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For decades, the US has relied on criminalisation, incarcerating individuals for drug possession rather than offering medical support. This produced dangerous, unregulated drug supplies where contamination and overdoses are common. Fear of arrest discourages people from seeking urgent care, worsening preventable deaths and the spread of HIV and Hepatitis C. Framing drug use as a crime also obscures the underlying issues of poverty, homelessness, and poor mental health care.
Decriminalisation offers a different path by treating drug use as a health issue rather than a crime. In 2001, Portugal decriminalised possession of all drugs for personal use, shifting the response from punishment to health-based interventions. By 2018, heroin use had fallen by 75%, HIV infections linked to drug use dropped 90%, and overdose deaths became the lowest in Western Europe (Shea, 2023). Portugal shows that when governments focus on health instead of punishment, outcomes improved dramatically.
The US crisis, however, is not only about health but also about race. Black Americans make up 13% of the population yet nearly one-third of drug arrests (NAACP, 2022). From anti-opium laws targeting Chinese immigrants to Nixon’s 1971 “War on Drugs,” drug policies have consistently reinforced racial hierarchies, destabilising families and perpetuating poverty across generations.
Legalisation may be the long-term goal, but the urgent first step is decriminalisation. By removing criminal penalties, the US can reduce overdoses, expand healthcare access, and begin repairing the racial injustices embedded within drug policy. A shift from punishment to care would redirect resources toward treatment, housing, and education, building a society that values health, dignity, and equity over control.
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