Several articles last week highlighted the continuing shift in drug policy away from public health responses and toward punitive approaches.

The context: This shift has occurred as the public and policymakers grow frustrated with the overlapping mental health, addiction, and homelessness crises, which all worsened and grew more visible during the COVID pandemic (see e.g., Lancaster, CA).

• Several places that had implemented less punitive responses for drug use are starting to roll them back, claiming they did not work (see e.g., San Francisco, CA). But it is COVID and the emergence of fentanyl that exacerbated the issues, not the policies. The policies also were too short-lived and not accompanied with adequate investment in treatment.
• States and localities are increasingly embracing involuntary treatment for those with serious mental illness or addiction, particularly those who are homeless (see e.g., San Jose, CA; New York and Oregon)
• The Supreme Court issued a ruling last year allowing state and local governments to criminalize homelessness by imposing fines and/or jail time for offenses such as sleeping outside.

The stats: 27 states classify possession of certain drugs as felonies, which often lead to multiple years of incarceration. 17 states restrict sleeping or camping in public spaces, and many local jurisdictions are implementing camping bans in the wake of the Supreme Court ruling.

The details:

• Such policies stem from flawed narratives that people who use drugs and are unhoused are dangerous and the assumption that harsher penalties can improve public safety.
• But: That’s not what the research shows. The laws expose vulnerable individuals to the harms of incarceration, fail to improve public safety, and exacerbate the homelessness crisis.
• Jails/prisons often do not provide effective addiction treatment, and the risk for relapse upon release is high. Criminal penalties (particularly related to substance use) often do not deter future crime, and having a criminal record creates additional barriers to treatment, housing, employment, benefits, etc. Criminalizing substance use and homelessness exacerbates the crisis by fueling a cycle of incarceration and further homelessness.
• Mandated treatment does not work if high-quality treatment is not sufficiently available, which is often the case due to decades of underinvestment. Treatment availability is further at risk because the federal government is decreasing vital funding for mental health and addiction treatment, including Medicaid.