Transforming Drug Laws in the United States: From Retributive to Restorative Justice


"Because incarceration does little to reduce the harms that ever-present drugs cause to our society, a harm reduction approach favors treatment of drug addiction by health care professionals over incarceration in the penal system." from the Drug Policy Alliance Network.

Harm Reduction

(*Note-All information on this page is taken directly from
Harm reduction is a public health philosophy that seeks to lessen the dangers that drug abuse and our drug policies cause to society. A harm reduction strategy is a comprehensive approach to drug abuse and drug policy. Harm reduction's complexity lends to its misperception as a drug legalization tool.

Harm reduction rests on several basic assumptions. A basic tenet of harm reduction is that there has never been, is not now, and never will be a drug-free society.

A harm reduction approach acknowledges that there is no ultimate solution to the problem of drugs in a free society, and that many different interventions may work. Those interventions should be based on science, compassion, health and human rights.

A harm reduction strategy demands new outcome measurements. Whereas the success of current drug policies is primarily measured by the change in use rates, the success of a harm reduction strategy is measured by the change in rates of death, disease, crime and suffering.

A harm reduction approach advocates lessening the harms of drugs through education, prevention, and treatment.

Harm reduction seeks to reduce the harms of drug policies dependent on an over-emphasis on interdiction, such as arrest, incarceration, establishment of a felony record, lack of treatment, lack of adequate information about drugs, the expansion of military source control intervention efforts in other countries, and intrusion on personal freedoms.

Harm reduction also seeks to reduce the harms caused by an over-emphasis on prohibition, such as increased purity, black market adulterants, black market sale to minors, and black market crime.

A harm reduction strategy seeks to protect youth from the dangers of drugs by offering factual, science-based drug education and eliminating youth's black market exposure to drugs.

Finally, harm reduction seeks to restore basic human dignity to dealing with the disease of addiction.

Harm Reduction Strategies

Maintenance Therapies
The basic rationale is that of harm reduction: if some people are unable to quit using drugs, both users and society at large benefit if these users, i.e., addicts, are able to switch from "black market" drugs of indeterminate quality, purity and potency to legal drugs, of known purity and potency, obtained from physicians, pharmacies and other legal channels.  The risks of overdoses and other medical complications decline; the motivation and need for addicts to commit crimes to support their habits drop; addicts are more likely to maintain contact with drug treatment and other services, and more able and likely to stabilize their lives and become productive citizens.  In the United States, morphine maintenance clinics proliferated during the first two decades of this century, before being closed under pressure by law enforcement authorities. 

Maintenance therapies made a comeback in the U.S. during the mid-1960’s with the advent of methadone, a synthetic morphine substitute discovered by German scientists during World War II.  Methadone maintenance is now widely regarded as the most effective known treatment for heroin addiction. Used properly, methadone reduces drug use and related crime, death, and disease among heroin users.  But methadone has been handicapped by restrictive government regulations, by misinformation - among treatment providers and drug users alike - and by prejudice against methadone treatment.  Methadone is the most tightly restricted drug in the U.S.  Doctors in general medical practice can't prescribe methadone, and regular pharmacies don't distribute it.

The most dramatic development in drug substitution and maintenance is now underway in Switzerland.  On July 10, 1997, the government announced the results of a three-year experiment in which 800 heroin addicts were maintained on legal prescriptions of heroin, and a much smaller number on injectable morphine and methadone.  The promising results of the Swiss trials have led to ongoing pilot projects involving heroin maintenance in Germany, Spain and the Netherlands.  In December 2002, theCanadian House of Commons Special Committee on Non-Medical Use of Drugs called for “proposed clinical trials pilot project in Vancouver, Toronto and Montreal to test the effectiveness of heroin-assisted treatment for drug-dependent individuals resistant to other forms of treatment.”  In Australia two phases of a proposal to initiate a heroin prescription experiment in the Australian Capital Territory (Canberra) were approved in late July, 1997, but continue to face strong opposition from some members of the government.

Needle Exchange Programs

Increasing sterile syringe availability through needle exchange programs, pharmacy sales, and physician prescription reduces needle sharing among injection drug users, which decreases transmission of HIV/AIDS and hepatitis.  Needle exchange programs and pharmacy sale of syringes have also been shown to increase safe disposal of used syringes.  In addition, these programs provide injection drug users with referrals to drug treatment, detoxification, social services, and primary health care.Injection drug use is associated with a high risk of infection by blood-borne diseases such as HIV and hepatitis C.  Since the AIDS epidemic began, 34% of all reported cases in the United States have been among injection drug users and their sexual partners. Up to 75% of new AIDS cases among women and children are directly or indirectly a consequence of injection drug use. Zero-tolerance drug policies, which in many states criminalize both the possession of syringes and the distribution of sterile syringes, exacerbate the problem. These policies result in the re-use and sharing of contaminated syringes, spreading blood-borne diseases and creating poor health conditions.

There are currently 185 needle exchange programs operating in 36 states as well as Washington D.C., Puerto Rico, and Native American lands.  However, the legality of the programs often depends on a county-by-county certification of a State of Emergency that must be regularly renewed. (As of May 22, 2006).

Non-prescription, over-the-counter sale of syringes has recently expanded to include almost all of the United States. Only four states (Delaware, Massachusetts, Pennsylvania, and New Jersey) still require prescriptions to purchase syringes. States have taken several different approaches to revising their policies so that syringes can be sold without a prescription, including exempting syringes from paraphernalia laws and broadening language in laws related to medical need. 

Treatment vs. Incarceration

Recent developments in criminal justice indicate the emergence of a national movement in favor of treating, rather than incarcerating, non-violent drug possession offenders. These developments include drug courts, local policies which favor treatment, and statewide ballot initiatives that divert non-violent drug offenders to treatment instead of incarceration.

Public health approaches towards drug offenders have gained national attention and public support. In a 2002 survey sponsored by the Open Society Institute, "Changing Public Attitudes Towards the Criminal Justice System," 63% of Americans considered drug abuse a problem that should be addressed primarily through counseling and treatment, rather than the criminal justice system.


In November 2000, 61 percent of California voters passed Proposition 36, the Substance Abuse and Crime Prevention Act of 2000 (SACPA), an initiative requiring rehabilitation rather than incarceration for nonviolent drug possession offenders. Under SACPA, most people convicted of a nonviolent drug possession offense are given the opportunity to receive community-based drug treatment in lieu of incarceration.

Since the program’s inception in 2001, more than 36,000 people have accessed treatment through SACPA each year. In the first six years, a total of more than 70,000 people have graduated. Each year more than half of program participants (or more than 19,000 people) receive treatment for methamphetamine addiction, making SACPA the country’s largest and most successful methamphetamine treatment program. Participants receiving treatment for methamphetamine addiction actually fare better than do SACPA participants in general, a fact that has helped educate some community members and lawmakers who previously, and erroneously, believed that methamphetamine addiction was untreatable.