It’s Time To End The ‘Aura Of Illegality’ For Drugs, Top Federal Health Official Says

The government bears some responsibility in perpetuating stigmas against drug addiction that have created barriers to treatment, the head of the nation’s top drug research agency says.

In an op-ed published by the Association of American Medical Colleges (AAMC) last week, National Institute on Drug Abuse Director Nora Volkow shared a personal story about the stigmatization of drug use and the negative consequences that’s had for people suffering from substance misuse disorders. Part of that stigma comes from the enforcement of punitive drug policies, including some that remain in effect, she said.

Volkow said that “stigma remains one of the biggest obstacles to confronting America’s current drug crisis.”

“Government policies, including criminal justice measures, often reflect—and contribute to—stigma,” she said. “When we penalize people who use drugs because of an addiction, we suggest that their use is a character flaw rather than a medical condition. And when we incarcerate addicted individuals, we decrease their access to treatment and exacerbate the personal and societal consequences of their substance use.”

Addiction stigma pervades medicine, policy & communities. In @AAMCToday, NIDA Director Dr. Nora Volkow writes about her personal experience with stigma & the need for a large-scale social intervention to change public attitudes toward addiction. Read more: https://t.co/RdZQOrZeJJpic.twitter.com/HvnYUfECsN

— NIDAnews (@NIDAnews) November 8, 2021

The official has made similar remarks in the past, arguing that there’s an apparent need to decriminalize drug possession and emphasizing that the drug war has disproportionately impacted communities of color.

“The aura of illegality affects the treatment of people with addiction,” Volkow said. “For example, some treatment programs expel patients for positive urine samples, as if relapse were not simply a known symptom of the disorder and a clinical signal to adjust the treatment approach but instead actual wrongdoing.”

Stigma has also slowed the adoption of harm reduction programs like syringe exchange and access to the anti-overdose medication naloxone “out of a moralistic—as well as factually incorrect—belief that those measures encourage illegal drug use,” she said.

Volkow similarly talked about how decriminalization, coupled with increased treatment, would represent a superior alternative to incarcerating people over drugs in a recent interview with Marijuana Moment.

“We need a large-scale social intervention to change public attitudes toward addiction and people who have the disease,” she wrote in the new op-ed. “Besides ensuring proper training and the resources needed to help patients with substance use disorders, we need to seriously reconsider policies—not only laws but regulations and practices in health care and other settings—that promote viewing substance use as wrongdoing.”

Far too often, shame and stigma fuel addiction and prevent treatment, argues Nora Volkow, MD, director of the National Institute on Drug Abuse (@NIDAnews). But replacing judgment with compassion can save lives.https://t.co/VxsRKpTwuk#MedTwitter#OpioidCrisis

— AAMC (@AAMCtoday) November 2, 2021

In other recent remarks, Volkow argued that there’s no need for further research to prove that the criminalization of drugs has disproportionately impacted communities of color.

The official has also been pressed on issues related to marijuana prohibition and psychedelics.

She acknowledged in a podcast interview released in August that cannabis legalization has not led to increased youth use despite her prior fears, and she spoke about the therapeutic potential of certain psychedelics that have long been deemed “dangerous” under federal law.

And when it comes to marijuana research, she said scientists should be allowed to investigate products from state-legal dispensaries instead of using only government-grown plants.

NIDA separately submitted a report to congressional lawmakers emphasizing that the Schedule I status of controlled substances like cannabis is preventing or discouraging research into their potential risks and benefits.

It also said that current restrictions that block scientists from studying the actual cannabinoid products that consumers can purchase at dispensaries is impeding research to an extent that constitutes a public health concern.

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