drug policy Archives - Bolts https://boltsmag.org/category/drug-policy/ Bolts is a digital publication that covers the nuts and bolts of power and political change, from the local up. We report on the places, people, and politics that shape public policy but are dangerously overlooked. We tell stories that highlight the real world stakes of local elections, obscure institutions, and the grassroots movements that are targeting them. Mon, 23 Dec 2024 20:28:28 +0000 en-US hourly 1 https://wordpress.org/?v=6.7.1 https://boltsmag.org/wp-content/uploads/2022/01/cropped-New-color-B@3000x-32x32.png drug policy Archives - Bolts https://boltsmag.org/category/drug-policy/ 32 32 203587192 A Michigan Sheriff and Prosecutor Join Forces to Implement Progressive Policy https://boltsmag.org/a-michigan-sheriff-and-prosecutor-join-forces-to-implement-progressive-policy-washtenaw-county/ Mon, 23 Dec 2024 20:27:57 +0000 https://boltsmag.org/?p=7278 On Jan. 1, Alyshia Dyer will take office as sheriff of Washtenaw County, Michigan, an event that will mark the union of some strange bedfellows in the county’s criminal legal... Read More

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On Jan. 1, Alyshia Dyer will take office as sheriff of Washtenaw County, Michigan, an event that will mark the union of some strange bedfellows in the county’s criminal legal system: With Dyer at the helm, the county’s public safety strategies will soon be guided by an alliance between the top enforcers of the justice system and the grassroots reform groups who are often its toughest critics. 

Dyer is a road patrol deputy-turned social worker who campaigned on a reform vision that includes trying to steer people away from the justice system rather than draw them into it. Her win in November is a culmination of prior wins by a coalition of reformers in the county that also brought progressives into the prosecutor’s office and courts. 

Dyer has worked with these reformers to lay out plans to reduce unnecessary police encounters and arrests by limiting officers from making stops for certain low-level violations. She has pledged to address the stark racial disparities in traffic enforcement by ending quotas for traffic stops, and says arrests are the wrong tools for dealing with substance abuse and the opioid crisis: Her approach rejects the war on drugs and aims to steer people towards support rather than criminal punishment.

“Looking at the disparities involving drug arrests, there was a general understanding that we don’t want officers wasting their time,” Dyer told Bolts in an interview. “There is a frustration when officers are nickel and diming or getting involved in low-level things, and a frustration with pretext stops in general was resounding countywide.”

Dyer’s platform appealed broadly to voters in the liberal college town of Ann Arbor, as well as the surrounding rural areas where even many voters with more conservative values are fed up with the kind of policing that cycles people through the legal system without addressing their needs. 

But to effectively carry out her plans, Dyer will also need allies in the justice system. She has at least one in Eli Savit, who was just reelected as Washtenaw’s Prosecuting Attorney after running unopposed. Savit first won office in 2020 at the height of the racial justice movement that swept through the country following the police killing of George Floyd. The movement helped give rise to a brand of progressive prosecutors including Savit, who embraced a less punitive approach that broke away from his tough-on-crime predecessor. His office took aim at the issue of racial profiling by announcing he would drop the charges in situations where officers use minor traffic violations as an excuse to search for drugs or other contraband. A slew of other policies offered leniency towards juveniles arrested on minor offenses, and declined charges for consensual sex work and certain low-level drug crimes — but those reforms can only make an impact after an arrest has already been made. 

Now with Dyer as the county’s top cop and Savit as its lead prosecutor, they hope to move these reforms forward by working collaboratively on policies that were previously siloed in different parts of the justice system. 

“What you see in Washtenaw is a lot of different partners in conjunction with the community are largely working towards the same goals and from the same playbook,” Savit said. “It reflects our community values. Ultimately, what people in Washtenaw want is for us to work together to get people on the right track, rather than cycling them through the justice system over and over again in an ineffective fashion.”


In November of 2020, Savit’s win was hailed as a success for the progressive prosecutor movement that for at least a decade has sought to reform local DA offices across the country. His policies gave reformers in Washtenaw an inroad for curbing the harm wrought on by excessive criminal punishment by deflecting some low-level arrests. 

Savit regards his policy on pretextual stops — where minor traffic violations are used as an excuse to search cars for contraband — as a success. His office initially declined several of those cases, Savit told Bolts. But soon, police agencies across the county largely stopped sending those kinds of cases to his office. The approach later gained support in Ann Arbor, the county’s largest city, where the city council unanimously voted last year to limit police from stopping drivers for minor violations like cracked windshields or broken taillights that do not pose any risk to traffic safety. 

Now with Dyer in office as well, organizers hope to stop even more of those arrests from happening in the first place. 

“Our racial disparities in low level traffic stops are through the roof at the sheriff’s office,” Dyer told Bolts. “Regardless if the prosecutor decides to charge a case, the harm is still caused at the forefront. Avoiding those stops when possible, when it’s not a safety-related issue, is really important. There are so many instances where somebody has been pulled over, pulled out their car and searched. The police find nothing. They let them go, but the harm stays with that person.”

Like Dyer, Savit also embraced a legal strategy for addressing drugs that is focused on harm reduction and rehabilitation rather than punishment. His office decriminalized the possession and distribution of controlled medications like methadone and buprenorphine that are used to treat opioid addiction and curb fentanyl use. Like with the traffic stop arrests, very few of those cases now come across Savit’s desk. The remaining arrests for illegal possession of methadone or buprenorphine mostly come from people incarcerated in nearby prisons, and Savit’s office typically drops those cases, he said. Even though prosecutors rarely need to decline charges now, it is critical to have a public policy in place so the fear of criminal penalties will not deter people from accessing life saving medications, he said. 

“Why on earth would we want to be discouraging somebody from using a medicine that we know is an alternative to using a dangerous drug that could kill them? We want less overdose deaths, not more. ” Savit told Bolts.

Washtenaw County Prosecuting Attorney Eli Savit in 2021. (Facebook/Eli Savit – Washtenaw Prosecuting Attorney)

But a policy of non-enforcement is only effective if the entire criminal legal system is aligned across prosecutors and police, which isn’t the case for most places in the state. As Michigan has scaled up harm reduction initiatives in recent years—funded in part by payouts from pharmaceutical companies acquired through opioid settlements—the enforcement around controlled methadone and buprenorphine has been a patchwork across the state and even within Washtenaw County. 

Dyer’s position—that criminal enforcement and arrests are the wrong way to address addiction issues—is rooted in her background as a social worker and therapist. She has advocated for unarmed community responders and public health outreach workers to deal with opioids, rather than police. And she plans to end internal quotas that encourage officers to make stops, search people for drugs, and cite or arrest them for minor drug violations.

Having a sheriff who’s onboard with harm reduction tactics helps establish a uniform approach to managing the opioid crisis, said Jonathan Laye, program director for Supportive Connections, a social service group aimed at steering people away from the justice system.

“The county is definitely starting to go in the right direction when it comes to prioritizing treatment or engagement rather than locking people up over petty stuff. The question is really getting people in the right places who understand the difference between a symptom and a crime,” Laye said.

Even when police don’t make arrests for drug paraphernalia, those items are sometimes still used by officers as probable cause to justify a search, said Cindy Bodewes, president of the Washtenaw Regional Organizing Coalition, a grassroots group pushing for reforms in the county. She hopes Dyer will bridge the “disconnect between the prosecutor’s strategy and arrest strategy,” Bodewes said.

“That’s why it is so important to have a law enforcement policy in place in order to have harm reduction in a community where they don’t have to be looking over their shoulder, afraid of the police taking action, regardless of whether they can be charged or not,” Dyer said.

Even when prosecutors signal that they will not pursue certain cases, changing the culture and behavior of police departments can be more difficult. Police leaders don’t always know what is happening on the ground, and are sometimes unaware that officers need to be brought up to speed on policy changes, Bodewes said. That is why it is important for grassroots organizations and community members to have a way to “report directly to the sheriff,” she said.

Dyer says her experience as a rank-and-file deputy showed her the extent to which officers are often slow to adapt to new policing strategies, especially when changes are not written into department policy and backed with additional training. 

She is forming community advisory committees on issues like traffic stops, jail visitation and mental health to bolster transparency and accountability by allowing the public to help shape department policy. Savit formed similar committees after first winning office to develop his reforms, which also helped prosecutors develop a restorative justice process that diverts people from criminal punishments. Dyer aims to create another group of diverse community voices to make policy recommendations directly to her office. It’s another step, she says, to ensure that her advisors are not just an echo chamber of police brass: critics will have access to the inner workings of the department.hold their elected officials accountable. 

“Having a community that is educated around what we’re doing, our operations, our policies, can be a really powerful ally to make sure that what I think is happening at the top is what’s actually happening at the bottom,” Dyer said.


Dyer’s and Savits’ victories last month were an exception to what was largely a nationwide turn away from reform politics. 

In Chicago, retiring State’s Attorney Kim Foxx, who championed reforms like the abolition of cash bail statewide and the development of the nation’s first restorative justice community court, will be replaced by tough-on-crime Democrat Eileen O’Neill Burke, who has promised to roll back some of Foxx’s policies. In Los Angeles and Alameda Counties, progressive prosecutors George Gascon and Pamela Price were unseated amid complaints that their lenience was to blame for crime, which has largely declined since the pandemic, and social issues like opioids and homelessness. On the national stage, the Democratic party’s national platform abandoned issues like police violence and mass incarceration that were at the core of past campaigns

For many observers, this election signaled a waning in the strength of the criminal justice reform movement that came into full force just four years ago. 

But criminal justice reform has managed to remain on the agenda in Michigan. In October, the state enacted an overhaul of the juvenile justice system to eliminate most of the fines and fees that saddled young people with debt and penalized them for being unable to pay. Widespread dissatisfaction with the juvenile justice system helped stoke an appetite for continued change in Washtenaw, according to some of Dyer’s supporters. She wasn’t the only progressive candidate running for sheriff in Washtenaw. She narrowly won the primary against Derrick Jackson, the current director of community engagement at the sheriff’s office who works closely with grassroots reform groups and has a track record of boosting diversion efforts. In many communities, Dyer’s message resonated more deeply in many Washtenaw communities because her vision for reform was more bold, said Carolyn Madden, co-chair of Friends of Restorative Justice. 

“It was a matter of being a bit more progressive, a bit more out there, a bit more bold. And that is what we need in our criminal justice system right now—some boldness—and Alyshia seems to want to make some real change,” Madden said. 

Madden’s organization has already worked with Savit to help develop his office’s restorative justice process to repair the harm caused by a crime without “heaping on punishment,” Madden said. The program puts charges on hold for 18 months while the perpetrator of a crime works with the victim and community-based mediators to repair the harms they caused and address the underlying issues that led to their actions. Prosecutors drop the case if there are no new violations at the end of the period—though offenses that pose a serious risk to public safety or involve domestic or sexual abuse are not eligible for restorative justice. She hopes Dyer’s expertise in social work will help expand restorative justice practices in Washtenaw and improve opportunities for rehabilitation both in the community and in the jail.

“When police work very closely with the community, they know the people and they can go about addressing issues with different kinds of programs. Even if you’re not going to arrest them, particularly young people, you have to help them. You have to give them other things, especially if it’s a result of young people being confused or impoverished,” Madden said.

Alyshia Dyer at her swearing-in ceremony on Dec. 3. (Photo by Charlotte Smith)

The county is already piloting a program to that effect: the Law Enforcement Assisted Diversion and Deflection (LEADD) initiative, which was spearheaded in part by Jackson’s community engagement team within the sheriff’s office. Unlike typical diversion programs, where the court drops charges once a person meets certain conditions like completing drug treatment, LEADD allows county officers to connect someone to a case manager to get the support they need in lieu of making an arrest in the first place.

