Support, don't punish: Drug decriminalization is harm reduction [Commentary] (2023)

Despite large investments in and policy support for harm reduction including naloxone, syringes, and medications for opioid use disorder, people who use drugs continue to experience unprecedented rates of mortality from overdose and morbidity from infectious diseases. The criminalization of drug use has disproportionately exacerbated these drug-related harms and imposed short- and long-term burdens on already marginalized and vulnerable populations. Pharmacy professionals and students are not immune to the effects of drug criminalization, where one conviction can lead to the loss of their license, employment, or educational progress. Communities become less healthy and stagnate in punitive criminalization systems, further reducing opportunities for growth. Decriminalization of drug use and possession is an urgently needed and effective approach to drug use that shifts resources from punishment to public health, thereby reducing the negative impacts of drug use and keeping communities safe and healthy. Pharmacists play essential roles in the prevention and management of drug misuse and use disorders. As policy makers consider and implement drug decriminalization, pharmacists must actively advocate for these policies and educate community and organizational partners on the individual, professional, and community benefits of this harm reduction strategy.
Key Points:
Background:
People who use drugs face health risks including infections, overdose, and death.
The criminalization of drug use and often subsequent incarceration disproportionately worsens the morbidity and mortality of marginalized populations.
The American Pharmacists' Association (APhA) has enacted several evidence-based policies supporting harm reduction of drug use and resolution of racial and socioeconomic health inequities at the root of marginalization.
Findings:
Drug decriminalization offers advantages over failed punitive measures, potentially breaking the cycle of despair caused by each step of the justice system for both pharmacists and their patients.
As more drug decriminalization policies are enacted, pharmacists should educate the public and their peers on their positive impact, and advocate for their implementation, evaluation, and expansion.