Even the most fervent drug warrior would have to concede that cannabis legalization has been a success. In thirty-eight states patients can now freely access high-quality cannabis for medical conditions that are often notoriously resistant to other treatments. In the twenty-three states in which cannabis is legal for both medical and recreational purposes, citizens enjoy the right to partake in a substance that is far safer than other recreational drugs—including and especially alcohol—without fear of prosecution. Driving fatalities have not increased and rates of psychosis (which cannabis can contribute to) have been broadly stable. Teen usage rates and rates of addiction haven’t spiked. Drug War-fueled prosecutions that were particularly devastating to Black and brown communities are down.
At the same time as cannabis legalization sweeps across the country, the opioid epidemic continues tragically apace. If we are serious about ending the latter it’s time to apply the lessons of the former. That may seem counter-intuitive. After all, cannabis is a comparatively safe substance and opioids are often deadly. That doesn’t make criminalization the cure. Criminalization is a formidable barrier to treatment and enhances risk on a number of fronts. I know this because of my work as a physician and because of my own hellish struggle with opioid addiction, which nearly destroyed my life. I’m one of many. We have lost more than one hundred thousand people per year to opioid overdoses for the last several years. Millions of others continue to limp through their miserable addicted lives. The police and the courts have become the de facto first responders to a public health scourge, when it should be doctors, addiction specialists, and other healthcare professionals on the front lines.
I’m fifteen years into recovery. I have helped hundreds of other doctors who were addicted, and I have treated thousands with addiction over the decades. I’ve come to realize that it is the criminalization of drugs more than the drugs themselves, that causes most our problems.