Dismantling War on Drugs Policies in COVID-19's Aftermath

• Published in: American journal of public health (1971) Vol. 112; no. S1; pp. S24 - S27
• Main Authors: Cooper, Hannah L F, Cloud, David H, Fanucchi, Laura C, Lofwall, Michelle, Young, April M
• Format: Journal Article
• Language: English
• Published: United States American Public Health Association 01.02.2022
• Subjects: Arrests; Black people; Buprenorphine; COVID-19; COVID-19 - epidemiology; Decriminalization; Drug abuse; Drug addiction; Drug and Narcotic Control - legislation & jurisprudence; Drug and Narcotic Control - organization & administration; Drug dosages; Drug overdose; Drug policy; Drug use; Drugs; Emergency preparedness; Emergency response; Ethnic groups; Harm reduction; Health care industry; Health Policy; Health services; Hepatitis; Hepatitis C; HIV; Human immunodeficiency virus; Humans; Indigenous peoples; Latinae; Mental health care; Methadone; Minority & ethnic groups; Narcotics; Neighborhoods; Opiate Substitution Treatment - methods; Opinions, Ideas, & Practice; Opioid Epidemic - statistics & numerical data; Opioids; Other Infections; Overdose; Pandemics; Police; Policies; Populations; Prisons; Public health; Public Policy; Racism; Rural areas; Rural Health; SARS-CoV-2; Shores; Substance abuse treatment; Substance use; Substance use disorder; Success; United States; United States Substance Abuse and Mental Health Services Administration - legislation & jurisprudence; United States Substance Abuse and Mental Health Services Administration - standards; Viral diseases; Viruses; War; White people; White supremacy; United States; United States > US
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2021.306680

Each day of the COVID-19 pandemic's transformative months has taught us anew that viruses exploit the weaknesses of their host populations. COVID-19 arrived on our shores to find a nation made fragile by centuries of White supremacy, and the virus surfed our exhalations and inhalations toward Black people, Indigenous people, and other people of color (BIPOC) and Latinae communities. The pandemic collided with the US racialized war on drugs policies-such as police drug crackdowns targeting predominately BIPOC and Latinae neighborhoods- and exacerbated their harms. For generations, these policies have channeled HIV and the hepatitis C virus (HCV) into the networks of BIPOC and Latinae people who use drugs (PWUD); the pandemic is projected to amplify racial/ethnic inequities in these harms and has already escalated inequities in overdoses.1-3 Likewise, war on drugs policies disproportionately incarcerate BIPOC and Latinae PWUD, and the COVID-19 mortality rate in prisons has been triple the national rate.This collision has also transformed select war on drugs policies and illuminated possible pathways toward more just, compassionate, and effective approaches to drug use. These transformations are, however, currently time-limited emergency responses to the COVID-19 pandemic. We consider some of these transformations, mining the national investigation by Pro et al. (in this issue of AJPH; p. S66) of multilevel correlates of substance use disorder treatment success overall and for particular racial/ethnic groups. Substance use disorder treatment systems are vital to creating populations that are relatively unaffected by a host of drug-related harms, viral and otherwise. We focus in particular on the finding of Pro et al. that Black PWUD (but not other PWUD) have higher rates of substance use disorder treatment success in states with greater access to buprenorphine, a medication to treat opioid use disorder. We argue that COVID-19-era temporary reversals of policies that restrict medication to treat opioid use disorder access, and of policies that surveil, arrest, and incarcerate PWUD, should be made permanent to help eradicate inequities in HIV, HCV, and overdoses.