“The goal is to provide an alternative to arrest or citations for individuals who have unmet basic needs that stem from things like mental illness, substance abuse, and severe poverty and homelessness. It can increase the number of people getting the services they need and decrease the number of people in contact with the criminal justice apparatus,” said Hailey Richards, the program coordinator for LEADD.

Many of Dyer’s supporters hope she will continue to build upon the LEADD program, which is currently being tested in Ypsilanti Township, and expand it across the rest of the county. The pre-arrest diversion model “is a less harmful way police can offer someone assistance, and it can really help change people’s lives,” Dyer said. But there remains a need for community-based alternatives for responding to many issues that armed law enforcement officers are not best suited to deal with. Dyer says she also plans to support these by using a portion of the county’s budget dedicated to mental health and public safety initiatives.

“We as a country have dumped everything on law enforcement. But officers are not doctors, are not social workers, they’re not therapists, and we keep expecting them to be. I talk to officers who say they don’t like to go on low-level calls or calls involving mental health when they’re not trained to understand how to handle it,” Dyer said.

 “We have a unique opportunity to really start building safety net responder programs that avoid the legal system.”

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How California’s Embrace of a Tough-on-Crime Measure May Undo a Decade of Reform https://boltsmag.org/california-prop-36-tough-on-crime-prison-reform/ Mon, 25 Nov 2024 18:08:36 +0000 https://boltsmag.org/?p=7201 The passage of Prop 36 marks a return to harsher punishments for some drug and theft crimes. Advocates worry it will also lead to a surge in prison populations.

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Earlier this month, California voters turned back toward the tough-on-crime era with the overwhelming passage of Prop 36, a ballot measure that elevates certain drug and theft charges from misdemeanors to felonies. The measure will effectively revive a sort of “three strikes” policy for some low-level crimes in the state, raising penalties for theft under $950 and drug possession and making those charges punishable by jail or prison time if defendants have two prior drug or theft convictions. The measure passed with roughly 70 percent of voters approving it. 

The passage of Prop 36 will also lengthen the sentences of some existing felonies up to three years if the crime, like felony theft causing property damage, was committed together by three or more people. It will also require that felony convictions for selling drugs be served in state prisons, whereas currently some of those sentences are served in county jails. The measure will also create a new category of offense, a “treatment-mandated felony,” which carries a prison sentence of up to three years for people with previous drug convictions who fail to complete court-ordered treatment.

Prop 36 reverses some of the changes California voters made a decade ago when they passed Prop 47, which made some felonies misdemeanors in order to reduce severe overcrowding in the state’s prisons. The state estimates that the reduced incarceration from Prop 47 helped save $800 million over the past decade, the majority of which was reallocated to mental health and drug treatment services.

Advocates who supported those reforms a decade ago are now bracing for a reversal of those trends, as the state’s own analysis predicts that costs associated with increased punishment and prison will soar as state funds allocated to treatment services fall with the passage of Prop 36. While this year’s ballot measure was put forth as a way to make communities safer, opponents worry it will bring a drop in services that erodes community safety. 

“Rather than strip money away from resources, we should have doubled down and really fund these things that actually worked,” said Jose Bernal, Political Director of the Ella Baker Center for Human Rights. “The safest communities are the ones that are the most resourced, and so that’s the alternative. That’s what we’ve been fighting for.”

Advocates for incarcerated people fear that Prop 36 will also exacerbate the overcrowding and dangerous conditions that still exist inside many local jails and state prisons. Sam Lewis, executive director of the Anti-Recidivism Coalition, one of the groups that opposed Prop 36, said jails are already severely overcrowded and understaffed, and sending more people to jail will prevent them from getting treatment and prevention.

“We’re going to fill them up with more people, that means people are going to die in there, it means people are going to take a longer time to be able to go to trial, that means more people in the county jail will be suffering instead of actually receiving the treatment that they need.” 


Prison overcrowding, and the dangerous and squalid conditions that it created behind bars, helped motivate California to take a step away from mass incarceration with the 2014 passage of Prop 47. 

At the time, California prisons held about 156,000 men and women in custody, almost twice their holding capacity. The prison system averaged around one death each week as overcrowding created dangerous conditions inside. Civil rights lawsuits over inadequate medical and mental health care eventually led to a 2011 Supreme Court ruling that the California Department of Corrections and Rehabilitation had violated people’s Eighth Amendment rights. The 5-4 ruling, which found that overcrowding was the primary cause for lapses in treatment, upheld a lower court’s order for the prison system to decrease its population by 46,000. 

“Prop 47 was passed because we decided that we want to change felony [charges] so people would not be incarcerated, cost us millions of dollars and human lives,” Lewis said.

From the time the measure passed in 2014 to now, the incarcerated population has fallen from about 131,200 to over 91,800. But after a decade of falling prison populations, Prop 36 is now set to rapidly grow the number of people behind bars in the state. According to an analysis by the Prison Policy Initiative, elevating penalties for theft and drug crimes could increase California’s prison population by 35 percent over the next five years, which would fully undo the reductions the state has seen over the past decade.

A state legislative analysis estimated that implementing Prop 36 would increase state spending on criminal punishment “ranging from several tens of millions of dollars to the low hundreds of millions of dollars annually.” The analysis also estimated that local criminal justice authorities like jails and police departments could see costs increase “by tens of millions of dollars annually.”

The Prop 47 reforms a decade ago funneled savings from decarceration toward community-based support services like mental health and addiction treatment, school truancy and dropout prevention, and job training and housing assistance. Since 2014, the state has allocated around half a billion dollars in savings from Prop 47 to local programs that have helped reduce recidivism for low-level offenses across California. 

As those savings dry up thanks to the passage of Prop 36, so will state funding for those local programs, according to the legislative analysis, which estimated a reduction of state spending “in the low tens of millions of dollars annually.”

Bernal with the Ella Baker Center said he would often hear people who supported Prop 36 say that they thought the measure supported programs for people who needed treatment or housing. He said that grassroots organizers who opposed the measure struggled to convince voters concerned about public safety that it could actually threaten community programs that help prevent crime. “I think the people who voted in favor of Prop 36 really want to live in safe communities and don’t want everyone locked up, particularly Black and brown folks,” Bernal added. “But I think folks were misguided.”

A press conference and rally against Prop 36 in LA’s Boyle Heights neighborhood (photo courtesy of Jose Bernal)

Prop 36 was introduced as an effort to assuage voters’ fears about surging rates of shoplifting and commercial theft, which did increase during the pandemic. This time also saw dramatic videos of so-called smash-and-grab burglaries that spread widely across social media and national news. 

But a longer-term view reveals an opposite trend: Property crime rates are at some of the lowest levels they’ve been in 40 years. More recent analysis by the California Budget and Policy Center shows that rates of shoplifting remain below pre-pandemic levels. 

At the same time, a study of the Prop 47 reforms published in the journal Criminology & Public Policy found that its passage had no impact on homicide, rape, aggravated assault, robbery and burgalary; while motor theft and larceny rates went up, California’s rates still remained below the national average. Bradley Bartos, a professor of government and public policy at the University of Arizona who co-authored the study, said he doesn’t think that “the nitty gritty technical details of the proposition are going to address the change to the landscape of property crime.”

The authors of Prop 36 have also stated that it is aimed to reduce homelessness, but studies show that formerly incarcerated people are ten times more likely to become homeless than the general population. Accordingly, California’s leading homeless policy organizations have come out against the measure. 


Already, observers are characterizing the passage of Prop 36 as part of a larger “pendulum swing” towards harsher punishment in California politics. At the same time voters approved Prop 36, they rejected another measure—Prop 6, which would have prohibited slavery and banned forced labor in California. Los Angeles also ousted progressive District Attorney George Gascon in favor of his more conservative opponent, and in Oakland, voters recalled progressive prosecutor Pamela Price after just two years. More California counties voted red than in 2020. Bartos said “it certainly is movement in the opposite direction California had been moving” over the last decade.

But advocates point out that this swing has much more to do with public perceptions of crime than facts on the ground. Lewis attributes the measure’s success to scare tactics pushed by politicians and harmful narratives from news media that led people to believe that crime was going up, despite FBI data showing otherwise.

“The narrative has been one to scare people, to believe that if we lock people up for addiction, that’s going to help us,” Lewis said. “We did that before, and we found that it didn’t work.” 

Bartos at the University of Arizona concurs: “People’s perception of how at risk they are has changed over the last four years,” he said, in large part due to shoplifting videos that have gone viral on social media.

The Prop 36 “yes” campaign was backed by large retailers such as Walmart, Target, and Home Depot, which collectively gave more than $4 million to the campaign, as well as statewide prosecutor and prison guard organizations. Bartos fears Prop 36 will give law enforcement officials the discretion to arrest and prosecute low level offenders.

“If police and prosecutors interpret this as a broad countering crime mandate, you may start to see them act as such and be more willing to arrest, pursue,” Bartos said. “It’s going to be a question, how people view it more so than how it changes the calculus of crime.”

Ricardo Garcia, the Los Angeles County Public Defender who opposed Prop 36, said California has “gone back in time 10 years” and predicted a decline in services that will likely lead to worsening drug addiction, substance abuse and trauma.

7-Eleven leadership and franchisees present a $1 Million US Dollar check for the Yes on Prop 36 campaign outside the 7-Eleven that was robbed by about 50 juveniles in late September in Los Angeles at a news conference in October. (AP Photo/Damian Dovarganes)

“After this election, we may find ourselves in the most challenging landscape for the criminal legal system and reform that we’ve seen in decades,” Garcia said. “But it doesn’t mean that we stop the struggle or that the struggle is over. Elected officials need to own the solutions that bring us real safety, accountability and justice, and they need to be proud of them.” 

Lewis points out that poverty is a main driver of criminal behavior, and that addressing people’s material needs is a more lasting solution, rather than mass incarceration. He points to instances he has heard of people being arrested for selling baby formula, for example.

“When we think about people that are committing these petty crimes, do you think they’re trying to take over the world and make a million dollars from that? No, they’re trying to feed their children, but those are also the type of people that will be locking up,” Lewis said.

Numerous advocates have said that they will continue to push local and state elected officials to find ways to fund resources that are going to lose money following the passage of Prop 36. The goal, they said, is to redirect resources into proactive measures like substance treatment, schools, creating jobs, and affordable housing for individuals and families. 

“We’re not going to stop, we’re going to keep fighting,” Lewis said. We’re going to do the things that the government that’s supposed to represent us, that’s supposed to really fight for us. If they won’t do it, we’ll do it.”

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“We Need to See the Bigger Picture”: How Cuts to Medicaid Hurt Public Safety https://boltsmag.org/medicaid-coverage-public-safety-study/ Mon, 08 Apr 2024 16:30:07 +0000 https://boltsmag.org/?p=6018 When a state made cuts to Medicaid, depriving people of access to health insurance, the crime rate increased: That’s the finding of a new academic study, supported by the National... Read More

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When a state made cuts to Medicaid, depriving people of access to health insurance, the crime rate increased: That’s the finding of a new academic study, supported by the National Institutes of Health and released as a working paper in March by four scholars who study public health.

The study comes at a time when many states are ramping up punishment in response to crime, while leaving public services largely underfunded. One of the study’s authors, Catherine Maclean, a professor of public policy at George Mason University, tells Bolts that policymakers should keep in mind the critical value of a strong social safety net for stabilizing communities. 

To study these relationships, Maclean and her coauthors examined crime rates in Tennessee before and after that state disenrolled some 200,000 people from Medicaid, with little warning, in 2005. That was and still remains one of the most sweeping state-level Medicaid drop-offs in U.S. history.

