To Beat the Opioid Crisis, Virginia's Ralph Northam Should Think Like Portugal

Narcotics-induced deaths have plummeted since the European country decriminalized all drugs.

Virginia's next governor will confront many pressing needs but few burning oil platforms—except one. The opioid crisis just keeps getting worse.

Drug overdoses, which now constitute the leading cause of death for anyone in America not yet old enough to join AARP, topped 64,000 in 2016. That represented a nearly one-fifth increase over 2015. The other day The Wall Street Journal reported that from January 2016 to January 2017, drug overdose deaths rose another 21 percent. Opioids are driving most of the fatalities.

The figures for Virginia are equally grim. According to the latest report from the state medical examiner's office, drug overdoses have been the leading cause of unnatural death in the commonwealth for the past four years. And they are getting worse: From 2015 to 2016, heroin overdoses rose 31 percent; overdose deaths from all drugs rose 39 percent; and deaths from fentanyl and fentanyl analogs spiked by 174 percent.

Measured by Seung-Hui Cho's massacre at Virginia Tech, which took 32 lives, the drug epidemic in Virginia is now inflicting the equivalent of roughly one Virginia Tech massacre per week.

President Trump has declared the opioid scourge a national emergency, but his solution is tissue-thin: a few minor tweaks to federal policy, such as relaxing Medicaid rules regarding treatment facilities, and a promise of "really great advertising"—perhaps a rehash of those old 1980s commercials with the eggs: "This is your brain. This is your brain on drugs. Any questions?"

Which will accomplish nothing. As The New York Times reported recently, a meta-analysis of "rigorous studies collectively examining over 180,000 people reported that the average effect of mass media campaigns on drug use in randomized studies was essentially zero."

Republican Ed Gillespie, who lost last night to Democrat Ralph Northam, produced a substantive and thoughtful— albeit insufficient—plan to address the drug crisis. It began with the recognition that addiction "is a disease—not a moral failing" and that "We cannot arrest our way out of the current epidemic of addiction." Gillespie also insisted on getting immediate help for people in crisis and encouraging a focus on recovery in the criminal justice system. Northam, Virginia's next governor, has offered issue and policy statements on his campaign website here and here..*

Gillespie certainly was right that trying to stop the drug crisis by arresting people will not work. It would have been nice if conservatives had recognized that point earlier—say, during the heyday of the crack epidemic, which afflicted largely poor urban blacks rather than affluent suburban whites, and which was met with get-tough crime policies. But better late than never.

In any event, in recent decades the number of people serving time for drug offenses has increased more than tenfold—from 40,000 in 1980 to half a million today. America's war on drugs has cost taxpayers more than $1 trillion. If locking people up stopped drug use, the entire country should have been clean by now.

Realization about the drug war is dawning all over. Those who say we tried to beat addiction into submission but failed include the editors of National Review, Republican Gov. Chris Christie of New Jersey, former U.S. drug czar Gil Kerlikowske, the Global Commission on Drug Policy, and many others.

Which should not have been news. The war on illegal drugs can't cure addiction any more than Prohibition cured alcoholism.

And this gives Virginia's next governor an opportunity to break with the useless past. He should declare Virginia's part of the war on drugs over, and announce a different policy to replace it: Virginia is the new Portugal.

Virginia currently is considering—ever so gingerly—the possibility of decriminalizing the possession of small amounts of marijuana. Sixteen years ago, Portugal decriminalized not only pot but all drugs, including the hardest. At the time, the move elicited warnings about a parade of horribles. But the results have been remarkable.

Portugal's approach is two-pronged. It still treats drug dealers harshly and sends pushers to prison. But those caught with small amounts for personal use are sanctioned through an administrative, not a criminal, process. They are first sent to a "dissuasion commission," through which casual users are steered away from progression to habitual use. Addicts are sent to treatment.

And it has worked. While Portugal still has a drug problem ("Business is still pretty good," one drug dealer told The New York Times in September), it does not have anything like a drug crisis. Drug-related HIV infections have dropped 90 percent, thanks to needle distribution programs. Drug use rose slightly after decriminalization, but it is now lower than it was before decriminalization.

Most important: Drug-induced deaths have plunged, and are now five times lower than the average for the European Union. The country's drug overdose death rate, per million residents, is three to six, depending on the year.

In the United States, it's 312.

Any questions?

This column originally appeared at the Richmond Times Dispatch.

*CORRECTION: While the story suggested Northam offered a single paragraph of boilerplate on addiction, his campaign website has more detailed position information on the website here and here.