An Ohio town is trying an extreme strategy with drug overdose survivors: It will charge them with “inducing panic.”
Amanda Hoover at the Christian Science Monitor reported that Washington Court House, a small town in central Ohio, rolled out the idea last month as part of a strategy to deal with the opioid painkiller and heroin epidemic. After first responders revive someone with the opioid overdose antidote naloxone, officials will formally charge the person with “inducing panic.” That charge can lead to a $1,000 fine and up to 180 days in jail, but it can also lead to court-ordered treatment.
“It gives us the ability to keep an eye on them, to offer them assistance, and to know who has overdosed,” City Attorney Mark Pitsick told reporters. “Sometimes we can't even track who has overdosed.”
Pitsick added that he wants drug users to know that city officials “are here to help. We are not here to put them in jail.”
But charging them with a crime is a counterproductive way of doing that. Not only can it literally lead to jail time, but it also perpetuates the kind of stigma that keeps drug users underground and away from getting help — accomplishing the exact opposite of what the town wants.
Addiction is a serious illness that requires medical care
Addiction is a disease. Major medical groups recognize this, from the American Medical Association to the World Health Organization. As Stanford psychiatrist Anna Lembke recently told me, “If you see somebody who continues to use despite their lives being totally destroyed — losing their jobs, losing loved ones, ending up in jail — nobody would choose that. Nobody anywhere would ever choose that life. So clearly it is beyond this individual’s control on some level.”
The common response to someone who’s sick is not to charge them with any sort of crime. It’s to get them to care.
Imagine for a second if this were any other disease. A first responder responds to a person who just had a heart attack. They, thankfully, manage to save the patient. Then they charge them with a misdemeanor for inducing panic.
This would be outrageous. And it should be equally outrageous from someone who survived one of the negative health consequences of addiction.
In fact, the best evidence shows that the most promising way to deal with opioid addiction is by treating it as an illness — and even giving people medicine to treat it. Such medicines, known as methadone and buprenorphine, are opioids that effectively tame people’s cravings for opioids like painkillers and heroin without producing, when taken as prescribed, the kind of euphoric high that painkillers and heroin do.
Decades of research have deemed these medicines effective for treating drug abuse. And the Centers for Disease Control and Prevention, the National Institute on Drug Abuse, and the World Health Organization all acknowledge their medical value and recommend their use. Yet they remain generally restricted by different levels of government — due in large part to the misconception that using methadone and buprenorphine is merely replacing one opioid with another.
“I can certainly relate to the paradox and being uncomfortable with it,” Lembke said. “But the data at this point is just overwhelming that somebody with severe opioid addiction, if you get them on opioid agonist therapy, their lives are vastly better.”
Treating addiction as a crime pushes people underground
What’s more, approaches like Washington Court House’s are counterproductive. The town, like much of the country, is suffering from a serious opioid epidemic, with the county it resides in recently reporting six overdose deaths in 10 days. But the answer should be more access to treatment, not criminal charges.
Consider an opioid user in this kind of situation. After hearing about what your city is doing, you now not only have to fear being caught by police and being charged with possession of illegal substances like heroin, but now you know that overdosing on those drugs may lead to more legal trouble. How likely are you to go to the authorities to seek help?
Pitsick, the city attorney, argued that the approach is necessary to force people into the system and ultimately into care. The city is apparently concerned that other places who have offered immunity to drug users, such as Cincinnati, haven’t seen fast enough progress in dealing with the opioid epidemic.
But as reporter Maia Szalavitz, who’s covered addiction and drugs for decades, notes, criminalization just leads to stigma, and stigma pushes drug users underground.
“To argue that ‘addiction is a disease’ while criminalizing possession of the drug involved in the addiction is, then, to make an impossible case,” she wrote. “You are saying ‘I think your addiction is shameful and users of the drugs you take should be caged,’ while also claiming ‘You have an illness that should be treated like any other disease.’ Neither cancer patients, nor people with diabetes nor those with depression are put into this double bind: no actual disease is seen this way.”
If you want people to seek care, you should make it more accessible. The reality, though, is that people with drug use disorders can face huge hurdles in their attempts to seek out care. They might not have health insurance, their insurance company might not cover the treatment they need, and they might face weeks- or months-long waiting periods for care even if they can afford care.
These are the kind of barriers that drug policy experts argue need to be dealt with to get people into care — by, frankly, just spending more money on treatment programs. Adding another punishment to drugs is not going to achieve that.