By 2007, the study finds, the crime rate in the median Tennessee county had increased by almost 17 percent, with large increases observed in both violent and non-violent crime; the study attributes this to the disenrollment through a series of causal analyses. “Losing Medicaid induced changes in economic standing, housing stability, healthcare use, and health, all of which are documented to be determinants of crime,” the authors write.

It stands to reason, Maclean said, that crimes inspired by desperation or behavioral health crises—or both—became more common in Tennessee post-2005, as poverty increased and people became more likely to delay needed health care. This was especially devastating for people who might have benefitted from mental health care or treatment for substance abuse disorder, the study found.

These patterns now risk repeating themselves at a large scale. Just last year, every state in the U.S. experienced a major contraction in Medicaid coverage, as the federal government ended an emergency pandemic policy that had kept millions enrolled in the program. States are still feeling the effects of that decision, as Bolts recently detailed

A number of states are contemplating further Medicaid cuts, including Kentucky, Utah, and New York. Elsewhere, in Mississippi and South Dakota, voters have tried to force elected leaders to expand Medicaid via direct democracy, but with mixed success. And on the national stage, Donald Trump is running for president again, calling for dramatic slashing of public funds for health coverage. 

Bolts spoke with Maclean about what the Tennessee study can tell us about the link between health insurance and public safety today; about what has and hasn’t changed since 2005; and about current proposed cuts to government-provided health insurance. 

“You might save some dollars in terms of Medicaid, but that may lead to some other problems with other objectives, like promoting public safety,” she warned.


There’s plenty of existing research on how people become less likely to commit crimes after gaining health coverage. Your study notes there’s been much less research into what happens when people lose coverage. Why did you find that important to examine? 

Over time, generally, Medicaid policy has led to expansion in coverage. But we’re now starting to see increasingly more talk and action about policy that could curtail it. 

Some of these losses may come as more of a surprise. (Editor’s note: People who lose Medicaid coverage due to a change in rules, or a lapse in documentation, may not find out in a timely manner or with advance warning.) If you’re gaining Medicaid, it may be that you’ve taken steps—you’ve applied for Medicaid and you’ve shown documentation, so it’s not much of a surprise. If you just suddenly lose Medicaid, that can be very destructive in and of itself, and also for the inability to plan for what you’re going to do next.

Your study found that crime increased generally in Tennessee among those who’d lost health coverage, and that the increase in nonviolent crime was particularly clear. What does that tell us?

I think our findings pointed toward a financial resources story. That is, we found stronger, more stable effects for non-violent crime, which tend to be property crimes. The property crimes we looked at are burglary, theft, motor vehicle theft, and arson. The violent crimes we looked at were murder, manslaughter, rape, sexual assault, robbery, and assault. When we broke these crimes out, we see that our findings for non-violent crime were really driven by theft. 

That, to me, suggested that some of these crimes we see might be financially motivated, which might be due to the loss of resources that one experiences when Medicaid is removed, or it could be increased need to finance medical bills. 

What new information can we glean about health care and crime from looking at what happened 20 years ago in Tennessee?

The broader theme is thinking about the value of Medicaid. You can think about it as the value of the social safety net, providing support for people who don’t have much. It doesn’t just impact those people. It impacts society. 

Even if we take a very restrictive view and we say that it’s each person’s responsibility to make a go of it themselves—finding jobs, getting insurance, staying out of quote-unquote trouble—there are implications for other people. So when you think about whether or not to provide a benefit to a particular segment of the population, I think we need to see the bigger picture: we’re all connected, we all live here together, and there are implications of policies targeting a particular group for the broader society. 

We’re just focusing on crime here, but we can think about improvements in economic standing, the impact of [Medicaid] contraction on evictions. We need to look beyond just the individual, and more at society, when we’re considering the benefits of providing these social programs. 

That would be my largest piece of advice: Don’t view any particular policy in isolation, because it’s very likely, given how complicated our world is, that that policy is going to spill over into other domains.

Today, many politicians who tend to oppose expanding social services, including government-covered health benefits, also tend to support “tough on crime” policies. Why do health access and public safety so often appear in conflict?

It does seem to me that there’s a strong correlation between policymakers and politicians being tough on crime while also taking a conservative view of the role of government in the provision of health insurance. People can certainly have different views about that role of government, but I sometimes suspect there is less [of] an understanding of the potential linkages between the two.

When you give people access to Medicaid, they generally have better financial outcomes. 

You see increases in poverty when you curtail Medicaid, as was done in Tennessee. The idea is that health insurance, in addition to providing access to care, also protects people against the risk and cost of unexpected health care expenditures. You see increases in evictions as well. You can think of a whole range of outcomes that could be improved with the provision of health insurance. It seems like there are other means through which we could reduce reliance on the criminal justice system.

Just to say, alright, let’s hire some new police officers or let’s buy some new infrastructure for the police to use—it’s there, it can be seen, you can show your constituents what you’ve done. There’s something about being able to show your constituents that you did something.

Your study is timely, given the recent Medicaid contraction and the fact that several states right now are contemplating further serious cuts. New York’s governor, for instance, proposed slashing Medicaid by $1.2 billion at the same time she’s making a public show of her desire to fight crime, including by putting National Guard soldiers in Subway stations. How does your study inform these debates?

A policymaker’s job is a very hard one and I’m certainly cognizant of that, but I do think that points to an overlooked linkage: I think that as people lose access to coverage, as is going on through the unwinding, this can be quite destabilizing for individuals, and we think that could contribute to crime.

Medicaid is the largest purchaser of behavioral health care services in the country, so it plays a really important role of connecting people to services. I’m not trying to say that every crime is related to behavioral health, to substance use, because I don’t think that’s true, but I think it could be a bit short-sighted for policymakers not to consider those linkages.

The way these two things jibe together—being concerned about crime but also curtailing expenditures on a very valuable program, particularly for people with behavioral health conditions—I’d encourage people to think about what that might mean. You might save some dollars in terms of Medicaid, but that may lead to some other problems with other objectives, like promoting public safety.

Jails and prisons are often terribly unhealthy and even deadly places to be. To build off your study a bit: It seems that these so-called houses of correction and rehabilitation not only fail the people they’re holding, but—to the extent that health care access is a predictor of criminality—actively harm public safety when they release people in worse health conditions than when they arrived.

I certainly can’t disagree with that. 

At various levels, be it people who are incarcerated, people who are not incarcerated, those goals—being “tough on crime” and taking a conservative view of the role of government in the provision of health care—can very often work against one another. The social determinants of health, or just health care access, can’t be forgotten if we’re going to try to improve outcomes. And I think a lot of these very punitive approaches have unintended negative consequences.

Overdose deaths have soared since 2005. What is your view of the importance of Medicaid to treat substance use disorder and ultimately to limit the number of people dying, and to limit the criminalization of drug use?

We are looking at a time period of the mid-2000s, which was the first wave of the opioid crisis. The second wave started in roughly 2010 and transitioned more toward heroin. We’re now in a third wave, at least, of the opioid crisis, where there’s been a substantial movement to synthetic opioids like fentanyl and analogs. 

So what might that mean? Fentanyl is just substantially more harmful and easier to overdose on than prescription opioids in the 2000s, and I think that’s why we see this huge spike in opioid overdoses. At the same time, for a variety of reasons, we’re seeing more medications that can be used to treat opioid use disorder, we’re seeing what I’d say is a reduction in stigma around receiving treatment for substance use disorder. Medicaid in many states has increasingly played a larger role in providing that treatment, so my take is that, comparing the 2005 experiment to what we’re seeing now, Medicaid plays a larger role today in fighting the opioid crisis. 

I do think understanding how cutting people off Medicaid is going to affect society—especially when we have these goals of enhancing public safety being talked about in so many localities across the country—I would just hope policymakers would consider that there are some things you can’t get back. You can of course reinstate Medicaid, but the negative implications of removing it will have already occurred.

This interview has been edited for length and clarity.

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Drug Treatment Crisis Grows in West Virginia, But State Just Looks Toward More Punishment https://boltsmag.org/west-virginia-drug-treatment-medicaid-drug-criminalization/ Thu, 07 Mar 2024 17:20:47 +0000 https://boltsmag.org/?p=5906 Amid record overdoses, lawmakers ignore calls to restore pandemic-era Medicaid policies expanding access to treatment. They used this session to debate ratcheting up penalties.

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In the months leading up to her death, Ashley Omps of Charleston, West Virginia, felt ashamed to be taking suboxone. It was prescribed to her to treat opioid dependency by limiting cravings and withdrawal symptoms, and though it was clearly a much healthier alternative to the pills and heroin she’d been taking before, she hated that she had become reliant on it. Omps felt like she’d replaced one dependency with another.

“I’ve never been sober a day or two since I was 16,” Omps, who was 34, texted her sister on Oct. 5 of last year. “I do not want to be addicted. I fucking hate needing something to feel normal. I might as well actually get high if I’m going to be an addict.”

Though she resented the suboxone, people close to her said it was crucial to her recovery from substance use disorder. And so it was catastrophic that she could no longer obtain it, midway through 2023, after she was kicked off Medicaid. 

At the onset of COVID-19, the federal government suspended normal rules for Medicaid to keep people from losing coverage during the pandemic, allowing recipients, including Omps, to go three years without having to demonstrate eligibility. But that policy ended in March 2023, and Omps and millions of others across the country were swiftly dropped from government coverage—for instance because they forgot to file for renewal or made a mistake on their paperwork, or because they had moved to a new state or started earning too much money to qualify for Medicaid. In West Virginia, this change was compounded by the existing staffing and funding challenges in the state’s Medicaid office, and the legislature’s inaction to avert this cliff.

In 2022, Omps started working at the nonprofit West Virginia Family of Convicted People, where she organized events to protest and raise awareness about conditions inside West Virginia’s deadly jails. The job paid $22 an hour, which put her in a difficult spot: She was making too much money to stay on Medicaid, but the job didn’t provide health insurance and Omps couldn’t afford to pay out-of-pocket for her drug treatment.

“She had to go off of suboxone and that is what put her body under a lot of stress,” Omps’ sister, Victoria Omps, told Bolts recently. “It was so hard on her, because of how expensive it was going to be to stay on.”

Already in withdrawal from hard drugs, Omps suddenly found herself in withdrawal from the medication that was treating her addiction. On Oct. 18, she entered the steam room of a YMCA in Charleston, West Virginia’s capital city, then collapsed and died as she got up to leave. She was 34 years old, and though she officially died of a heart attack, Victoria and others who knew Ashley told Bolts they have no doubt about what killed her.

“I think it was entirely about her having to come off of suboxone,” Victoria said. “The withdrawal was so hard. That was the reason she was even in the steam room, so she could try to sweat it out of her pores.”

The so-called unwinding of Medicaid coverage has, as of late last month, led to the disenrollment of more than 17 million Americans, according to a Kaiser Family Foundation analysis. West Virginia has been hit particularly hard: It is one of the poorest states in the country, and thus has one of the highest rates of Medicaid enrollment. The return to normal Medicaid rules has led to the removal of nearly a quarter of all West Virginians who’d been enrolled as of last spring, the Kaiser analysis shows.

Those who work in drug treatment and addiction recovery in West Virginia say this drop-off in coverage has endangered people with substance use disorder and compounded a larger crisis in a state that has already led the country in overdose death rate every recorded year since at least 2014, according to federal data. 

As patients like Omps lost access to addiction treatment, advocates pressed state leaders to expand Medicaid eligibility and treatment options in the state. Instead, even in the face of this crisis for drug treatment and recovery, many West Virginia lawmakers have turned to a different approach, pursuing new punishments for people addicted to illegal drugs in a state that already incarcerates more people for drug possession than for almost any other charge. 

