{"id":699,"date":"2018-07-11T15:55:25","date_gmt":"2018-07-11T19:55:25","guid":{"rendered":"https:\/\/sites.bu.edu\/dome\/?p=699"},"modified":"2018-07-11T15:55:25","modified_gmt":"2018-07-11T19:55:25","slug":"massachusetts-death-by-dealer-bill-is-the-wrong-opioid-policy","status":"publish","type":"post","link":"https:\/\/sites.bu.edu\/dome\/2018\/07\/11\/massachusetts-death-by-dealer-bill-is-the-wrong-opioid-policy\/","title":{"rendered":"Massachusetts&#8217; &#8220;Death By Dealer&#8221; Bill is the Wrong Opioid Policy"},"content":{"rendered":"<p>On January 30, 2018, the Massachusetts Joint Committee on the Judiciary heard testimony on <a href=\"https:\/\/malegislature.gov\/Bills\/190\/S2158\/BillHistory\"><span>S. <\/span>2158<\/a>, An Act Updating Laws Relating to Dangerous Drugs and Protecting Witnesses. Despite its relatively innocuous title, the bill, proposed by Governor Charlie Baker, represents a substantial scaling up of the War on Drugs in the Commonwealth.<\/p>\n<p>Like many other states, Massachusetts is in the midst of a <a href=\"http:\/\/www.mass.gov\/chapter55\/\">public health crisis<\/a>. The opioid-related death rate in the state has surpassed the national average, with a <a href=\"https:\/\/www.mass.gov\/files\/documents\/2017\/08\/31\/data-brief-overdose-deaths-aug-2017.pdf\"><span>nineteen percent increase<\/span><\/a> in overdose deaths between 2015 and 2016. In addition, three-quarters of opioid-related deaths in 2016 <a href=\"https:\/\/www.bostonglobe.com\/metro\/2017\/02\/17\/nearly-died-from-overdoses-mass-last-year\/NdvnkZUYTQlCONAChnIivN\/story.html\"><span>involved fentanyl<\/span><\/a>, a synthetic opioid that is roughly 50 times more potent than street heroin. As opioid overdoses decimate local communities, officials are understandably investigating ways to curb the epidemic, and one solution, to which <a href=\"https:\/\/www.deseretnews.com\/article\/900011600\/utah-lawmakers-consider-new-crime-for-drug-induced-homicide.html\">legislatures<\/a> <a href=\"https:\/\/www.usnews.com\/news\/best-states\/rhode-island\/articles\/2018-03-01\/proposed-law-could-define-drug-induced-homicide-as-murder\">are<\/a> <a href=\"http:\/\/www.kslegislature.org\/li_2014\/b2013_14\/measures\/hb2044\/\">increasingly<\/a> <a href=\"http:\/\/www.miamiherald.com\/news\/local\/crime\/article136809238.html\">turning<\/a>, entails drastically increasing punishment for drug crimes that result in death.<\/p>\n<p><a href=\"\/dome\/files\/2018\/03\/opioid-1.jpg\"><img loading=\"lazy\" src=\"\/dome\/files\/2018\/03\/opioid-1-636x382.jpg\" alt=\"\" width=\"376\" height=\"226\" class=\"wp-image-564 alignleft\" srcset=\"https:\/\/sites.bu.edu\/dome\/files\/2018\/03\/opioid-1-636x382.jpg 636w, https:\/\/sites.bu.edu\/dome\/files\/2018\/03\/opioid-1-768x461.jpg 768w, https:\/\/sites.bu.edu\/dome\/files\/2018\/03\/opioid-1-1024x614.jpg 1024w, https:\/\/sites.bu.edu\/dome\/files\/2018\/03\/opioid-1.jpg 1200w\" sizes=\"(max-width: 376px) 100vw, 376px\" \/><\/a>For decades, federal prosecutors have been able to pursue stringent penalties in cases of \u201cdeath by dealer.\u201d Passed by Congress in 1988 in response to the highly publicized death of a <a href=\"https:\/\/en.wikipedia.org\/wiki\/Len_Bias\"><span>University of Maryland basketball star<\/span><\/a> who overdosed on cocaine just days after being drafted by the Boston Celtics, the so-called <a href=\"https:\/\/www.congress.gov\/bill\/100th-congress\/house-bill\/05210\"><span>\u201cLen Bias\u201d law<\/span><\/a> sets mandatory minimum sentences for selling drugs that lead to another person\u2019s death. More recently, twenty states have adopted analogous laws, and several others have \u201cMcGyvered\u201d existing homicide statutes\u2014e.g., <a href=\"https:\/\/www.leagle.com\/decision\/2006724189sw3d5351717\">reckless homicide<\/a> and <a href=\"https:\/\/www.leagle.com\/decision\/2001682544se2d1381674\">felony murder<\/a>\u2014to prosecute the same offense. With Governor Baker\u2019s bill, Massachusetts joins a number of <a href=\"http:\/\/mgaleg.maryland.gov\/2017RS\/bills\/hb\/hb0687f.pdf\">additional<\/a> <a href=\"https:\/\/www.cga.ct.gov\/asp\/cgabillstatus\/cgabillstatus.asp?selBillType=Bill&amp;bill_num=HB05367&amp;which_year=2017\">states<\/a> with pending legislation that would allow prosecutors to charge drug sellers with murder or manslaughter.<\/p>\n<p>While these laws may seem like a good idea at first\u2014as a way to cripple the organized drug trade and to give prosecutors new tools to attack upper echelon drug traffickers\u2014the criminalization of accidental overdose has a number of possible unintended consequences. Massachusetts legislators should carefully consider these effects that may backfire and exacerbate an already dire situation.