Harsh Penalties for Drug Possession Negatively Impact HIV Treatment, Prevention

By Paul Gaita 05/25/17
"We must understand that punitive laws have neither decreased the supply or the use of drugs and have caused adverse health outcomes."
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Attorney General Jeff Sessions
Attorney General Jeff Sessions' push for harsher punishments for non-violent offenders will have an adverse effect on HIV treatment and prevention. Photo via YouTube

As Attorney General Jeff Sessions seeks to revive the War on Drugs by bringing back harsh mandatory minimum sentencing for non-violent drug offenders, a new review of published scientific material has found that such penalties for drug possession have a deleterious effect on efforts to treat individuals with HIV and prevent the spread of the disease among drug users.

The review, published May 14 in The Lancet HIV, analyzed more than 100 studies that looked at the impact of criminalization of people who inject drugs (PWID) such as heroin, and found that more than 80% of the studies showed "worse health outcomes" among that demographic when threatened with incarceration. The authors conclude that alternative policies would be a more effective means of prevention.

The review, conducted by researchers at the Johns Hopkins Bloomberg School of Public Health and the University of British Columbia, examined 106 peer-reviewed studies published between January 2006 and December 2014, all of which examined the link between criminalization of drug use and HIV prevention and treatment.

The studies, which ranged from randomized controlled trials to qualitative and mathematical modeling studies, determined more than 100 indicators—or evidence that a certain condition exists—of criminalization, as well as 150 indicators for HIV among PWID, including syringe-sharing.

Upon tallying the information, the researchers found that 91 of the 106 studies suggested that criminalization had a negative effect on treatment and prevention of HIV through a variety of means—from stigmatizing treatment for fear of incarceration to discouraging alternative programs like needle exchanges and safe use facilities.

Fifteen of the studies suggested no association between criminalization, while six posited that there was a beneficial element to criminalization and HIV treatment and prevention. But study lead author Stefan Baral, MD, of the Bloomberg School, noted that the latter studies showed only a small benefit and made weak arguments for their case. 

"We must understand that punitive laws have neither decreased the supply or the use of drugs and have caused adverse health outcomes," said Baral. "The current approach is not working. People have addiction and they have nowhere to turn. They are getting HIV and hepatitis C because they are sharing dirty needles. They end up in jail or the emergency room or worse. We are at a turning point with a massive increase in the number of people using opioids and there seems to be no end in sight."

Worldwide statistics suggest that between 11 and 22 million people use IV drugs, and about 13% of PWID are believed to be living with HIV.

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, Amazon.com and The Los Angeles Beat, among many other publications and websites. 

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