The “dysfunction” of rural justice systems has hampered efforts to combat the national opioid crisis in the regions where the crisis has had the most tragic impact, according to an Arizona law professor.
While rural communities have experienced a disproportionate share of overdose deaths, they have too often favored punishment over treatment—a strategy compounded by the lack of resources and scientific training, wrote Valena E. Beety, a law professor at the Arizona State University Sandra Day O’Connor College of Law, and a specialist in rural legal scholarship.
The approach has been especially harmful in dealing with drug-induced homicides, she wrote in an essay published in the Ohio State Law Journal.
“The scientific core of a drug-induced homicide charge exposes the everyday dysfunction of rural criminal courts and the lack of engagement with, or individual attention to, the cases presented daily,” Beety wrote, adding that the frequent resort to drug homicide charges exposes how defendants in effect are “punished by their rurality.”
The shortcomings of rural justice systems include poorly trained coroners, lack of public defenders, and the absence of oversight by intermediary courts, she wrote.
Such shortcomings are compounded by aggressive efforts to prosecute individuals accused of providing the drugs that resulted in an overdose death as murder—with little regard for intent or for the tolerance levels of the individual who died. In contrast, many urban communities have passed “Good Samaritan” laws that encourage bystanders or relatives to seek emergency assistance without fear that they will be exposed to prosecution as accessories to crime.
“Prosecutors can bring these drug-induced homicide charges in rural communities by relying on coroner–layperson findings of ‘homicide’ and ‘overdose’ and then using this ‘scientific evidence’ for plea negotiations in the existing plea system,” Beety wrote.
“While a medical examiner in an urban or suburban area may have the funding to perform a full toxicology report, coroners in rural areas often do not have that capacity.”
Beety said the problem of rural opioid deaths can best be addressed by eliminating drug-induced homicide charges entirely from a prosecutor’s toolkit.
Instead, she argued, rural communities should “expand Good Samaritan laws to protect eyewitnesses to overdoses and encourage life-saving interventions.”
She also urged local or state governments to enact legislation establishing coroner training or, alternatively, separate the roles of coroner and sheriff.
The fact that “rural communities with fewer resources are less able to effectively distribute the limited resources they have available… makes the implementation of evidence-based harm reduction strategies all the more critical,” she added.
A key problem identified in the essay is the myth that the rural opioid epidemic is a problem confined to largely white, insular and “backward” communities. Actually, she pointed out, the epidemic has struck with equal force on rural African-American and native communities.
“The white-washing of the opioid crisis was likely provoked because the crisis revolved around prescription pill overdoses,” Beety wrote. “This is because physicians were more reticent to prescribe prescription opioids to people of color.
“This biased health care treatment relies on antiquated but persistent stereotypes about race and pain tolerance.”
In fact, indigenous North American communities saw a larger increase in overdose deaths between 1999 and 2015 than any other group, and people of color in urban cities are overdosing at a faster rate than individuals in the suburbs and rural areas, the essay argued.
But the popular conception has obscured the way financially stressed and emotionally trained smaller communities have opted for punishment as a template for dealing with the opioid crisis in their midst.
In one example cited by Beety, prosecutors in North Carolina revived a drug-induced homicide statute originally created to address the crack-cocaine “epidemic” in the 1980s, and passed a new statute with the heightened charge of “Death by Distribution.” Similarly, Ohio and Pennsylvania also created new statutes to criminalize the sharing of drugs resulting in an overdose.
But few rural counties have the scientific resources to analyze the evidence that might or might not back up such a charge.
“These death investigations are not necessarily impartial—and are not necessarily scientific,” wrote Beety, noting that rural coroners are “absolutely overwhelmed by the mass overdose deaths occurring in their counties.”
A link to the full essay is available here.
Additional Reading: See TCR’s special resource page “Rural (In)Justice” on the crisis facing heartland communities.
This summary was prepared by TCR intern Nia Morton.