<\/p>\n<p>Although <a href=\"https:\/\/www.cnn.com\/2014\/03\/11\/justice\/new-jersey-overdose-laws\/\">proponents argue<\/a> that drug-induced homicide law will prevent future drug trafficking, there is <a href=\"http:\/\/www.journals.uchicago.edu\/doi\/abs\/10.1086\/599368\"><span>broad consensus<\/span><\/a> that harsh sentences have minimal, if any, deterrent effect. Contrary to conventional wisdom, <a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1745-9125.2010.00189.x\/abstract\"><span>studies<\/span><\/a> have <a href=\"https:\/\/www.ussc.gov\/research\/research-reports\/recidivism-among-federal-drug-trafficking-offenders\"><span>found<\/span><\/a> that, among individuals facing drug-related charges, variations in prison and probation time have no impact on recidivism rates. The focus on supply reduction also seems misplaced: <a href=\"http:\/\/www.ccjrc.org\/wp-content\/uploads\/2016\/02\/Correctional_and_Sentencing_Reform_for_Drug_Offenders.pdf\"><span>many studies<\/span><\/a> suggest that market demand for drugs drives a continuous \u201creplacement effect,\u201d such that incarcerating drug dealers simply \u201copen[s] the market for another seller.\u201d Instead, such policies may inadvertently <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0955395911000223\"><span>increase<\/span><\/a> drug-related violence and lead to dangerous fluctuations in the contents of street drugs.<\/p>\n<p>Drug-induced homicide laws also risk undermining Good Samaritan policies. As overdose deaths skyrocket, <a href=\"http:\/\/pdaps.org\/datasets\/good-samaritan-overdose-laws-1501695153\"><span>37 states<\/span><\/a>, including Massachusetts, have enacted laws to reduce the legal barriers to calling 911 in the event of an emergency. Most of the laws are limited to drug possession, however; they do not encompass drug selling or homicide. Although popular imagination places drug users and drug sellers in separate buckets, reality proves far <a href=\"http:\/\/america.aljazeera.com\/articles\/2016\/2\/16\/a-blurry-line-divides-addicts-and-dealers-in-heroin-underworld.html\"><span>blurrier<\/span><\/a>: drug users frequently participate in the supply side of the market\u2014whether by actively selling drugs or by helping in some way, such as acting as a lookout\u2014in order to support their habits. Ostensibly intended to prosecute high-level drug suppliers, in practice, these statutes often ensnare <a href=\"https:\/\/www.courtlistener.com\/opinion\/1958893\/state-v-ervin\/\"><span>family<\/span><\/a>, <a href=\"https:\/\/www.leagle.com\/decision\/1994673137nj5361295\"><span>friends<\/span><\/a>, and acquaintances who supplied the drugs and who themselves may have a substance use disorder. <a href=\"https:\/\/www.drugpolicy.org\/sites\/default\/files\/dpa_drug_induced_homicide_report_0.pdf\"><span>In Wisconsin<\/span><\/a>, an analysis of the 100 most recent drug-induced homicide prosecutions found that \u201cnearly 90% of those charged were friends or relatives of the person who died, or people low in the supply chain who were often selling to support their own drug use.\u201d<\/p>\n<p>While prosecutors <a href=\"https:\/\/www.wbez.org\/shows\/wbez-news\/dupage-county-tries-to-keep-drug-users-out-of-jail\/cffee4c1-ef83-4252-96d0-43c47e399db1\"><span>talk<\/span><\/a> about \u201caggressively prosecuting those people that peddle the poison in our community,\u201d users counter that \u201cevery drug-induced homicide charge that is made sends a ripple through the using community to not call 911 and might result in somebody else&#8217;s death.\u201d In fact, <a href=\"https:\/\/www.cnn.com\/2014\/03\/11\/justice\/new-jersey-overdose-laws\/\">a recent study<\/a> found that a majority of surveyed drug users feared calling 911 during an overdose due to concerns about criminal repercussions. Overall, then, treating overdose deaths as crime scenes and prosecuting overdose witnesses as perpetrators of murder or manslaughter limits the potential benefits of Good Samaritan legislation and other efforts to reduce overdose deaths.<\/p>\n<p>Finally, punitive approaches, which place the blame for overdose deaths on drug sellers, focuses on the wrong problem. Criminal sanctions have the benefit of immediate visibility\u2014they make it appear to constituents that policy makers are <em>doing something<\/em>. Public health approaches, on the other hand, are virtually invisible because, if successful, the harms that they target will never materialize. This <a href=\"https:\/\/academic.oup.com\/ije\/article\/14\/1\/32\/694724\"><span>\u201cprevention paradox\u201d<\/span><\/a> often leads policy makers towards individualized, instantly tangible solutions to complex problems such as drug-induced homicide laws.