Addiction science experts, including the National Institute on Drug Abuse’s Director, Dr. Nora Volkow, have frequently discussed how social stigma steers people toward more drug use and, at least indirectly, more fatal overdoses.
And yet, stigmatizing those who use drugs persists, even as our governments declare the opioid epidemic a public health emergency.
To counter this stigma, though, we first have to understand it.
The harm reduction organization Eleyvst, the Pennsylvania Recovery Organizations Alliance (PRO-A), and the data firm RIWI sought to do just that with their new, ambitious public opinion survey.
Over 30,000 US respondents answered questions from an online survey on perceptions of people who use drugs, suffer from addiction, and/or are in recovery.
The report, released last week, found that white people are more likely to report higher perceptions of stigma than non-white people, while conservatives are more likely to report higher perceptions of stigma than liberals. This demographic data suggests that training people to recognize addiction as a health issue should not leave out police.
In fact, it should probably start with the police.
Indeed, police tend to be whiter and more conservative than the rest of the US population. Meanwhile, police officers have much more power than the average citizen to reduce harm in the lives of people who use drugs.
While the latter can vote for better drug policies, it is the police who witness people using drugs on the street, while they must determine whether they should be arrested or diverted from the criminal justice system.
In that circumstance, stigma matters.
A recent study published by Brandon del Pozo (the former Burlington, Vt. police chief) and his academic colleagues found that a majority of police officers surveyed “perceived control” over their decision to arrest for misdemeanors (69 percent) or confiscate drug paraphernalia like syringes (56 percent).
Stigma toward people who use drugs was “negatively associated with stated practices of non- arrest.” Respondents identified supervisors as “having the most influence over use of discretion.”
As a professional who has worked with both harm reduction and criminal justice reform nonprofits, seeing these survey results immediately got me thinking about the constellation of organizations under the harm reduction umbrella.
(Harm reduction has been defined by SAMHSA as “the proactive and evidence-based approach to reduce the negative personal and public health impacts of behavior associated with alcohol and other substance use at both the individual and community levels.”)
Many harm reduction organizations, such as the aforementioned Elevyst, work with partners like the Pennsylvania Sheriffs’ Association to educate law enforcement professionals on various aspects of substance use and recovery. They discuss with law enforcement the importance of harm reduction initiatives, such as providing access to medication-assisted treatment behind bars, and simultaneously advocate the public’s accessibility to overdose-reversing drugs like Narcan.
They also foster relationships with unlikely partners that have the power to shift drug policy to a more health-centered approach.
In contrast, some organizations and supporters contend that police cannot be part of a harm reduction approach. So long as drug crimes exist, they argue, police are harmful by definition. On a grassroots level, many harm reduction proponents argue that police officers are inherent obstacles or enemies to rebuff.
I believe that there is a naivete to this latter camp’s logic.
Police officers are natural allies of harm reduction workers
Rethinking the ‘Hard Line’ on Drug Enforcement
Privileging a hard line on drug legalization or decriminalization, policy goals which may well prove impossible to reach, the camp has alienated police officers who could prove to be natural allies.
There are many compelling reasons for police to support less harsh policies and practices directed toward people who use drugs, suffer from addiction, and/or are in recovery.
Having a stressful, often traumatizing job while also being only human, one in four officers struggle with substance misuse.
Many police departments, even in liberal jurisdictions, have discipline-first policies for problematic drug or alcohol use: something that leading experts consider a health issue. Reductions in stigma may result in more humane and realistic workplace policies for police.
Research has also shown that about a third of police departments forbid hiring recruits who have ever tried marijuana in their lives. That causes departments to miss out on new hires that may have been fantastic additions to the force.
Recruits who have experienced drug use, including those who have had a substance use disorder, have unique insights and experiences that allow them to better understand and manage people struggling with mental health and substance use issues. Excluding them is also a particularly bad idea because of current declines in police recruitment.
The so-called “war on drugs” is also unpopular, and it harms efforts to foster positive police-community relations. Polling in Portland, Ore., from late 2021, after months of George Floyd protests, may even suggest that the role police have in perpetuating harsh drug policies contributes to support for defunding or abolishing the police.
A mere 8 percent of Portlanders wanted to reduce the number of police, compared with about 25 percent of Americans nationwide. Not coincidentally, Oregon decriminalized drug possession in 2020.
For those convinced that the badge defines the person, this opinion is not bound to win any awards. But for those who wish to reduce harm to people who use drugs now, not just in a hypothetical future, where drugs are no longer subject to criminal law, working with the police is of paramount importance.
Rory Fleming is an attorney and writer who has worked for various criminal justice organizations, including the Law Enforcement Action Partnership, Harvard Law School Fair Punishment Project, and the National Network for Safe Communities. He writes from Philadelphia.
