The last time one of my patients was arrested for drug possession, we never saw him at my medical clinic again. He had been excited to start treatment for his infection and for his substance use. Sadly, our first reaction when he didn’t show up to clinic was to check the obituaries. And then the local jails, which is where he was. Just three weeks into his treatment, he never ended up completing it.

I have spent the past 13 years treating patients with substance use disorders, including in my current position in Portland. I have experienced personal loss because of substance use. I have conducted research and collaborated with infectious disease and addiction medicine colleagues through the Infectious Disease Society of America. I can tell you personally and professionally that the way we’ve been doing drug policy for decades – focusing on criminal punishment – is killing people. It’s time for an approach to drug policy that centers health, healing and saving lives.

Three bills in particular in Maine are seeking to develop a humane drug policy, where health and healing are the priorities – not locking people up. L.D. 967 would eliminate criminal penalties for small amounts of drug possession; L.D. 994 would eliminate criminal penalties for possessing syringes (even new ones), and LR 1817 would no longer permit a person to be charged with felony drug trafficking based only on the weight of the drugs they’re found with. I urge legislators to support these bills.

We simply cannot arrest our way out of a public health crisis. The reality is that after incarceration, my patients face major barriers to accessing care for their infections and substance use. Prior research and a lawsuit over providing medication for addiction treatment in Maine jails and prisons have shown that many incarcerated people fail to receive the care they need. Criminal justice-involved populations are at risk for developing infections such as HIV and viral hepatitis. They are also more likely to experience premature death and worse health outcomes, often because of existing health inequities.

In particular, removing criminal penalties for syringe possession and exchange should be a priority. The risk of developing an infection after reusing syringes is incredibly high, and these infections can be costly and often fatal, as my colleagues and I have seen here in Maine. We recently conducted a study on patients in Maine who developed endocarditis (a serious heart infection) because of injection drug use, and the median cost for treating each infection was $150,000. The number of these costly infections has skyrocketed since then. In another recent study here in Maine, nearly 80 percent of hospitalized patients with injection drug use-associated infections reported reusing syringes. Notably, 88 percent of the study patients had been previously incarcerated.

Broadly, removing criminal penalties for possession of drugs for personal use will allow individuals and families more opportunities for housing, employment, health care and other essential services – things that become harder to access with a criminal record or when cycling in and out of jail. To be clear, eliminating criminal penalties and centering health and well-being in our drug policy is not a novel approach. Oregon recently passed legislation removing criminal penalties for small amounts of drug possession, as well as increasing access to treatment, recovery, and other harm reduction services. Baltimore recently followed suit. Several European countries have taken this approach for years.

I don’t want to check the obituaries to see if my patients – our community members – have potentially overdosed after incarceration. I don’t want my patients to disappear midway through their treatment because they’ve been arrested again. We need a public health approach to substance use. We need to prioritize the health and well-being of our neighbors and community members, not their punishment. Right now in Maine, at least three bills are on the table that offer this scientifically sound and compassion-centered alternative. We ought to make sure each of them passes.


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