Newly Introduced Legislation Pushes People Who Use Drugs Into Harm’s Way Amidst an Overdose Crisis and Pandemic
By: Savannah O’Neill, MSW, CATC
Mandated substance use disorder treatment is a step backward for people who use drugs. Research shows that forced institutionalization is not linked to less drug use and yet, some policymakers continue to push for this outdated and ineffective strategy. California Assemblymember Kevin McCarty (D) introduced AB 1542, a mandated treatment bill, which would give Yolo County the power to divert people convicted by broadly defined “drug motivated crimes” to Substance Use Disorder (SUD) treatment in secured facilities. Secured Treatment Facilities as proposed in the bill, look like jails and do not involve any of the measures we know work to support people and address the harms of drug use. In this moment of unprecedented overdose death and surging hospitalizations, it is more critical than ever that approaches to drug use and substance use disorder are rooted in evidence. California lost over 3,000 people to overdose last year, with drastically increasing rates for the Latinx population and the highest rates being among the Native American Indigenous community. We can not afford to invest resources into failed policies while bodies continue to pile up.
AB 1542 proposes a pilot project, yet this model emulates drug court and mandated treatment programs that already exist nationwide. Drug courts may have been created with a commitment to providing care to individuals at their most vulnerable, but decades of research demonstrate their harms. In Massachusetts, patients can be committed to mandatory treatment by a judge or family member, and a study by the Massachusetts Department of Public Health found that individuals were more than twice as likely to experience a fatal overdose as those who voluntarily engaged in treatment. Yolo County’s own Public Defender Tracie Olson shares these fears saying, “study after study shows that coerced treatment does not work in the long run.”
This mandated treatment bill argues that efforts like Proposition 47, which reduced criminal penalties for drug possession, have contributed to decreases in drug court engagement and therefore fewer people are getting into treatment. This is untrue. In California, and nationwide, we are seeing a move to ensure people with SUD are treated with a public health approach rather than a criminal justice approach and although participation in drug courts might be down, engagement in a broader range of voluntary treatment has increased. Not only are people less likely to experience fatal overdose when they voluntarily engage in treatment, but research also shows that offering accessible, evidence-based treatment in the community works better.
In the proposed pilot, treatment length would be determined by a judge, without any expertise in clinical treatment for SUD. If we want appropriate treatment for our loved ones and community we must ensure decisions about their care are made by a clinician, treatment provider, or medical professional, not a judge. When someone returns to drug use a judge’s only option is to sentence them to jail, criminalizing relapse which is a common part of SUD. Therefore mandated treatment remains punitive, not governed by professionals. It carries the potential of incarcerating the person for even longer — increasing their jail time and costing the County money.
Californians are looking for solutions to support marginalized communities that use drugs, but mandated treatment is not the solution. In order to address the systemic and individual harms of drug use we need continued investment in a variety of voluntary treatment options, we need expanded harm reduction services and education to reduce stigma in all healthcare and behavioral health sectors. People who use drugs deserve treatment in a way that is culturally relevant and supports not stigmatizes them.
The author Savannah O’Neill, MSW, CATC, serves as the Associate Director of Capacity Building at National Harm Reduction Coalition and as a Board Member of Humanistic Alternatives to Addiction Research and Treatment (HAART). As a Certified Addiction Treatment Counselor and Social Worker, prior to Savannah’s role at NHRC she worked in Substance Use Disorder treatment in primary care, outpatient, and jail settings in California.
