I got busted and was facing 15 to life under the Rockefeller laws. And eventually, two years after I got arrested, I realized that I needed help and that, you know, I was going to die. And so I sought treatment and, fortunately, have been in recovery since 1988 now.

AMY GOODMAN: How did you end up not going to jail for 15 to life?

MAIA SZALAVITZ: That’s a little bit of a story, but what basically happened was the judge saw me a year after I voluntarily chose to go into treatment—I wasn’t mandated—and I looked very, very different. I had gone into treatment sort of 80 pounds, grey, covered with tracks, looking like I was dying of something, and I came out tan, fat and blonde. And, you know, she just saw. She said, "Well, OK, if you can manage to stay off drugs, I will try to keep you out of jail." And that was very difficult because the mandatory minimum. And so, there was just years and years of negotiation with the prosecutors, but finally she dismissed the case in the interest of justice, because the prosecutors continued to insist that I go to jail or prison, and she was like, "This woman has been in recovery for five years now. This really doesn’t make any sense." So, you know, I was extraordinarily lucky. And being white and female and middle-class had a lot to do with it. If we are really to deal with the heroin problem that we have now, we have to, you know, acknowledge the racism that drives our drug laws, and create drug laws that don’t criminalize people for having a medical problem.

AMY GOODMAN: And what do you think of President Obama’s announcement yesterday?

MAIA SZALAVITZ: It’s a good step forward. It doesn’t do some of the important things that I would like to see. For example, medication-assisted treatment with buprenorphine or methadone are the only things that actually cut the overdose death rate by 50 percent. And we need people to stay on those medications indefinitely in order for that to happen. Yet we restrict methadone to these horrible clinics. And doctors formerly could only prescribe to a hundred patients for buprenorphine; Obama has just raised it to 200, which is great, but they can still prescribe to thousands of people if they’re treating pain, rather than addiction. So, it makes no sense to restrict the treatment.

JUAN GONZÁLEZ: And, Michael Collins, what progress does the Drug Policy Alliance see at the state level, examples of more foresighted—farsighted policy at the state level?

MICHAEL COLLINS: Well, one thing, I think that disappointed us about the Obama administration’s announcement is, if this is truly a crisis, which we believe it is, then all options should be on the table, and I think we didn’t see all options on the table yesterday from the Obama administration. And so, for example, there are a lot of interesting initiatives and proposals in places like Ithaca, New York, around safe injection facilities. Maryland has a proposal around a safe injection facility. There is interesting programs in places like Seattle and Santa Fe called Law Enforcement Assisted Diversion—much more of a harm reduction approach to drug use. And—

AMY GOODMAN: Can you explain, Michael, what you mean by safe injection sites?

MICHAEL COLLINS: Sure, yeah. A safe injection site is essentially a safe place where an injection drug user can go and use drugs. They are therefore not using drugs on the street. They’re not using drugs in a rush. They’re not using drugs in a situation where, you know, they could cause themselves harm. They’re doing it under medical supervision. And this is not something new, when you look at it globally. This is something that has existed in Canada for a number of years now. There’s strong evidence to show that safe injection facilities result in a reduction in overdose use, you know, principally because, as I say, you are engaging drug users in medical help. And, you know, the bottom line here is, I think we have to get to a place where we are treating drug users as human beings. And it’s not enough just to show them compassion. Drug users really should be at the table when we’re having these policy discussions. They should have a voice. And I think that’s the direction, certainly, the Drug Policy Alliance wants to go in.

AMY GOODMAN: And finally, how the racial disparity will be and should be dealt with in the policy announcement of President Obama yesterday, Michael Collins?

MICHAEL COLLINS: I mean, I think the president did acknowledge that, you know, the sort of changing face of heroin has resulted in more compassion. You know, the president has spoken out a lot on criminal justice reform and on the need for sentencing reform and reductions in mandatory minimum sentences. Unfortunately, now there is legislation being held up by Senate Leader Mitch McConnell. We’re awaiting a floor vote on a comprehensive criminal justice reform bill that would roll back mandatory minimums, but he will not allow the bill to come to the floor. So, as I say, we are making progress, but, you know, one thing that’s true about the U.S. is that it’s very easy for the U.S. to get involved in wars—and the war on drugs is a war—but it’s far more difficult to unwind these wars, and we’re seeing that right now. You know, it’s very challenging to move away from—

AMY GOODMAN: We’re going to have to leave it there.

MICHAEL COLLINS: —law enforcement—

AMY GOODMAN: But, Michael Collins, I want to thank you for being with us, of the Drug Policy Alliance. And, Maia Szalavitz, please stay with us after the show. We’ll continue our conversation, and we’ll post it online at democracynow.org. Maia’s new book is called Unbroken Brain: A Revolutionary New Way of Understanding Addiction.

This is Democracy Now! When we come back, we’re going to North Carolina to the "bathroom bill" that’s just been passed. Stay with us.


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