The state legislature, which is controlled by Republican supermajorities, already restricted syringe exchange programs in 2021; this year, it considered bills to outlaw syringe exchanges entirely, as well as to ban methadone—a medication that treats opioid addiction, as suboxone does—and the distribution of clean drug supplies. West Virginia lawmakers also have repeatedly advanced legislation to turn simple drug possession from a misdemeanor to a felony offense punishable by up to five years in prison. 

“We’re trying to be proactive here,” Republican state Senator Vince Deeds, the sponsor of that proposal, told Mountain State Spotlight in January. “Right now, if you have someone go in for simple possession, they’re back out and they’re committing more crimes to feed their habits. The idea here is to have early intervention with these end-level users.” (Deeds did not respond to multiple requests for comment from Bolts.)

Deeds’ bill passed the state Senate both in 2023 and this January, but it stalled in a House committee last week as lawmakers declined to pass it. Instead, House Republicans decided to study higher penalties for drug possession in the future, which would push this focus on increased penalties into coming years. 

Many who advocate for those struggling with addiction in West Virginia feel frustrated seeing lawmakers focus during their limited time—the 2024 session is already set to end this week—on such solutions. These advocates argue that treatment offers more public safety benefits than harsher punishment, a position bolstered by years of research showing that incarceration does not deter drug use. 

“Instead of putting the money and funds into increasing access to treatment, increasing resources and funding to organizations helping with drug treatment, they’re talking about throwing good money after bad by increasing penalties and increasing incarceration rates,” said Kenneth Matthews, a recovery coach who is himself in long-term recovery from addiction. 

“There’s not enough money put into treatment facilities,” he said. “Never in the history of people committing crimes has anybody in the midst of their substance use said, ‘Oh, they just increased the penalty, so I’m not going to do this.’ As someone who was formerly incarcerated and in long-term recovery, when I was in the midst of substance use I wasn’t following the legislature and I really didn’t care.”

David Foley, the chief public defender in Mingo County, a rural area in the southern part of West Virginia that The Guardian once called “the opioid capital of America,” said he sees a host of other criminal charges that seem to stem from untreated addiction. “I see so many crimes where, if they are not drug offenses, they are fueled by the desire to get money to get drugs, or it’s people so down on their luck because of drugs,” Foley said. “It just seems like the entire spectrum of criminal charges are in some way influenced by substance abuse.”

Mingo County Sheriff Joe Smith, a Republican, confessed that he sometimes wonders whether arrests and incarceration for certain drug charges are doing any good for people suffering addiction. Smith told Bolts that he and his deputies often arrest the same people over and over again for the same drug-related crimes, and added that even if he could arrest every single person who sells drugs in the area, he doesn’t think Mingo County could solve its problems related to addiction through enforcement alone.

“Out of every crime we work, 80 percent is drug-related. We’ll arrest someone who stole grandma’s earrings, but when you get to the root of it, it was to sell the earrings for a hit of meth or some fentanyl,” Smith said. “It’s a sad situation. I’ve arrested people, and arrested their kids, and worked overdoses off people who I’ve begged to get help.”

Overdose deaths are a regular occurance in Mingo County, which has a population of just over 20,000. Rebecca Hooker, who runs a social services organization in the county, told Bolts that, recently, on a single day in a single 10-mile radius, her community saw four people die of suspected overdoses. “The people in the sector of harm reduction or prevention or rehabilitation really need more money,” Hooker said. “Right now it’s just catch and release.”

Matthews said his work as a recovery coach is particularly difficult these days, now that he must contend with the fact that many of his clients, who are already at high risk of incarceration or overdose—or both—are also trying to navigate the ongoing Medicaid mess. He talked about one client who had to leave a treatment facility because they lost Medicaid coverage, then spent months re-establishing eligibility, only to find that the treatment facility had no bed space for him to return.

“I was worried he’d have a fatal overdose,” Matthews said. “People lost their health care and had to leave their residential programs because they no longer had the ability to pay for it through Medicaid. Some of them were able to hold on and some were not.” 

West Virginia’s state Medicaid office has faced criticism for not doing enough to help people keep coverage after the rules changed. In a letter last summer, the federal Centers for Medicare and Medicaid Services admonished the state for keeping people on hold for long periods of time when they called in for help, and warned that this and other forms of administrative dysfunction would lead to many eligible people losing coverage. 

Rhonda Rogombe, health and safety net analyst for the West Virginia Center on Budget and Policy, said administrative hurdles have been a particular problem for people needing treatment for substance use disorder. “This is a very vulnerable group of people,” she told Bolts, “and they’re being disconnected from programs they were enrolled in, or could be eligible for.”

Deborah Ujevich, who works at a detox facility outside Charleston, and was close with Ashley Omps, says people have been scrambling over the past year to find addiction treatment after losing Medicaid coverage. “People would call us for a bed and you look their Medicaid up with the system, you go look at member eligibility, and you see no enrollment found,” Ujevich said. “So you can’t take them, and they can’t get meds because the pharmacy isn’t going to fill their protocol.”

Omps’ death while searching for treatment was sadly not unique, Ujevich said, adding, “We have had a number of past patients die because they aren’t getting the care that they need.”

She finds it frustrating that the state continues to pursue harsh enforcement despite little evidence that incarceration is helping to stem substance abuse, especially after so many lost access to addiction treatment under Medicaid.

“They are doubling down here on bad policy and they are not taking into consideration what is actually happening. It’s very, very, very out of touch,” Ujevich said. “We’re really going backward.”

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How Will Philadelphia’s Next Mayor Tackle the Overdose Crisis? https://boltsmag.org/philadelphia-mayor-harm-reduction-overdose-crisis/ Mon, 15 May 2023 17:05:47 +0000 https://boltsmag.org/?p=4664 When Melanie Beddis opens the Savage Sisters drop-in center in Philadelphia’s Kensington neighborhood each weekday morning, there’s often a small crowd waiting at the door.  “People know that our shower... Read More

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When Melanie Beddis opens the Savage Sisters drop-in center in Philadelphia’s Kensington neighborhood each weekday morning, there’s often a small crowd waiting at the door. 

“People know that our shower list fills up quickly,” Beddis said. She says the drop in center is one of only two places unhoused people in Kensington can consistently take a shower. Visitors can also pick up safer use supplies like drug testing strips, get clean clothes and snacks, or simply hang out—lounging and chatting under the center’s neon purple lights and framed posters of the Philadelphia Eagles. 

“It really is a community,” Beddis said. “If somebody spills their coffee, we have our regulars that will jump up and be like, ‘Just give me the mop. I’ll take care of it,’ you know what I mean?”

Kensington and the people who live, work, and use drugs in this small neighborhood on the city’s northeast side have drawn scrutiny in the run up to Philadelphia’s May 16 Democratic primary, which will likely decide the city’s next mayor.

In a tightly-run race animated by issues of crime and public safety, debates on substance use have honed in on Kensington’s opioid crisis and significant unhoused population. All five of the leading candidates say the city needs to end what’s widely described as an “open-air drug market” and increase policing in the neighborhood. At least two of these candidates also propose raising the police budget. 

But local critics of a law enforcement-first approach to substance use worry that it may elevate overdose risks and perpetuate harm against people who use drugs, especially in Black and Latinx communities that already experience more policing. Instead, they hope the city’s next mayor will embrace harm reduction—a set of public health and social justice strategies aimed at protecting the dignity, autonomy, and rights of people who use drugs.

The city government’s response to substance use and the overdose crisis has thus far involved a complex patchwork of departments including police, public health, behavioral health, and homelessness services, and dozens of others, with guidance from the mayor’s office. Meanwhile, grassroots organizers in the city are locked in a years-long battle with state and federal officials to create a space for safer drug consumption. The proposal, championed by a nonprofit called Safehouse, has enjoyed some support from city officials since 2018 but has been delayed by lawsuits and now state legislation, even as similar sites have appeared in New York City. 

The next mayor will oversee the city’s response to the ongoing overdose crisis and shape its policies, wielding powers like its budget proposals, executive orders, or appointing the police commissioner. The mayor’s position on an overdose prevention site may also make or break the proposal in light of some state politicians’ ongoing efforts to preempt the sites. 

“The next mayor must take research about the effectiveness of harm reduction techniques seriously,” said Shoshana Aronowitz, an assistant professor at Penn Nursing who studies racial equity in substance use treatment and works with several harm reduction organizations across the city. 


A skyrocketing overdose crisis

Over 1,200 Philadelphians died of accidental overdoses in 2021—the highest number ever recorded. The potent opioid fentanyl has found its way into stimulants such as methamphetamine and cocaine, and an increasingly unpredictable drug supply, plus a lack of adequate prevention resources are driving up overdose rates citywide, especially in its Black and Latinx communities. A 2021 city report recommended using the phrase “overdose crisis” rather than “opioid crisis” to more adequately capture this impact. 

Much of Philadelphia’s current response infrastructure dates to 2017, when Mayor Jim Kenney convened a task force to determine how to “combat the opioid epidemic in Philadelphia.” The task force’s final report called for easier access to medication assisted treatment, in which doctors prescribe drugs called methadone and buprenorphine to relieve withdrawal symptoms and reduce the risk of overdose. It also advocated increasing access to naloxone, which can help reverse overdoses, expanding drug treatment court, and providing additional resources for housing and jobs training. 

As fatal overdose rates continued to increase, however, Kenney declared an “opioid emergency” in Kensington and directed law enforcement to reduce “open-air drug use and sales.” Since then, the police have increased foot patrols in the neighborhood, seizing cash and drugs and making over 2,500 arrests in 2022 alone.

Since 2020, a harm reduction program within the city’s department of public health has been distributing naloxone and fentanyl test strips through street-based outreach and training Philadelphians on how to spot and reverse overdoses. The city also funds some of the work of a Kensington-based harm reduction nonprofit offering syringe exchanges. And the department of health has committed to reducing overdoses that involve stimulants 20 percent by the end of 2023, according to its strategic plan

All five leading mayoral candidates have expressed some vision of treatment for people who use drugs, but Rebecca Rhynhart and Helen Gym’s proposals most resemble this existing plan. Both have expressed support for medication assisted treatment. 

A spokesperson for Gym’s campaign told Bolts the candidate would “improve prevention, [drug] testing, and treatment outreach,” especially in “underserved Black communities in North, Southwest, and West Philadelphia, where overdose rates are rising.”

Candidate Jeff Brown has advocated for drug treatment through the criminal legal system. 

“Drug court [is] a very effective way to have a good outcome, because you monitor their substance use. If they fall off the wagon, they have a choice. Do you want to go to jail for your crimes, or do you want to go back to treatment?” he said at a recent candidate forum about public health.

But Aronowitz warns that not all treatment options are created equal. “We know what doesn’t work,” Aronowitz said, “And that is expecting people to just quit cold turkey and be fine, because we know that that’s associated with extreme overdose risk.” 

“When a politician says we need more access to treatment, that’s not enough,”she continued. “We need to know if they’re going to fund the things that work and defund the things that not only don’t work but are potentially harmful.” 


The battle over Safehouse

Advocates doing harm reduction work in Philadelphia are pushing the city government to expand its focus on keeping people alive, beyond offering treatment, and they have fought to establish an overdose prevention site in Philadelphia, an effort the city government nominally supports. Such sites, also known as safe drug consumption sites, are places people can use pre-obtained drugs more safely, in the presence of staff trained to spot and reverse overdoses. 

As of July 2022, more than 120 overdose prevention sites existed in ten countries across the world, and no fatal overdoses had ever taken place in one. But they remain controversial in the United States. So far, only two such sites exist in the country, both in New York City, where staff have reversed more than 700 overdoses in the less than two years since they were created. Rhode Island legalized the creation of a pilot site in summer 2021 and is set to open one in early 2024. California governor Gavin Newsom last year killed legislation that would have allowed San Francisco, Oakland, and Los Angeles to establish their own sites. 

