More than 8,200 Americans died of a heroin overdose in 2013. Most of the response to the growing crisis has focused on treating this as a public health problem — leaning on drug rehabilitation and treatment, educating doctors on how to properly prescribe drugs that can lead to opioid (including heroin) addiction, and even giving police access to naloxone, which reverses opioid overdoses.
But some prosecutors, who are incredibly powerful in the criminal justice system, have taken a different approach. As Vice News's Daniel Denvir reported, prosecutors are starting to bring murder and manslaughter charges against heroin dealers and even users who give the drug to friends. The idea is that people who provide heroin to others who overdose and die are culpable for the deaths, because they provided the drug that got someone killed.
These types of practices are a callback to the tough-on-crime tactics first enacted in the beginning of the war on drugs. And even though there's evidence that these tactics have failed to significantly curb drug abuse, these prosecutors are only a few among many more politicians and lawmakers trying to use the heroin crisis as a justification for doubling down on the drug war.
Tough-on-crime politicians have called for a tougher approach
To some degree, Vice's story shows the power of prosecutors: Since they can use their discretion to decide what laws to enforce, they can dig up old statutes passed during the crack cocaine epidemic (to go after crack dealers) to now go after heroin dealers. And it's not just dealers facing murder charges: In New Orleans, for example, a woman and her ex-boyfriend were charged with murder for giving, not selling, heroin to a friend. Prosecutors, then, don't just get to decide what laws they enforce and charges they bring, but even whom to charge — and that can lead to stepped-up drug war efforts even if no new laws are passed.
But it goes beyond prosecutors. With the rise of opioid abuse and overdose deaths, some politicians have called for a response that more closely mirrors the tough-on-crime response to the crack epidemic of the 1980s than the public health focus many drug policy experts and public health officials prefer.
Louisiana Gov. Bobby Jindal, for instance, signed legislation that increased the possible penalty for heroin dealing to 99 years, up from 50. Maine Gov. Paul LePage has discussed using the state's National Guard to fight heroin trafficking. And two former drug czars for Presidents George H.W. Bush and George W. Bush called on the Obama administration to dedicate more resources to treating drugs as a law enforcement problem instead of a public health issue.
This is a repeat of how the drug war happened: People got scared about a drug (crack back then, heroin now), and resorted to using the criminal justice system and punitive policies, instead of a public health approach, to deal with the issue. It's exactly how the war on drugs happens over and over — even if the public and policy experts don't want it.
America does have a seemingly growing heroin problem
All of this is in response to a real crisis: Since the late 1990s, the number of people dying from opioid painkiller overdoses has steadily risen — with more than 16,000 deaths reported in 2013. What's worse, one study in JAMA Psychiatry found opioid painkiller users have moved on to heroin — another opioid that's deadlier and more addictive than painkillers — because heroin is cheaper and doesn't require a prescription. (A 2015 CDC analysis, for example, found people who are addicted to prescription painkillers are 40 times more likely to be addicted to heroin.)
But the harsh criminal justice tactics conflict with public and expert opinion. Polls have found that most Americans prefer treating drugs as a public health issue, not a criminal one. And many experts, including the International Narcotics Control Board, have asked for a greater focus on public health policies to curtail demand for drugs. There's good reason for that: The evidence shows that, by and large, traditional tough-on-crime policies haven't significantly cut on drug abuse.
Harsh anti-drug tactics have failed for decades
The point of the traditional war on drugs, including both international interdiction and domestic law enforcement efforts, is to go after the supply of drugs. The idea is that if you hit the drug trade, supply will shrink, prices will go up, and drug habits will become unaffordable.
Yet since the US stepped up its war on drugs in the 1980s, federal data shows the opposite occurring, with prices for heroin in particular crashing over the past few decades.
The numbers we have on supply back this up. A 2015 report by the UN Office on Drugs and Crime (UNODC) found that the production of opium, which is used to make heroin, has generally trended up since the late 1990s — with a brief drop in 2001 after the invasion of Afghanistan, the world's largest opium producer.
Not only has the drug war failed to reduce the global production of opium, but, the UNODC report notes, production in 2014 reached its second-highest levels since the 1930s. That's despite concerted US efforts in Afghanistan to crack down on the drug: The US spent $7.6 billion between 2002 and 2014 to eliminate Afghani poppy cultivation.
"The bottom line — record opium cultivation and production — clearly shows we are not winning the war on drugs in Afghanistan," John Sopko, the US military's watchdog in Afghanistan, said in a May 5 speech. "Of course, the US government announced its own war on drugs in 1971, almost 45 years ago, and we haven't won that, either."
So despite billions in spending, the war on drugs never appeared to have a significant impact on the supply or price of heroin.
That doesn't necessarily mean the war on drugs had zero impact. It's possible that it reduced supply and raised prices, just not enough to reverse larger trends.
But that's exactly the problem: If the costly drug war wasn't enough to reverse these trends, then maybe it's worth trying something else, like putting more money toward reducing demand for drugs by treating drug abuse as primarily a public health issue.