Federal Drug Official Nora Volkow’s Op-Ed Explainer On Harmful, Stigmatizing Drug Policies in the U.S.

Nora Volkow, director of the federal government’s National Institute on Drug Abuse (NIDA), published a powerful op-ed last week where she took on the intertwining complexities of drug addiction, criminalization, social stigma, and healthcare.

“While attitudes around drug use, particularly use of substances like cannabis, have significantly changed in recent decades, the use and possession of most drugs continue to be penalized,” Volkow wrote near the top of her essay. “Punitive policies around drugs mark people who use them as criminals, and so contribute to the overwhelming stigma against people contending with an often debilitating and sometimes fatal disorder — and even against the medical treatments that can effectively address it,” she continued. On the topic of successful addiction treatment, it’s important to note that as cannabis becomes more socially accepted and genuinely legal, research is beginning to show that cannabis consumption is “associated with lower odds of opioid usage among subjects undergoing drug treatment for Opioid Use Disorder.” But getting to the point where people struggling with addiction can receive that sort of intervening treatment is wildly more complicated than it may seem.

According to a statistic Volkow included in her piece, “only 18% of people with drug use disorders receive treatment for their addiction,” and that staggeringly low number has a lot to do with stigma. “Fear of possible criminal consequences for drug use can shape people’s health decision-making in many potentially deleterious ways,” and “[substance use] concealment can lead a physician to overlook major factors in a patient’s health.” Volkow goes on to discredit imprisonment for drug possession or use as an ultimately unhelpful and, in many cases, actually very harmful way to treat people with substance addictions. She notes how because of the long period behind bars where people lose their previously high drug tolerances, “all too many” addicts face fatal consequences upon being released. 

Near the end of her op-ed, Volkow touched on how there is little to no legal and safe way for people with present drug use disorders to interact with the public and with policy-makers about revising their prejudices and “the policy landscape of criminalizing substance use.” While that is very largely true, there was a recent glimmer of hope that those opportunities may crop up more often: the Office of National Drug Control Policy’s (ONDCP) 30-day public comment period, which just ended a few days ago. They wanted “to hear from those directly impacted by the ‘systemic barriers’ the ONDCP’s existing policies create for them – specifically those in underserved communities and/or those who use drugs themselves.” As we await news on what the public had to say during the 30-day period, at least all of us, Volkow included, can cling to the ONDCP’s example as a step in the right direction toward true drug and addiction reform.