<\/p>\n<figure id=\"attachment_112\" aria-describedby=\"caption-attachment-112\" style=\"width: 262px\" class=\"wp-caption alignright\"><a href=\"\/dome\/files\/2015\/03\/dome-boston.png\"><img loading=\"lazy\" src=\"\/dome\/files\/2015\/03\/dome-boston.png\" alt=\"\" width=\"252\" height=\"344\" class=\" wp-image-112\" \/><\/a><figcaption id=\"caption-attachment-112\" class=\"wp-caption-text\">The Massachusetts State House<br \/>Boston, 1787<\/figcaption><\/figure>\n<p>The opioid crisis is, fundamentally, a structural issue, rooted in <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/9143635\"><span>poverty<\/span><\/a>, <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28817333\"><span>lack of opportunity<\/span><\/a>, and <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28182980\"><span>social isolation<\/span><\/a>. Structural issues require structural solutions. Legislators are understandably grabbing at any and every straw to quell what seems like an intractable problem, but, at a time when much of the country seems poised to approach problematic substance use as a health issue, rather than a criminal one, it is critically important that Massachusetts policy makers carefully consider the ways in which S. 2158\u2019s drug-induced homicide provision might backfire.<\/p>\n<p>Rather than focusing on misguided \u201cquick fixes\u201d that further criminalize vulnerable populations, legislators should, instead, redirect their energies towards public health strategies with demonstrated effectiveness in reducing fatal overdoses. These include implementing comprehensive, <a href=\"https:\/\/www.annualreviews.org\/doi\/full\/10.1146\/annurev-publhealth-031914-122957?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub%3Dpubmed\">evidence-based addiction prevention initiatives<\/a>; increasing <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3864124\/pdf\/nihms494464.pdf\">overdose education<\/a> and <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4004504\/\">naloxone access<\/a>; promoting the use of <a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMp1402780\">medication-assisted treatment<\/a> for opioid use disorders; and expanding and <a href=\"http:\/\/harvardlpr.com\/wp-content\/uploads\/2017\/07\/Blake.pdf\">maintaining insurance coverage<\/a> for addiction treatment. The United States has been trying to arrest its way out of substance use and addiction for decades, and today\u2019s crisis attests to the futility of that approach. If our policy makers are serious about ending the opioid epidemic in the Commonwealth, they need to shift their focus from policing and prisons to people and public health.<\/p>\n<p><a href=\"\/dome\/files\/2018\/07\/1531250796.jpeg\"><img loading=\"lazy\" src=\"\/dome\/files\/2018\/07\/1531250796.jpeg\" alt=\"\" width=\"103\" height=\"114\" class=\"wp-image-710 alignleft\" \/><\/a><strong>Alexandra Arnold<\/strong> anticipates graduating Boston University School of Law in May 2019.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>On January 30, 2018, the Massachusetts Joint Committee on the Judiciary heard testimony on S. 2158, An Act Updating Laws Relating to Dangerous Drugs and Protecting Witnesses. Despite its relatively innocuous title, the bill, proposed by Governor Charlie Baker, represents a substantial scaling up of the War on Drugs in the Commonwealth. Like many other [&hellip;]<\/p>\n","protected":false},"author":15016,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,5],"tags":[171,23,109,169,167,170,22,75,168],"_links":{"self":[{"href":"https:\/\/sites.bu.edu\/dome\/wp-json\/wp\/v2\/posts\/699"}],"collection":[{"href":"https:\/\/sites.bu.edu\/dome\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sites.bu.edu\/dome\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sites.bu.edu\/dome\/wp-json\/wp\/v2\/users\/15016"}],"replies":[{"embeddable":true,"href":"https:\/\/sites.bu.edu\/dome\/wp-json\/wp\/v2\/comments?post=699"}],"version-history":[{"count":5,"href":"https:\/\/sites.bu.edu\/dome\/wp-json\/wp\/v2\/posts\/699\/revisions"}],"predecessor-version":[{"id":752,"href":"https:\/\/sites.bu.edu\/dome\/wp-json\/wp\/v2\/posts\/699\/revisions\/752"}],"wp:attachment":[{"href":"https:\/\/sites.bu.edu\/dome\/wp-json\/wp\/v2\/media?parent=699"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sites.bu.edu\/dome\/wp-json\/wp\/v2\/categories?post=699"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sites.bu.edu\/dome\/wp-json\/wp\/v2\/tags?post=699"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}