In 1971, President Nixon declared a war on drugs. Estimates on the cost of this war range from $1-2.5 trillion in the last 46 years. Despite this, drug use disorders have lured people into jail cells and caskets at an ever increasing rate. After nearly five decades, it is difficult to ignore the fact that the “war on drugs” has been a complete failure. 

Additionally, the war on drugs has made it impossible for the United States to fund needle-exchange programs on a federal level. As early as 1998, the Department of Health and Human Services conclusively stated that needle-sharing programs are associated with decreased incidence of HIV and hepatitis C that is attributable to IV drug use.

The Centers for Disease Control and Prevention, the World Health Organization and the National Institutes of Health likewise endorsed this intervention in the 1990s, followed by the American Medical Association in 2000. We lag miserably behind countries like Canada, Brazil, and the UK in this regard, meanwhile, our rates of HIV and Hepatitis C continue to climb.

The drug enforcement approach to substance abuse has exacerbated the issue in several ways. Addiction in jail is like bacteria in Petri dishes- the conditions are ideal for the proliferation of the disease.

The Journal of Addiction Science and Clinical Practice Criminalized reported in 2012 that "in prisoners released in Washington State, overdose mortality rates were 12-fold higher than what would be expected in similar demographic groups in the general population.” Similar statistics can be sited across the board. Addicts finish their sentences with more connections in the drug world, dismal opportunities for employment, and a label and often don’t know where else to turn.

 Research shows that shame is one of the primary psychosocial contributors to addiction. It’s sobering to think of the shame distributed by the war on drugs. Policies intended to eradicate drug use in the United States have instead created a war on addicts. The stigma of addiction is beginning to dissolve, but it’s going to take more than billboards to reverse five decades of government endorsed alienation. 

With all of these issues glaringly obvious, the American Public Health Association (APHA) has called for a new approach to the substance use epidemic: a health approach. Some key elements of this approach include:

1. Critical reviews of drug policies by experts in social work, public health, medicine, drug treatment, law enforcement and even former and current drug users. APHA urges that policies by altered in such a way that drug treatment and harm reduction programs can be expanded. 
2. Increased federal funding for effective treatment modalities that are currently in place. 
3. Deprioritizing funding of drug enforcement entities that are non-health related, such that individuals are cared for by health interventions rather than criminal justice. 
4. Encouraging resources of the Affordable Care act to be redirected to include addiction rehabilitation. 
5. Eliminating federal and state criminal penalties for personal drug use and possession, barring circumstances that endanger the lives of others. 

These changes in policy would cause a dramatic shift in our response to drug use and abuse on a governmental, cultural, and even on an interpersonal level. 

Often, policies and statistics can make us forget the narratives that make up the story of the addiction epidemic. Beneath the surface of the court rulings and census reports are lives ruined and lives lost. There are tears, failure, relapse, funerals, and broken families. By encouraging changes in policy, we can turn a war on addicts into a war on addiction.