Justice Systems Increasingly Adopting Public Health Approaches to Respond to Opioid Crisis, New Report Shows

New York, NY– The United States is experiencing an epidemic of drug overdose deaths that cuts across economic, racial, and geographic boundaries. In the recent presidential campaign, one of the few areas of agreement between the candidates was support for treating substance use outside of the justice system—including the use of overdose prevention drugs such as naloxone. In response, criminal justice system stakeholders are increasingly adopting public health strategies—such as diversion, medication assisted treatment, and overdose prevention—according to a new report released today from the Vera Institute of Justice.   

Since 2000, the rate of overdose deaths involving opioids—including both prescription pain relievers and heroin—has increased 246 percent, and overdose related deaths have overtaken automobile accidents as the leading cause of injury-related death in the United States. In 2015, an average of 91 people died every day from overdoses on opioids.   In response to the current crisis, and amid widespread recognition that the punitive, abstinence-based drug policies of the 1990s failed to deter drug use, some local justice systems are now turning to “harm reduction”—a public health philosophy and set of practical strategies that seeks to reduce the negative consequences associated with drug use. Many harm reduction strategies have been used successfully to address drug use in the community, but they have only recently begun to be implemented in the justice system.  

A New Normal: Helping the Criminal Justice System Address Opioid Overdoses describes harm reduction strategies, such as syringe exchanges and the distribution of the opioid antidote naloxone, currently used in a growing number of jurisdictions. It features the voices of 14 justice stakeholders from across the political spectrum—from law enforcement, court systems, and corrections departments in New Mexico, New York, North Carolina, and West Virginia—who were interviewed about the challenges of implementing harm reduction strategies in the justice system, and the feasibility of their widespread adoption.  

“In cities and states across the country, there is a growing appetite for shifting the way we respond to people who use drugs away from strictly punishment and towards more effective, compassionate responses,” said Leah Pope, co-author of the report and senior program associate in Vera’s Substance Use and Mental Health program. “We have the opportunity to fight the current opioid crisis with proven, evidence-based approaches. Though there is still much work to be done, we can use interactions with the justice system to not only avoid the too-common and preventable overdose deaths, but also to help people using drugs live healthier, more productive lives.”  

The report drew conclusions and formed recommendations based on the stakeholder interviews and review of research, including:

  • The current overdose crisis has created a significant opportunity for shifting the United States’ response to substance use away from criminalization and toward a public health approach.
  • Obstacles to the widespread adoption of harm reduction strategies include the need to elevate understanding among stakeholders about what harm reduction means and which strategies are use viable at different stages of the justice system; deeply held beliefs about the nature of addiction and recovery; and questions about the appropriate role for the criminal justice system in responding to drug use—including determining when the justice system should be the pathway to treatment, and when it should be avoided altogether.
  • These challenges can be overcome through more research on the best practices for implementing harm reduction approaches; the dissemination of practical guidance on how jurisdictions can implement these strategies; and a public engagement campaign to build support for a harm reduction approach to addiction.

This report is the final in a series from Vera’s Justice Reform for Healthy Communities initiative, which aims to improve the health and well-being of the individuals and communities most affected by mass incarceration.

The full report and an accompanying explainer video are available at: www.vera.org/new-normal-report.