In Philadelphia, efforts to open such a site have been caught for years in a protracted battle pitting harm reduction advocates and some city officials like DA Larry Krasner against the U.S. Justice Department, some state politicians, and opponents in law enforcement, business, and residential communities across the city. 

The struggle dates to a recommendation from Mayor Kenney’s 2017 opioid crisis task force to explore creating a space for safe consumption. In 2018, a nonprofit called Safehouse launched with the aim of opening a site in the city. But soon after, a U.S. Attorney appointed by President Donald Trump sued Safehouse invoking a federal law which prohibits “maintaining drug-involved premises” where criminalized drugs are manufactured, distributed, or used. 

Current Philadelphia Mayor Jim Kenney, who has supported harm reduction efforts, including the creation of an overdose prevention site. (Facebook/Mayor Jim Kenney)

In February 2020, the federal judge’s ruling in Safehouse’s favor led the group’s leaders to announce the site’s imminent opening in South Philadelphia. But after vehement opposition from neighbors, the plans folded in just two days. In 2021, a federal appeals court reversed the ruling that had cleared the way for Safehouse to open, relaunching the legal battle.

The plan remains uncertain at this time. Settlement talks between Safehouse and the U.S. Justice Department have been ongoing for over a year. Local opposition exploded last month, when a group including the police union and business associations filed a petition to step in as party plaintiffs in the lawsuit, fearing that the Biden Administration would reverse its position. 

Opponents to the site scored a decisive win earlier this month when Pennsylvania’s state Senate voted to ban overdose prevention sites anywhere in the state on a bipartisan 41-9 vote.

The bill was sponsored by Democratic Senator Christine Tartaglione, whose district includes parts of Kensington. She told The Philadelphia Inquirer that she opposes “prolonging and allowing a system of state-sponsored addiction in Pennsylvania.” 

The bill now sits in the state House’s Judiciary Committee. If it passed the chamber, it would move on to Governor Josh Shapiro, a Democrat who has indicated he opposes safe consumption sites.

Meanwhile, five Philadelphia city council members introduced a local bill on May 11 that would prevent an overdose prevention site from being created anywhere in their districts, an area amounting to about half the city. Councilmember Quetcy Lozada, whose district includes Kensington, led the effort, saying that such a site would only worsen the neighborhood’s struggles with drug consumption. 

“We cannot continue to allow them to find ways where they can continue to remain in the same cycle,” she told Inquirer. The bill would still need to get a committee hearing and be voted on by the entire city council—a process that may not happen before the council’s summer recess beginning in July—before going to the mayor to be signed. 

In public statements and court filings, Kenney’s administration has supported efforts to open an overdose prevention site, and remains supportive even in light of the new city and statewide bills. Whether the next mayor supports Safehouse would likely be critical to its chances given that the proposal is assailed from many quarters.

Among mayoral candidates, Helen Gym, a former teacher and city council member embraced by activists on the left, is the only one to have directly stated support for an overdose prevention site, though she did so before the protracted legal battle over Safehouse. 

“[Safe injection sites] are among the most promising new approaches to come forward while we work to end the opioid crisis. I support establishing one in Philadelphia,” Gym said in 2017. Her statement at the time added momentum for the proposal by giving it a prominent supporter on the city council. Gym has recently offered more circumspect answers in public comments, and did not respond to Bolts’ question about whether she currently supports opening a site in the city.

Another leading candidate, former city controller Rebecca Rhynhart, expressed measured support for the proposal. “I won’t take a tool that experts say saves lives off the table,” she told Bolts. “But I would not put a safe injection site in any neighborhood that does not want one.”

“I think that the debate over safe injection sites in Philadelphia has clouded the bigger issue which is what is the comprehensive plan for dealing with the opioid crisis in our city,” she added. 

Three other major contenders—real estate mogul and former councilor Allan Domb, grocery store magnate Jeff Brown, and former councilor Cherelle Parker—all oppose the sites. Parker has been a strident opponent since Safehouse’s efforts to open a site in early 2020, when she participated in the city council’s mobilization against the opening. 

“We should not be participating in a ‘I know what’s best for you’ decision making where we use safe injection sites as solutions,” Parker said in a debate on April 18.


Policing a public health crisis

The role of policing has proved broadly divisive in the mayoral primary, and yet the five leading candidates support increasing police presence on the ground in Kensington, distancing themselves from advocates who worry it would exacerbate criminalization. 

Gym and Rhynhart each said they would do so by reallocating existing police funds to prioritize Kensington, while increasing the police budget overall is a central component of both Domb and Parker’s platforms.

A spokesperson for Gym’s campaign told Bolts the candidate will take a “public health and resident-focused, community-led response,” mentioning a focus on neighborhood improvements, trauma support, and mobile crisis units, but did not detail how increased policing will fit in. 

Rhynhart’s campaign website states that she will attempt to disrupt public drug use by focusing on dealers, with a mix of warnings for “non-violent dealers” and arrests for “those committing violent acts.”

Sheila Vakharia, who helps lead research at the Drug Policy Alliance, warns that the line between people using drugs and people selling drugs is much more fluid. 

“There’s this idea that there is this big bad demon-ish seller and this poor victim user and oftentimes the seller is racialized. The victim is also racialized, but differently,” Vakharia said. “And oftentimes all of this can create heroes and villains.”

To both Aronowitz and Beddis of Savage Sisters, ending the overdose crisis requires a solution beyond what has been proposed by any candidate in the Philadelphia mayor’s race: addressing the toxicity of the criminalized drug market. They argue instead for access to a safe supply of criminalized drugs in a way that clinical and community-led programs have modeled across Europe and Canada, but which has not been piloted in the U.S.

“The way we regulate alcohol is safe supply,” Aronowitz said. “We make sure it’s not poison, and that when you take a drink, you can reliably know how much alcohol is in it.” 

But even if those goals are still far off, at the very least, they say, the city government should meet communities impacted by the overdose crisis with resources and care—not criminalization.

“Our friends have necrotic limbs. Can’t access treatment. Can’t access housing. Can’t access compassionate pain management. Can’t even get a shower,” Savage Sisters’ founder and executive director Sarah Laurel wrote on LinkedIn last month.

“It’s time we respond to this public health crisis accordingly.”

Pennsylvania Votes

Bolts is closely covering the ramifications of Pennsylvania‘s 2023 elections for voting rights and criminal justice.

Explore our coverage of the elections in the run-up to the May 16 primaries.

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In Pennsylvania’s 2023 DA Races, There’s Already a Winner: Unopposed Prosecutors https://boltsmag.org/pennsylvania-da-races-2023/ Wed, 22 Mar 2023 18:53:49 +0000 https://boltsmag.org/?p=4448 This is the first installment of Bolts’ primers on 2023 prosecutor elections. Explore our guides to DA races in New York and across the South in Kentucky, Mississippi, and Virginia. Tom Marino,... Read More

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This is the first installment of Bolts’ primers on 2023 prosecutor elections. Explore our guides to DA races in New York and across the South in Kentucky, Mississippi, and Virginia.

Tom Marino, a former member of Congress, is running this spring for a job he held more than two decades ago: district attorney of Lycoming County, in Central Pennsylvania. On his website, he vows to “prosecute offenders to the fullest extent of the law,” and in the brief list of issues he says he’d tackle with a “tough-on-crime approach,” he includes the fact that “drugs are making their way into our neighborhoods.”

Lycoming County has been hit hard by the opioid crisis, overwhelming local officials with a surge in overdoses. But Marino’s campaign posture today sticks out given the accusations he faced just five years ago that he worsened this trend.

In late 2017, Marino’s nomination to be then-President Donald Trump’s drug czar derailed after The Washington Post and 60 Minutes reported that he pushed legislation that made opioids more readily available. The investigation revealed that Marino collaborated with the pharmaceutical industry to draft language that gutted the Drug Enforcement Administration’s authority to go after large drug companies suspected of fueling the crisis, all while receiving big donations. Besides sinking Marino’s appointment, the news sparked a national reckoning over his law and, back home in Lycoming, condemnation as well as fresh reporting on overdoses.

But any debate over Marino’s record and how it fits with his new campaign’s rhetoric ended before it even began: No one filed to run against him. 

Pennsylvania’s deadline to run for DA as a major-party candidate passed on March 7 with no other contender entering the race, leaving Marino highly likely to win the job and complete his comeback with little additional scrutiny. Marino, who also survived a residency challenge last week, did not reply to Bolts’s requests for comment over his legacy and platform on drugs.

The same scene repeated itself throughout the state this month. Upon compiling the list of candidates in the 49 Pennsylvania counties with DA elections this year, I found that only 14—less than a third of the total—drew multiple candidates, with a few of those races seeming to offer voters a stark choice. 

Thirty-five counties, meanwhile, drew only one candidate by the deadline.

Missed windows for democracy

That’s 35 candidates—typically incumbents, but in six cases nonincumbents like Marino—who are poised to waltz into office without facing much scrutiny into their policies. In Dauphin County, where PennLive recently reported on mounting jail deaths and local officials offering little information or accountability, DA Frank Chardo faces no opposition, just like the last time he ran in 2019. The same is true for DA Brian Sinnett in neighboring Adams County, where the DA’s office faced allegations that it is not taking rape complaints seriously. In Lehigh, which saw sustained activism after prosecutors decided to not charge police officers in a publicized use-of-force case, the DA is retiring and his chief deputy is the only candidate who filed to replace him.

The strangest saga is unfolding in Northumberland, where DA Tony Matulewicz filed his petition too late by a matter of minutes and was denied a ballot spot. He is suing to be reinstated but, for now, challenger Mike O’Donnell remains the sole qualified candidate. O’Donnell, who is a Republican like Matulewicz, works as a defense attorney and said upon entering the race that “he wanted to fix a broken system,” but did not reply to questions about what that means.

Independents may still file to run later, but it’s very rare for candidates outside of the two major parties to win. In 2019, when each of these 49 counties held their last DA race, all 49 winners had filed as a Democrat or Republican. Newcomers could also mount uphill write-in campaigns.

It’s common across the country for DAs to run unopposed. For one, it’s hard for attorneys to challenge a sitting prosecutor without fearing professional repercussions should they lose, especially in smaller communities. Still, the number of Pennsylvania counties hosting contested elections plummeted this year compared to 2019. At the time, 24 of the 49 counties drew multiple major-party candidates, compared to 14 counties this year. 

The pattern is also not confined to the state’s smallest jurisdictions. There are 12 DA elections in counties with at least 250,000 residents, and only four drew multiple contenders; in Montgomery County, for instance, a county of more than 800,000 residents, incumbent DA Kevin Steele will be running for re-election unopposed for the second straight cycle.

“Many people just don’t know all of the power that district attorneys actually possess,” says Danitra Sherman, the deputy advocacy and policy director at the ACLU of Pennsylvania. “As voters, we often get excited about presidential elections, but not so much about local races, or state races at times, when those that hold positions at these levels have more say on and decision making power over the day-to-day life.” The state ACLU launched a voter education drive on the role of DAs in 2017, and in 2019 they sent out questionnaires to candidates, asking for their views on matters ranging from sentencing to bail, but many did not reply. Sherman says they recently sent out questionnaires to some candidates again this year.

In counties with contested DA races, this year is voters’ first opportunity to weigh in directly on criminal justice since the Black Lives Matter protests of 2020 and the latest round of GOP attacks over crime, which has put issues surrounding policing and public safety squarely in Pennsylvania’s political spotlight. Yet even when there’s a contested race, candidates often downplay the huge amounts of policy discretion that comes with the role. 

