We Have Been Unsuccessful in Framing the Debate About Drugs: Now is Our Opportunity

By Martha Coakley and Mary Coakley-Welch*

We all admire the Framers of our Constitution and Bill of Rights, whose visionary document has such elasticity and longevity!  The Supreme Court uses the framework to decide legal issues never even imagined at the time, from the Internet to same-sex marriage.

Framing is as crucial now as it was in 1787. She who successfully frames the argument should win, a lesson every first year law student learns during moot court. In legal practice, whether at a misdemeanor trial court or at the United States Supreme Court, the successful attorney frames the arguments so that her facts win.

In 1971, Richard Nixon framed US drug policy as The War on Drugs, emphasizing law enforcement strategies.  In using only a criminal justice framework, we are losing that war in Massachusetts and around the country. Heroin distributors now use proven business tactics not only to supply drugs, but to find new customers.

Drug abuse needs a new frame. Courts and judges see massive numbers of “drug” defendants, and can deal only with each case before them: a person-by-person approach.  They want more latitude in sentencing. But that policy change tackles only one dimension of this complex problem. District Attorneys respond to risks and dangers they see in the homes, streets, and schools in their jurisdictions. They use the tools they have available to keep drug dealers and dangerous drugs out. Their work can go only so far in rooting out the causes of substance abuse.  Legislators, averse to the label “soft on crime,” have struggled with how they can be “smart” about drug crimes at a time when new dollars for government spending are as rare as hen’s teeth. But well-targeted healthcare and education dollars can harness cost-effective tools to combat addiction and the pervasive devastation it brings to individuals, families and communities.

Heroin used to be mostly a gritty city problem. In the late 1990’s, as prescription use of Oxycodone for pain relief grew and it became popular for recreational use, communities throughout Massachusetts saw a growing addiction problem. In places where heroin sales had been rare, heroin became cheaper than beer.  At the same time, the cost of a single pill of “Oxy” skyrocketed.  A user who could no longer afford “Oxy” turned to heroin.

Now, nearly every community in Massachusetts is affected. Many Massachusetts public officials have cited substance abuse as a top priority.  We in Massachusetts have the opportunity to frame the issue as a public health emergency and establish winning strategies.

We must do five things:  step up prevention and early intervention;  increase investment in training more doctors and other treatment specialists; achieve true parity in coverage for, and access to, quality behavioral healthcare;  provide effective recovery resources before court involvement for those who are addicted; and provide effective resources for those incarcerated and as they transition back to their communities during pre-release and beyond.

Massachusetts, and the country, have paid a high price in lives lost and dollars spent by pursuing failed policies. Yet we in Massachusetts have the medical and legal expertise to pursue winning strategies.

Substance abuse is preventable and treatable. What we need now is the will to frame the issue properly and provide the resources for effective solutions.


*Martha Coakley is the former Attorney-General of Massachusetts. Mary Coakley-Welch is a licensed neuropsychologist.

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