This is a remarkable period for U.S. drug policy and criminal justice: after over 40 years of a failed war on drugs and mass incarceration, there is a growing bi-partisan consensus that this war has failed, mass incarceration is out of control, and a new approach is needed.

After decades of grassroots community advocacy and organizing for reform, policy makers are awakening to the crisis at hand: from city councils and state legislatures to Congress and The White House, policymakers are assessing the failures of current approaches and increasingly open to new – and sometimes even radically innovative — ideas. Fueled for decades by mass criminalization, the war on drugs and long prison terms, a national debate has finally emerged about the significance and adverse impacts of mass incarceration.

Now political leaders and political actors from across the ideological spectrum – from the ACLU and the Soros Foundations to the Koch Brothers — are increasingly calling for reform and actually working together to achieve it. And U.S. voters are far ahead of the elected officials and political leaders. In the 2012 and 2014 state election cycles, voters dealt a blow to marijuana prohibition by legalizing in Colorado, Washington, Alaska, Oregon, and Washington, D.C.. During the same period, voters made history in California by passing Prop 47, making dramatic reductions to that states criminal penalties for drug offenses, and in New Jersey, voters curtailed the power of those profiting from mass incarceration by enacting unprecedented reforms to that state’s broken bail system. National polls show an openness for even more far reaching change. And all of this is unfolding in the midst of a growing national debate about racism in the U.S. – long a hallmark of the war on drugs and mass incarceration.

These and other reforms suggest that the era of mass incarceration and the war on drugs may very well be coming to a close. Yet there is too little discussion about what will replace it. And significant questions remain about meaningful alternatives to the drug war and mass incarceration. How these questions are answered will determine whether a new era is truly being ushered in, or if the drug war and mass incarceration will simply be rearranged under a different guise. Nor is it clear if what comes next will redress racial disparities, or worsen them.

For instance, in the growing debate about drug policy and criminal justice, it has become fashionable to declare that drugs are a “public health” issue; over the last 20 years, it’s become acceptable to call for treatment not incarceration. But in practice, this alternative has usually meant arresting people for drug possession or sales and then mandating them into coercive treatment programs as an alternative to incarceration, often through drug courts.

This kind of intervention is nothing more than dressing up the drug war with the language of public health. It is rooted in and builds upon the continued criminalization of people who use drugs, continues to intervene at the level of the individual while neglecting systemic factors, and perpetuates the specious and dangerous myth that drug use is equivalent to having a drug problem. As very real drug problems face families and communities today – e.g. the quadrupling of overdose deaths due to prescription opioids – there is a dire need to advance sensible solutions that depart of the drug war paradigm by ending reliance on the criminal justice system for solving health-related problem. What’s more, there’s been little acknowledgement that over the last 40 years, the policy responses to drug use have arguably caused more destruction and damage than the drugs themselves.

The future of effective drug policy and practices in the U.S. lies in full decriminalization of the possession and use of all drugs, along with the development and evaluation of alternative methods of drug control, aimed at minimizing the harms of drugs, while protecting public health and safety. A transition from the war on drugs and mass incarceration to a new, more effective approach will require an assessment of systemic racism and institutionalized racial bias. The public health field is beginning to turn its attention to these problems; the discipline could play a transformative role in tackling these problems – particularly with such systemic-level public health frameworks like social determinants of health.

A public health approach to drug policy can be developed by first defining what additional policy changes will be needed to make decriminalization succeed — including expunging criminal records for millions of Americans and addressing the systemic racial discrimination associated with the war on drugs and mass incarceration; and identify the advocacy mechanisms that will be necessary to secure such victories.


About the author

Gabriel Sayegh

Gabriel Sayegh is co-founder and co-director of the Katal Center for Health, Equity, and Justice. For nearly 20 years, Sayegh has worked on campaigns to end mass incarceration, the war on drugs, promote fair economies and racial equity, and more. From 2003 – 2015 he served as Managing Director of Policy and Campaigns at the Drug Policy Alliance, partnering with community organizing groups, human service agencies, and researchers to advance effective drug policies guided by science, equity, and compassion.