My own review of Pennsylvania’s 14 contested DA races found that many of the people who filed this year are running as status-quo candidates (such chief deputy prosecutors bidding to replace their retiring boss), competing largely over who has the most professional experience as a prosecutor, and eschewing sharing their thoughts on issues—all standard fare in DA races. 

In addition, some candidates have little to no campaign presence at this stage and did not answer requests for comment. That includes the sole challenger in Delaware County, one of the most populous counties with a contested race.

Our full database of DA candidates in Pennsylvania is available here.

Primaries in Pennsylvania are on May 16, and general elections are in November. State voters also weigh in on many local and state elections this year, including a seat on the state supreme court, county sheriffs, and Philadelphia’s mayor.

Still, a few DA elections are presenting voters with some contrasting paths on criminal justice policy.

What to still watch for

The year’s marquee race is the DA election in Allegheny County, home to Pittsburgh, where longtime incumbent Stephen Zappala faces the county’s chief public defender, Matt Dugan. 

Over his nearly 25 years in the DA’s office, Zappala has embraced a reputation for harsh prosecutions—other than in cases of police shootings—and sternly opposed advocates who have pushed for decarceration, accusing them of disregarding victims. “I don’t agree with their philosophy on a lot of things,” he said during his most recent campaign, explaining why he was “done with socialists and ACLU forums” and skipping some candidate events. Investigations have revealed significant racial disparities in prosecutions under Zappala’s watch but he has routinely dismissed addressing systemic inequalities as beyond the purview of his job. “I’m not running for public defender,” he quipped four years ago.

Now a public defender is running against him, adding to a wave of outsiders, including civil rights attorneys, who have run for DA nationwide in recent years. Dugan is pressing a basic disagreement over whether the DA’s office should even be tackling the root causes of crime and tracking class and racial disparities. “I do see a place for the district attorney to think more about crime prevention and to address the issues that are really driving people into the criminal justice system in the first place,” he told the Pittsburgh City Paper.

Hundreds of miles away, in Monroe County, the retirement of a local DA—Republican David Christine—has sparked an intriguing three-way race. In the Republican corner is Alex Marek, an assistant DA in a neighboring county who is pledging to bring a “tough on crime” approach. 

Democratic candidate Donald Leeth takes exception to that moniker. “Unfortunately being tough on crime is always locking up more people for a longer period of time, and I think the evidence has shown that that doesn’t work, that doesn’t make us a safer community, that doesn’t address the underlying issues within our society and our criminal justice system,” he told me. 

Leeth used to work as an assistant DA but says he became more aware of disparities in prosecution as a defense attorney. He faulted racial disparities in the county’s court system and an overreliance on police officers as “first responders for everything.” But he also remained largely cautious when it came to specifying reform he’d implement, for instance saying he’d want to recommend cash bail in fewer cases, but also that it has its role in the court system.

Leeth also said he “would not be open” to seeking death sentences if he was elected DA, and called on the death penalty to be repealed.

Also in the running is Democrat Mike Mancuso, who currently works as the county’s chief deputy prosecutor, and who did not reply to a request for comment on the death penalty and other issues. (The winner of the Democratic primary between Leeth and Mancuso will face Marek in November.)

Monroe is one of the ten counties in Pennsylvania that has sentenced someone to death over the last decade, according to data gathered by the Death Penalty Information Center. Pennsylvania’s Democratic governors have imposed a moratorium on executions but the death penalty remains available and state prosecutors regularly seek it.

Washington County is also on that list. Republican DA Jason Walsh came into office in late 2021 after his predecessor’s death and he has since pursued death sentences aggressively; the county had eight capital cases as of August, and more since. Walsh now faces Democrat Christina Demarco-Breeden, an assistant DA in a neighboring county. When I asked Demarco-Breeden if there are aspects of the DA’s office that she wishes to change, she zeroed in on Walsh’s use of the death penalty. She is concerned that it just keeps growing and that the county’s defense resources are at a breaking point. But she also said that, if she became DA, she herself would remain open to applying the death penalty “to the most brutal homicides.”

Some Democratic lawmakers are championing legislation this session to abolish the death penalty. “My job is to make sure that’s not even an option,” said State Representative Chris Rabb when I asked how he hopes DAs handle capital cases in the meantime. The money “could be much better spent on any number of things, most notably violence prevention so that we don’t have as many people committing the murders that get people on death row to begin with.” 

Rabb, who represents Philadelphia, was a vocal defender of  Philadelphia DA Larry Krasner, a figurehead for so-called progressive prosecutors, against state Republican efforts to remove the DA from office last year; Krasner, who easily won re-election in 2021, is not up again until 2025. 

Rabb says the GOP attacks on Krasner and other tough-on-crime messaging backfired—Democrats won a high-profile U.S. Senate race and flipped the state House—because most Pennsylvanians believe in reforming the criminal legal system. “They believe in second chances, and having parole and probation reform so that people are not surveilled for decades,” Rabb told me.

“Spending so much time denigrating Larry Krasner did nothing else than energize Philadelphia in saying, ‘You folks who don’t live in Philly claim to care about us, but what are you doing for us other than demeaning someone who we voted for twice?’” Rabb added. Krasner, unlike most of his peers, has faced opponents in every primary and general election.

Democrats’ takeover of the state House in the midterms changed the political dynamics around criminal justice reform by ushering progressive leaders into power. But Liz Randol, legislative director of the state ACLU, says one thing that hasn’t changed in Harrisburg is the role of the Pennsylvania DA Association, the influential group that lobbies on behalf of state DAs and has helped shape state laws to be more punitive. Randol is watching whether 2023 chips away at state prosecutors’ typical role as chief antagonists to reform legislation.

“The prosecutorial mindset runs through the entire criminal legal system, from legislating to charging, to sentencing,” said Randol. “Because the system is largely driven by the prosecutorial side of the equation, it’s going to take a lot to change it. But I certainly think you can poke holes in that veneer.”

Pennsylvania Votes

Bolts is closely covering the ramifications of Pennsylvania‘s 2023 elections for voting rights and criminal justice.

Explore our coverage of the elections in the run-up to the May 16 primaries.

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Oklahomans Reject Recreational Weed in Low-Turnout Election https://boltsmag.org/oklahoma-rejects-recreational-marijuana/ Wed, 08 Mar 2023 15:54:22 +0000 https://boltsmag.org/?p=4407 Oklahomans on Tuesday rejected a measure that would have legalized the possession and sale of marijuana for recreational use. State Question 820 lost overwhelmingly, 62 to 38 percent. It trails... Read More

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Oklahomans on Tuesday rejected a measure that would have legalized the possession and sale of marijuana for recreational use.

State Question 820 lost overwhelmingly, 62 to 38 percent. It trails in all Oklahoma counties, and the state’s rural areas rejected it by especially large margins.

In the five years since voters approved a measure to legalize medical marijuana, Oklahoma has seen an explosion in cannabis farms and dispensaries. Some business owners are making a fortune

But possession and sale outside of those strictures remains a criminal offense. An estimated 60,000 Oklahomans are weighed down by a past marijuana conviction and the number keeps climbing, with 5,000 people arrested over marijuana possession in 2020 alone, according to state data

“At a time when the state has legal marijuana millionaires, it seems both unjust and imprudent for there to be so many people who can’t get a job and can’t put food on the table for low-level marijuana convictions,” Damion Shade, executive director of OK Justice Reform, told Bolts

Had it passed, SQ 820 would have enabled these people to seek an expungement of their criminal records. Providing retroactive relief has become a staple of legalization efforts around the nation, since the effects of a conviction extend far beyond the sentence, affecting people’s ability to secure employment, housing, or college grants. And Black Oklahomans disproportionately suffer these repercussions; an ACLU study found that between 2010 and 2018, Black people were four times more likely to be arrested over marijuana than white people.

Organizers intended to qualify SQ 820 for the state’s November 2022 ballot. But challenges delayed approval and kicked it off to 2023. Then, Republican governor Kevin Stitt scheduled the referendum for March 7—a special election where SQ 820 would stand on its own—even though Oklahomans were already set to go to the polls on both Feb. 14 and April 4 for local and school board races. 

This left the state with a confusing schedule of three separate election days—each with their periods of mail-in ballots and early voting—within eight weeks.

“People can’t rearrange child care and jobs every month to go vote,” says Andy Moore, CEO of Let’s Fix This, an organization that promotes civic engagement in Oklahoma. “Doing it like this was clearly a way to suppress turnout.” 

While Oklahoma routinely sees some of the worst voter turnout in the nation (it was the lowest of any state in the 2020 presidential election), participation on Tuesday paled even in comparison to that low bar. Roughly 560,000 people voted in Tuesday’s election, 25 percent of registered voters and less than 20 percent of the total voting-eligible population in the state. 

When Oklahomans voted on medical marijuana in June of 2018, alongside the state’s primaries, nearly 900,000 people voted; turnout on Tuesday was 37 percent lower. 

“If we really want to get an assessment of what the voters want, we need to help them to the polls,” Moore told Bolts. “We can do things to make elections more accessible to more people so that we can have higher turnout.”

The governor who scheduled the election opposes legalizing marijuana and called on voters to defeat SQ 820, as did other prominent Republicans who said it would endanger the state. “I believe this is the best thing to keep our kids safe and for our state as a whole,” Stitt said on Twitter on Tuesday after the result was known.

Some Oklahoma Republicans are pushing changes to the ballot initiative process that could guarantee an odd placement on the calendar, lending credence to complaints that state officials are intentionally seeking to dampen turnout in those elections. 

One measure, introduced by Senator Warren Hamilton, would mandate that initiatives only go to voters in odd-numbered years, rather than on even-numbered years where turnout is far higher. The proposal goes against the burgeoning movement nationwide to move more elections to even-years in order to sync them with higher-turnout national election cycles and champion higher engagement.

Hamilton’s proposal is now technically dead because it did not survive a legislative deadline last week, though Moore warns that measures can always be revived by legislative leaders or poured into other legislative vehicles late into the session. But another measure, Senate Bill 518, is still alive. Introduced by Senator Julie Daniels, it would make it trickier to qualify a ballot initiative, doubling the time window for someone to challenge petitions and making it easier to invalidate signatures. The legislation would mandate that voters use their full legal name when signing a petition, raising the prospect that any misspellings, nicknames, or other deviations from a government ID could nullify their signatures.

Moore warns that this change would add to what he calls an “already totally bogus” verification process. Oklahoma officials drew complaints last year when they decided to outsource signature verification to a private vendor, claiming the authority to do so by invoking a new law, even if many legislators say they did not mean it to authorize outsourcing, The Journal Record reported last year

SB 518, which passed a Senate committee in February, is scheduled to be heard on the Senate floor on Wednesday morning. 

Daniels and Hamilton did not respond to requests for comment about their respective bills. 

Republicans nationwide have retaliated against popular initiatives they oppose by championing an avalanche of measures that make it far harder for organizers to gather signatures to get them on the ballot. In Oklahoma, voters approved a number of ballot measures in recent years that circumvented conservative lawmakers, including medical marijuana in 2018 and Medicaid expansion in 2020. 

SQ 820 won’t add to that list, however. Besides making marijuana more accessible in the state, the measure would have raised revenue off of a 15 percent excise tax on the sale of marijuana that would have funded public schools and addiction treatment programs.

The expungement provision would have given tens of thousands of people the option to clear their records, though it would not have made that process automatic. Last year, for convictions that were already eligible for expungement in Oklahoma (marijuana is not among those), the state adopted a “Clean Slate” law that will lift the need for people to file a burdensome petition for relief. 

