Several candidates for the 2020 Democratic presidential nomination spoke about opioids Tuesday during the CNN/New York Times debate in Westerville, Ohio. Perhaps most strikingly, candidates showed support for pursuing criminal prosecution and prison time for executives of pharmaceutical companies who marketed and sold large quantities of prescription opioids.
The New York Times’ Marc Lacey asked California Senator Kamala Harris if she will “hold the drug manufacturers that fueled the [opioid] crisis accountable”, and if she will send “those drug company executives to jail”.
Harris responded affirmatively, and said, “I do think of this as being a matter of justice and accountability, because they are nothing more than some high-level dope dealers […] Let’s end mass incarceration and end that failed War on Drugs, and let’s go after these pharmaceutical companies for what they’ve been doing to destroy our country and states like Ohio.”
Former US Housing and Urban Development Secretary Julián Castro also agreed with sending drug company executives to prison, and added, “You can draw a straight line between making sure that we hold executives accountable, whether it’s these drug manufacturers or Wall Street executives that should have been held accountable a decade-and-a-half ago.”
Other candidates like Minnesota Senator Amy Klobuchar, former Texas Congressman Beto O’Rourke, and entrepreneur Andrew Yang, also expressed support for holding pharmaceutical companies accountable more generally without specifically mentioning jail-time. O’Rourke called out Purdue Pharma and Johnson & Johnson by name.
But Yang and O’Rourke also had notable moments where they discussed drug policy and harm reduction reforms as a tactic to reduce problematic drug use. “[Part of] helping people get the treatment that they need is to let them know that they’re not going to be referred to a prison cell,” Yang said, “[but] they will be referred to treatment and counseling.”
He continued, “We need to decriminalize opiates for personal use […] And then we need to open up safe consumption and safe injection sites around the country, because they save lives.”
O’Rourke discussed expanding medical marijuana access and legalizing marijuana, and concluded, “Anyone with drug addiction today, is not a problem for the criminal justice system […] They’re an opportunity for our public health system in America.”
Tuesday’s debate was, in some respects, a step forward for opioids and drug addiction receiving significant attention in the national 2020 discussion. German Lopez of Vox reported that September’s debate didn’t mention the issue at all, and in the two prior debates earlier this year, opioids and addiction have only been mentioned vaguely or in passing in the context of other political issues. “Before Tuesday, we had gone through three debates with no substantial mention of the opioid epidemic,” he said. “That changed [Tuesday].”
But are the candidates for the American presidency really engaging on this issue with the depth it deserves? “Imprisoning pharmaceutical executives in no way translates to relief and improved quality of life for people affected by addiction, overdose, poverty, or intersecting issues such as their own interactions with the criminal legal system,” said Kacey Byczek, a Capacity Building Services Manager for the Harm Reduction Coalition, to Filter.
“This rhetoric is absolutely a diversion from investing in real harm reduction interventions,” she continued, “not just for people who inject drugs but for people who use drugs more broadly. It also ignores that […] criminalization and stigmatization of people who use drugs are the real drivers of the current overdose crisis, as well as the related HIV and [Hepatitis C] outbreaks in various parts of this country.”
Byczek pointed out that crises related to opioids and drug overdose are about much more than just prescription opioids. “The focus on pharmaceutical opioids is a simplistic analysis, and it totally obscures the whole picture,” she said. “Street heroin is being contaminated with fentanyl at increasing rates, and fentanyl-related overdose deaths continued to rise even as the national overdose rate went down last year.
“We’re also seeing an increase in deaths involving opioids and stimulants like cocaine and meth […] People don’t have access to a safe supply, but they do have access to increasingly cheap-to-make and powerful synthetic substances like fentanyl.”
Filter recently covered a growing crisis in Marion County, Indiana (Pete Buttigieg’s home state), where deaths from fentanyl and methamphetamine are increasing, while at the same time deaths from heroin and prescription opioids are decreasing.
This is a problem that has nothing to do with pharmaceutical executives, and everything to do with factors like inaccessible drug testing and criminalization of syringe possession in the state. Would a President Harris put as much resources into remedying those types of disparities as she would prosecuting Purdue Pharma?
Filter also covered how another proven harm reduction measure, syringe exchanges, could have prevented a severe outbreak of HIV in Scott County in 2014. Needle sharing among people who inject opioids and other drugs contributed to that outbreak. Brown University researcher William Goedel showed that had Scott County implemented syringe exchanges proactively, they would have reduced HIV transmissions by 80% over five years.
And that’s to say nothing of safe consumption sites, which are already found throughout Europe and in Canada. A federal judge ruled this month that a non-profit seeking to open such a site in Philadelphia would not be in violation of federal drug law, a ruling activists in New York are using to pressure their Mayor and Governor to implement a promised safe consumption pilot program.
Thankfully, Andrew Yang alluded to safe injection, but it should be receiving as much attention and press as Purdue and the Sacklers. “I was really excited that Yang spoke out in support of decriminalization, and about safer consumption sites,” Byczek said. “Realistically, the President and Executive branch do have a decent amount of power in terms of promoting and implementing harm reduction policy at a federal level. Maybe the most obvious thing that a sitting President can do is dedicate specific funding for harm reduction programs like syringe service programs.”
Byczek noted the President could instruct the Department of Justice to allow safe consumption sites to operate without being prosecuted, perhaps similar to how Obama allowed state-level marijuana businesses to operate un-molested under the Cole memo guidance. She also said the President could allocate federal money away from drug enforcement and incarceration, and incentivize states willing to make criminal justice reforms.
But the greatest power to enact progressive drug policy reform still remains in the president’s hands, Byczek said: “The President and executive branch would also have the power to un-schedule drugs and entirely abolish the Drug Enforcement Administration.”
Image of US Senator Kamala Harris courtesy of Kamala Harris for President via Facebook.