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Given the nearly 110,000 American lives lost to overdoses in 2022, it defies logic that our leaders would want to increase the number of drug users and encourage heavier drug usage. Instead, our nation should redouble its focus on prevention, treatment, and supply reduction, aiming to lower rates of drug use and limit availability. The calls to legalize all drugs and normalize recreational drug use should be summarily rejected.
Legalization of all drugs means exactly what it sounds like: full-scale commercial production of fentanyl, cocaine, methamphetamine, marijuana (THC), heroin, and more. It also means the widespread normalization of drug use and decreased perceptions of risk for users. For instance, most Americans likely don't realize that today's THC products, often marketed like candy, have been medically connected to depression, psychosis, schizophrenia, IQ loss, and suicidality.
When a new drug emerges, as we are seeing with xylazine, the response from legalizers is not to add it to the list of controlled substances or to crack down on the supply, but to make it available to the masses. This line of thinking allows individuals to use it freely, no matter the consequences. That's perfect for profit-driven industries, which can facilitate the mass production, manipulation, and potency of the drugs to increase frequency of use and drive sales.
The legalization of a drug inevitably results in more dangerous use and consequences. Through state-level legalization of marijuana, we've watched this experiment play out in real time. Today, past-year, past-month, and daily marijuana use reached the highest levels ever recorded among those aged 19 to 30, according to the National Institute on Drug Abuse. In fact, there are more daily users of the drug THC than daily consumers of alcohol—something that was inconceivable a few decades ago. The rise in use is clearly the end game for the industry that has funded the "legalization movement." What the industry and its supporters don't tell you is that one in four past-year users are daily users, and one in three now suffer from a marijuana use disorder—also known as addiction to marijuana. That means millions are using marijuana and millions more are abusing it.
Tragically, there's close to no margin for error for misuse with today's illicit drug supply. Even minor misuse can have disastrous consequences, partly explaining the unprecedented rise in overdose deaths witnessed in recent years. Two milligrams of fentanyl, the size of a few grains of salt, can be a lethal dose and fentanyl is increasingly being laced with non-opioid substances that are resistant to Narcan. Anything that is lethal or can cause mental and physical harm should not be considered "recreation."
Some criticize the "War on Drugs," or argue that legalization is social justice. Advocates often cite the ACLU's findings that Black people are four times more likely to be arrested for the possession of marijuana. While they are right to consider the possibility of disparate outcomes, these arguments overlook the health-related harms that are the reason these drugs were made illegal in the first place. Many voted to legalize marijuana due to racial disparities in the arrest rate, unaware that ownership in the marijuana industry would—even after a decade—be only 2 percent Black and that the industry would cluster dispensaries in communities of color. That means the economic impacts of the drugs and health-related harms have been concentrated among minority populations.
Protecting public health and helping more individuals achieve healthy, drug-free lives must remain the top priority when developing drug policies. That's real social justice.
Activists in the drug policy field have begun pushing another unprecedented and misguided policy: the decriminalization of drugs. Passed in Oregon in 2020, Measure 110 decriminalized the possession of harmful, illegal drugs on the assumption individuals would be better served by treatment than by incarceration. Measure 110 has failed in almost every regard. Rates of drug use and addiction in Oregon are among the highest in the nation. Fewer than one percent of individuals have accessed treatment services, and overdose deaths in Oregon have further increased, outpacing the national average.
Oregon also continues to see an increase in opioid deaths, outpacing the national average, and the state has the highest rates of past-year methamphetamine use and pain medication abuse, in addition to the second-highest rate of mental illness and third-highest rate of serious mental illness.
The removal of penalties for illicit drug use has resulted in unchecked drug use and misuse. Yet legalization proponents now argue that Oregon's policy failed not because it is inherently flawed––but because it did not go far enough. The drug crisis, they say, necessitates full-scale legalization.
Exploiting the public's desperation for solutions to the overdose and addiction epidemic, special interest groups have capitalized on unfolding national tragedies to advance radical agendas. Over the last decade, these organizations have bankrolled efforts to legalize marijuana and psychedelics and decriminalize all drugs, while overdose rates have continued to worsen.
The false dichotomy between criminalization and legalization overlooks the opportunity for tailored policies that can improve outcomes and minimize harm. Drug courts emphasize treatment and provide an alternative to incarceration, while still stopping short of decriminalization and legalization. The Foundation for Drug Policy Solutions, in collaboration with more than 50 policy experts, is currently crafting the Blueprint for Effective Drug Policy, which will outline evidence-based policies and best practices to minimize drug use and drug-related problems.
Despite the failures of decriminalization in Oregon, a well-resourced fringe continues to push for more. The Drug Policy Alliance, a pro-legalization special interest group, calls for "legal regulation and safer supply"––that is, the legalization of all drugs, creating a fentanyl industry, cocaine industry, meth industry, etc. Our experience with Big Tobacco should serve as cautionary tale, demonstrating that the regulation of these industries will do nothing to stem their pursuit of profits at the expense of public health and societal well-being. The data don't lie. The industry does. Getting stoned or high isn't recreation. It's not social justice and it's not safe. We do not need more drug users or an industry eager to supply them with pharmaceutical-grade narcotics. The only way out of our drug crisis is to deter drug use from starting in the first place, getting those using into recovery, and keeping our communities safe by disrupting open-air drug markets.
Dr. Kevin Sabet is a former senior drug policy advisor to the Obama administration and currently serves as president of Smart Approaches to Marijuana. His latest book, Smokescreen: What the Marijuana Industry Doesn't Want You to Know is available everywhere books are sold.
The views expressed in this article are the writer's own.