Shade, of OK Justice Reform, helped champion that “Clean Slate” law, which he says did not modify the criteria as to which offenses are eligible to be expunged—it only made the existing process automatic. With SQ 820’s failure, he says, he hopes to persuade state politicians to pass a bill to at least allow marijuana convictions to be expunged, which at least some Republicans seem to be open to. “It’s my goal to reach out to stakeholders and begin figuring out what type of legislative success we have going after this,” he said.

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Maryland Inches Forward on Harm Reduction to Fight Overdoses https://boltsmag.org/maryland-harm-reduction/ Tue, 07 Mar 2023 16:42:26 +0000 https://boltsmag.org/?p=4402 Facing a brutal toll of overdose deaths, Maryland has in recent years put in place safe-supply services to promote healthier drug use. People can obtain syringes and needles through programs... Read More

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Facing a brutal toll of overdose deaths, Maryland has in recent years put in place safe-supply services to promote healthier drug use. People can obtain syringes and needles through programs where those are distributed, but only if they register with a state-sanctioned provider. 

The existence of these providers, authorized by a 2016 law, serves as a recognition by the state that promoting safer drug use can reduce one of the nation’s highest overdose mortality rates. Advocates for harm reduction have also warned lawmakers that this first step is far from adequate.

For one, the program has been embraced by leaders mostly in Maryland’s more urban counties, preserving barriers to safer drug use in rural areas. Even then, participants are only shielded from arrest and prosecution if they constantly carry a small card proving they’re registered in the program.

Otherwise, getting caught with a syringe or other tools to consume drugs in Maryland can lead to a felony charge and up to four years in prison; lesser paraphernalia charges can still carry hundreds of dollars in fines—not to mention collateral consequences associated with incarceration, court debt, and a criminal record. 

“We are calling it a health crisis on the one hand, but on the other we are treating it as a criminal offense,” Marguerite E. Lanaux, lead public defender in Baltimore, told Bolts

While over most of the past decade officials in Baltimore ruled out charging people for low-level drug offenses, the new state’s attorney rolled back those policies earlier this year, worrying local reformers about the future of prosecution in Maryland’s largest city.

Making people register with a government-sanctioned program to obtain safe supplies is no solution, said Harriet Smith, director of education and services at the Baltimore Harm Reduction Coalition, during her testimony at a statehouse hearing in February. “You can’t lose the card and you have to keep it on you at all times. You have to hope that the police officers in your area will trust that the code on the back of the card corresponds to you and not someone else,” Smith told state lawmakers. “I don’t know about y’all, but I lose business cards constantly—and I’m not experiencing homelessness. 

She added, “Requiring people to keep a tiny piece of paper and find it during a tense interaction with law enforcement interactions is unreasonable and a deterrent to taking part in this public health program.”

Smith and other harm reduction advocates had gathered at the state house to support House Bill 173, a proposal to lessen criminal penalties for drug paraphernalia. The bill proposes to cut maximum penalties for possession of “controlled paraphernalia”—defined in the bill as syringes, needles, gelatin capsules, glassine envelopes and various chemical agents meant to dilute or enhance drugs—down from four years to one, and from a $25,000 fine to a ceiling of $1,000. 

The bill also clarifies that such charges only apply to people manufacturing or selling drugs, as opposed to people who simply use them. However, Smith noted that the distinction is often blurry, since many who use drugs also sell them.

Sponsoring the paraphernalia bill is state Delegate David Moon, a Democrat and self-described civil libertarian who ran for office in part because he wanted to decriminalize drug use. Frustrated that in Maryland, and so much of the country, those working to treat substance use as a health issue and not a criminal one must settle for baby steps, Moon confesses that he believes his own bill doesn’t go far enough; he’d prefer total decriminalization of paraphernalia meant for drug use. 

“I need to get the votes to pass it,” Moon told Bolts. “Unraveling the drug war, unfortunately, does not move at the pace I would necessarily move at in our state.”

Even in more liberal states, people like Moon often find it painfully difficult to sell people in power on the concept of harm reduction, a broad set of strategies meant to help people who use drugs stay alive and as healthy as possible. Advocates say they don’t seek to enable drug use but rather to build a society more conducive to safety and addiction recovery.

The approach is backed by piles of research from all over the world: studies consistently show that providing safe drug-use supplies and safe places to consume drugs saves lives and prevents disease. Conversely, research shows that criminalization is ineffective—and in fact counterproductive—as a strategy to cut down on drug use and on overdose deaths.

“This is a health crisis. This is not a criminal justice or criminal legal crisis we’re in. Other countries get it and we just don’t,” Nicole Hanson-Mundell, who works on re-entry for formerly incarcerated people as executive director of the Maryland organization Out For Justice, told Bolts. “It’s incredibly harmful for this country and this state to continue this practice of incarceration as the only tool to teach a lesson or help someone understand or hand down a consequence. It’s really lazy policy.”

Smith said that in her experience, it’s not enough to present lawmakers with evidence of harm reduction’s public-health benefits.

“The lessons we grow up with, what we’re inculcated with in terms of the myths of drug use, those are just as strong as studies,” she said. 

Harm reduction has gained some traction in American halls of power and is even now endorsed by President Joe Biden, a leading architect of the country’s “war on drugs” while a U.S. senator. But groups working to make drug use safer remain chronically underfunded, and, as Moon has found, even the most modest legal reforms in this area can be heavy lifts.

Every state but Alaska criminalizes drug paraphernalia in some form. In a majority of U.S. states, life-saving fentanyl test strips remain illegal. (Maryland legalized them in 2018.)

Proposals to operate supervised drug-use sites have ignited political firestorms, even in some of the most progressive-leaning places in the country. Democratic California Governor Gavin Newsom last year vetoed a bill to allow supervised drug injection sites, and a 2019 effort to legalize those sites in Colorado flamed out right after launching and is only now being rebooted. Advocates in Maryland are hoping these sites will one day be legalized in the state, but their political path is far from clear.

Even the paraphernalia policy Moon himself calls inadequate has been stalling for years in Maryland. In 2021, a similar bill made it all the way to the desk of then-Governor Larry Hogan, a Republican who had signed the earlier bills to legalize test strips and to set up the syringe services, but Hogan vetoed it because, he said, it was “dangerous” and would facilitate drug use and sales.

“I’m on year nine doing this crap,” said Moon, who was first elected in 2014. “People die, and we fail to reduce intravenous disease transmission.”

Though the bill is not as ambitious as Moon would like, many regard it as an important step. HB173 is endorsed by a wide range of public health groups, among others, and Moon is confident it’ll pass the legislature, as it did last time. (The bill cleared the House on March 2 and now sits in the Senate.) Unlike Governor Hogan, new Maryland Governor Wes Moore, a Democrat, has been outspoken in support of alternatives to incarceration, and would be expected to sign the bill into law.

Lanaux, the public defender in Baltimore, said policymakers evaluating HB173 should consider the way paraphernalia possession is actually charged. It leaves no question as to whom this statute is meant to target, she said.

“At the end of the day, if paraphernalia is the charge, the person being charged is a user, not a dealer,” Lanaux told Bolts. “Dealers are charged with more serious offenses. So, this is not addressing drug dealing. It is punishing users.”

Lanaux and other public defenders told Bolts they believe that people in rural areas will continue to face disproportionate hurdles to safe use, even if Moon’s bill passes. In addition to the fact that most safe-supply providers are in the more populous counties of Maryland, the crisis of overdose deaths is a relatively fresh one in rural and suburban areas of the state; substance-use deaths have tripled, or more, in many places that a decade ago suffered only a handful of them every year. 

Smith said HB173 plays an important part in reducing stigma around drug use, particularly in areas where the overdose crisis is relatively new.

“I think it will mean that people are much more likely to grab supplies for their loved ones,” she said.

Baltimore has long been home to a plurality of substance-use deaths in the state, but prosecutors lately haven’t been as hard on people dealing with addiction. The state’s attorney in Baltimore for the past eight years, Marilyn Mosby, had adopted a presumptive do-not-prosecute approach to low-level offenses such as paraphernalia possession. 

“If you go to some of the outer counties, the ones further out are always going to continue to prosecute” for paraphernalia as long as the option remains, said Joshua Speert, acting district public defender for two counties west of Baltimore. “Other counties didn’t stop charging small theft or drug possession just because Baltimore did.” 

Ivan Bates, the new lead prosecutor of Baltimore who ousted Mosby in the summer of 2022, has reversed her approach. He announced earlier this year that he was rescinding Mosby’s policies of declining to charge some low-level cases and would instead ramp up the prosecution of “quality-of-life offenses.”

Bates’s office did not respond to a request for comment on how it will approach paraphernalia cases going forward in light of its opposition to declination.

Moon and others wish the state would simply eliminate the option of prosecuting paraphernalia possession by people dealing with addiction issues, and thereby start to create some parity among counties’ respective approaches to drug use and treatment.

“If it can be charged,” Speert said, “it’s gonna be charged.”

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With Marijuana Bill, Minnesota Democrats Seek to Repair Harms of War on Drugs https://boltsmag.org/with-marijuana-bill-minnesota-democrats-seek-to-repair-harms-of-war-on-drugs/ Fri, 20 Jan 2023 19:07:27 +0000 https://boltsmag.org/?p=4284 Minnesota’s Democratic lawmakers, newly in control of the state legislature, plan to legalize the recreational use and sale of cannabis this year. And they insist that in doing so they... Read More

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Minnesota’s Democratic lawmakers, newly in control of the state legislature, plan to legalize the recreational use and sale of cannabis this year. And they insist that in doing so they must account for past harm—namely, harm done by wildly uneven enforcement practices that made their state one of the most dangerous places in the country to be a Black person in possession of marijuana. 

“For me, it’s a racial justice issue. I wouldn’t support this without it,” state Senator Clare Oumou Verbeten, a lead sponsor of the legalization effort and one of just three Black women ever elected to the Minnesota Senate, told Bolts. “There’s the argument that people are already using cannabis, so let’s not criminalize them for it. Well, yes, but the people who have to live in fear are Black people. They’re impacted the most. We’re trying to right these wrongs.”

A recent nationwide report by the ACLU found that Black Minnesotans were more than five times more likely than white Minnesotans to be arrested for marijuana possession between 2010 and 2018, one of the highest racial disparities across all states. That’s but one example of longstanding systemic inequality that has earned Minnesota the nickname “Mississippi of the North.”

“We’re constantly at the top of these lists in terms of quality of life, best places to live,” Oumou Verbeten said. “It’s not true for people who look like me.”

This is why she and many other backers of Minnesota’s legalization effort want the state’s program to be as dedicated to racial and class justice as any in the country. While early adopters like Colorado waited years after legalization to adopt policy confronting the damage done by the war on drugs, Minnesota lawmakers seek to do that work upfront. 

Their legalization bill, House File 100, proposes to help marginalized communities gain footholds in the regulated recreational cannabis industry by giving them preferential access to business licenses. These licenses would be awarded based on a points system weighted in favor of the poor and those who can demonstrate personal or familial harm from cannabis prohibition.

The bill would also automatically expunge records of low-level cannabis convictions, including for petty misdemeanor and misdemeanor charges over the sale or possession of up to 42.5 grams of marijuana. These convictions can acutely inhibit social mobility by blocking people from stable housing and employment, and can, in some cases, plunge people into a prolonged morass of criminalization and poverty. 

Jon Geffen, a law professor and attorney with The Legal Revolution, a Minnesota nonprofit law firm, explained that prior conviction records are currently public in Minnesota. As a result, “you can use that data for anything you want: hiring, renting—hell, even dating if you want it. Whether or not it was weed it comes up as ‘drugs,’ and people rarely hire people with drug convictions. People lose jobs and apartments. Families separate because of these things.”

For some advocates, though, these equity provisions may be too little, too late for those affected by the war on drugs.


Many political leaders now cast equity as core to their legalization efforts, rather than a footnote to be addressed years after state industries ramp up. In New York, people with past marijuana convictions are being given a first crack at business licenses. In Maryland, new Governor Wes Moore, sworn in this week, has insisted the state’s soon-to-launch legal cannabis industry must prize social justice and “economic parity.” Like the regulated cannabis industry itself, this concept of licensing equity is a rather new one; Oakland pioneered it in 2017.

But these equity projects have rarely gone smoothly, or delivered their stated impacts. Some Oakland licensees feel that the city’s program has done them more harm than good. Lawsuits challenging cannabis equity provisions in places like Detroit, Maine and Missouri have slowed or thwarted progress

Also, even the most equity-minded cannabis legalization policies do little to repair certain harms. Giving people from overpoliced communities special access to cannabis dispensary or cultivation licenses, for instance, won’t change the fact that those people are less likely to have business ownership experience, professional mentorship, and investor networks—intangible assets that help sustain an operation. 

Angela Dawson, a northern Minnesota hemp farmer and a champion for agricultural opportunities for Black people, said the expungement plan laid out in Minnesota’s pending bill would do very little for people like her younger brother, whose marijuana conviction two decades ago threw him for a prolonged tailspin.

“He lost time in school, never graduated. He met up with some pretty bad people while he was in jail. He didn’t have an opportunity to do anything else,” Dawson told Bolts. “He just got out of prison in November.”

Clearing marijuana charges like his will be relatively easy for the state, policy experts in Minnesota say. But that can’t undo twenty-plus years of compounding challenges and lost time that stemmed from his first drug charge. 

“It shouldn’t cost you your whole entire future,” she said.

Oumou Verbeten acknowledged that this bill alone won’t unwind these longstanding harms. She said she hopes to pair the cannabis legislation with complementary bills to seal eviction records and to ban public employers from asking job applicants about their criminal histories. She is also sponsoring legislation that would restore voting rights to Minnesotans on parole and probation—a population that skews disproportionately Black, Native American, and Latino.

These and other bills are viable in large part because Minnesota’s Democratic-Farmer-Labor Party flipped the state Senate in November, claiming full control of the state government for the first time since 2014. 

The state House passed legislation in 2021 to legalize cannabis but the bill fizzled in the state Senate, which was then under control of Republicans. (One GOP leader at the time said there was “zero chance” his party would go along.)  Minnesota politicos believe it’s nearly assured to pass this time around, though its final form may be several months and about a dozen more committee hearings away.

But now that they have a trifecta, Democrats see marijuana legalization as a headlining bill in a legislative session that is also poised to see Minnesota lawmakers codify abortion rights, advance paid family and medical leave, and seek to expand voting access.

A recent poll, conducted by Mason-Dixon, shows a slim majority of overall Minnesotans—and a wide majority of non-white Minnesotans—back cannabis legalization. The country at large favors it, too, and strongly supports expungement of cannabis convictions.  


The specific design of the major equity portions of this year’s legalization bill in Minnesota are getting mixed reviews from criminal justice reform and racial justice advocates.

On expungements, “the framework of it is pretty darn good,” Geffen said. He noted that the bill would make expungements automatic and free, a measure that MinnPost estimates would affect some 50,000 people with criminal records.

The state already accepts petitions for expungement, in a process that is anything but user-friendly. He described it as a winding road with all sorts of obstacles over which even his law students regularly trip. Any mistake along the way can lead a court to toss a petition, with no way for the applicant to recoup the $305 the state requires for every charge one seeks to expunge.

“So the populations that don’t use it are poor populations. It’s a double whammy, where poor people are over-prosecuted, over-charged, and then they don’t get expunged, even when they’re eligible, because they don’t have the money to pay an attorney,” Geffen told Bolts.

Tom Gallagher, a Hennepin County (Minneapolis) criminal defense attorney and libertarian advocate for legalized cannabis, wishes the bill went further by categorically granting gun ownership rights back to people who lost those rights because of felony drug convictions. He doesn’t expect liberal lawmakers to restore gun rights through this bill, but he argues they should, in order to thwart the cycle of criminality that drug prohibition can catalyze. 

“Let’s say you’re 19 years old and you get convicted of possessing two ounces of marijuana. Now, 10 years later, you get caught with a gun in your house, but now you’re an ineligible person in possession of a firearm, and you’re looking at a minimum of 3 years in prison in Minnesota,” Gallagher told Bolts. “It’s purely the status of the person in possession of the gun that makes the crime.”

The bill’s second core equity provision—licensing equity—also faces questions as to its scope and implementation.

The state has had a regulated medical marijuana industry for seven years, and, at present, that entire sector is controlled by one of two corporations,.

The new legislation contains provisions meant to chart a more equitable path for the recreational cannabis industry by requiring that the state substantially favor cannabis business license applications from so-called “social equity” applicants—that is, residents for at least five years in areas “that experienced a disproportionately large amount of cannabis enforcement,” as determined by a state report not yet produced. People could also qualify for “social equity” status in business licensing if they live in areas with poverty rates of 20 percent or more, or where the median family income does not exceed 80 percent of the statewide mark.

Oumou Verbeten said the idea, transparently, is to give a boost to Black and Latino would-be businesspeople, but that it’d be thorny, and possibly illegal, to legislate in explicit favor of one or more racial groups over others.

“If you look at concentrated places of poverty and overlay that with racial demographics, then, yes, a lot of those areas are where we’re going to see communities of color,” Oumou Verbeten said. “We want to make sure people who’ve been harmed get the priority. And those are people of color, and Black Minnesotans especially.”

This goal is easier stated than accomplished, Black leaders in Colorado’s cannabis industry told Bolts. Boosting an application is much easier and cheaper, after all, than providing sustained training and financial support needed to get a cannabis business up and running. 

And that’s leaving aside headwinds that these businesses face in the market; existing federal prohibition cuts off cannabis operators from the tools other industries enjoy, like basic inclusion in banking systems, or loans and guidance from the Small Business Administration.

“In trying to bend ourselves into equity and things that make right, basically the entire industry is failing top to bottom,” Denver entrepreneur Wanda James told Bolts. For years she was the only Black cannabis business owner in Colorado, among hundreds of businesses; now, she says, she’s one of a few.

“The really sad thing is we are setting up Black and brown entrepreneurs for a massive failure. And at that point of massive failure, they don’t even have bankruptcy protection,” because cannabis remains illegal federally, James added.

She said Colorado and other states can do much better in providing support to licensees and those harmed in the war on drugs, but she said she’s skeptical policymakers can ever truly legislate out the impediments to equity that she and others trace to federal prohibition.

Jeff Brinkman, a Minnesota hemp entrepreneur, is also concerned that the state will not adopt enough legal protections on how licenses can be transferred from one business to another. “I just feel that as the bill is developed and revamped, if they aren’t keeping their eye in the loopholes and on how to build this industry for small business, that’s when we’ll get the takeover” by wealthy interests. 

When “social equity” licensees fail to launch, policymakers are given cover to say, “See, we tried and it failed,” Hashim Coates, executive director of Black Brown and Red Badged, an organization representing Black and Latino business owners in the cannabis industry, told Bolts.

“Just creating an opportunity without the intention of success is not creating an opportunity,” he added. 

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Wins and Losses for State Referendums to Legalize Weed and Psychedelics https://boltsmag.org/wins-and-losses-for-drug-reform-referendums/ Wed, 09 Nov 2022 16:20:06 +0000 https://boltsmag.org/?p=3990 Drug policy reformers saw mixed results on Tuesday with victories in three states, and rejected legalization efforts in three others. Voters in Maryland and Missouri supported proposals to allow for... Read More

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Drug policy reformers saw mixed results on Tuesday with victories in three states, and rejected legalization efforts in three others.

Voters in Maryland and Missouri supported proposals to allow for the regulated sale of marijuana for non-medical purposes, joining 19 other U.S. states that have already done so. However, similar proposals in Arkansas, North Dakota and South Dakota all were shot down by comfortable margins.

Also, ten years to the week since Colorado and Oregon became the first two states to legalize recreational pot, Colorado voters are poised to approve a measure that removes criminal penalties for use, possession and home-grow of psilocybin (“magic mushrooms”) and some other psychoactive substances. Oregon went first on this front, passing a ballot measure decriminalizing those substances in 2020. 

“The more public dialogue there is on drug policy issues, the more sensible the policy outcomes are,” said Mason Tvert, a policy expert and industry advocate who co-directed Colorado’s landmark 2012 campaign to legalize non-medical cannabis use. 

“As we saw in North Dakota, South Dakota and Arkansas, there’s still a lot of work to be done. Most people alive right now have lived the vast majority of their lives in a world where cannabis was entirely illegal, and where they were hearing anti-cannabis propaganda. It’s not surprising that there are still voters with concerns. … But the writing’s on the wall.”

Underscoring Tvert’s point is the fact that even President Joe Biden, who has been a dedicated soldier in America’s war on drugs, is coming around. Last month he ordered a federal review of marijuana’s classification as a “Schedule 1” substance, defined as having “no currently accepted medical use and a high potential for abuse,” and he pardoned thousands of people convicted federally and in the District of Columbia for marijuana possession.

The marijuana map is diversifying rapidly in the U.S., as the issue is no longer a project only of progressive advocates for drug policy reform. Missouri, which approved its cannabis measure by six percentage points as of Wednesday morning, went for Donald Trump by at least 15 points in the 2020 presidential election. Maryland, which went for Biden by 33 points and approved its cannabis measure by about 30 points on Tuesday, was the bluest state in the country that had yet to legalize recreational marijuana.

The Missouri and Maryland measures were the only two of Tuesday’s five state-level marijuana initiatives to allow for record expungement by people previously convicted of marijuana-related activities that have now been legalized by voters. These states will now automatically expunge records for certain people, and make others fill out petitions. Missouri’s approach to prior convictions has been especially controversial, as some reformers fear it won’t be as effective in practice as on paper. The chair of the Legislative Black Caucus, plus some prominent cannabis advocates, came out against the ballot measure.

It’s relatively new that marijuana ballot measures would take this issue on at all. A decade ago, the reformist initiatives were focused squarely on the question of whether or not to legalize, and left questions of social equity, record expungement, banking and more for later on. 

“What’s happening now is there’s a far more detailed discussion taking place,” Tvert said. “There’s this growing sense that it’s inevitable that it will be legal, and so what should the details be?”

The two Dakotas took opposite paths to the same result this year. North Dakotans overwhelmingly rejected legal marijuana just four years ago, voting down a measure that, unlike this year’s, would have allowed for some record expungement. The previous North Dakota measure lost by 19 percentage points, while this year’s was losing by just 10 as of Wednesday morning. 

Fifty-four percent of South Dakota voters supported legal marijuana just two years ago, but after a lawsuit championed by Republican Governor Kristi Noem, who won reelection Tuesday, the state supreme court invalidated that measure. Given a chance to vote again on the issue, South Dakotans rejected it by a six-point margin.

The Arkansas measure looked little like the other four on the ballot this year, prohibiting home-grow of marijuana plants and placing a hard cap on cultivation and dispensary permits. More exclusive markets can perpetuate race and class disparity in who has access to the substance, and who is policed over it.

Market exclusivity was of chief concern to many who opposed Colorado’s ballot measure on psychedelics. Among these opponents were some of the organizers who pushed successfully for a 2019 Denver reform to decriminalize psilocybin mushrooms. They argued this year’s statewide measure, which allows for sale of approved psychedelics only by licensed providers, will benefit a small group of profit-seeking interests. “It’s opening the floodgates for corporations to come to Colorado to open their bougie life and healing centers,” one advocate who worked on the 2019 effort told The Denver Post

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