As a doctor completing an addiction medicine fellowship, I treat many patients who have worked incredibly hard to gain a measure of stability in their lives after a period of problematic drug use. Often, they were dealt a bad hand ― many were exposed to childhood traumatic events such as physical, sexual or emotional abuse, or have anxiety or depression that makes them more prone to perceive pain as intolerable. These circumstances make them more likely to fall prey to addiction. They are often the first to admit they could have played their cards differently. But they have scratched and clawed their way back to a life that most people take for granted—one that the war on drugs could take away from them again. They have escaped addiction, but can they escape the drug war?
Many of my patients have been coming to the clinic for years and are remarkably stable, avoiding heroin and pills as documented by repeatedly negative urine screenings. They have patched things up with their family and their community. They have found jobs and stable housing, and in many cases have gone on to become mentors for others struggling with similar issues. But more than a few of my patients smoke marijuana, explaining that it calms their nerves and helps with their depression. In my brief visits with patients, we usually have bigger fish to fry than their marijuana use, although I sometimes broach the issue as a conversation starter around potential signs of self-medication, for which there is scant research.
But my conversations with my patients about marijuana use have changed recently because of my concerns surrounding the Trump Administration’s approach to drug policy. Donald Trump advocated for a return of stop and frisk policing during his campaign and continues his tough-on-crime rhetoric to this day. He has been accused of encouraging police brutality in a speech on Long Island on July 28th, ultimately resulting in the acting DEA administrator declaring Trump “condoned police misconduct.” Attorney General Jeff Sessions has vocally expressed desires to be more aggressive on the federal enforcement of marijuana possession. Although the specifics of such a plan have not been released to date, memos ordering his staff to “charge and pursue the most serious, readily provable offense” give judges no room to make judgment calls for non-violent offenses such as marijuana possession.
This makes me terrified for my patients who have fought their way out of the criminal justice system and a life of debilitating addiction ― but could now be ensnared again by possessing a small amount of marijuana for personal use. This isn’t just hypothetical: Last year in New York City, more than 18,000 people were arrested for simple marijuana possession, and the overwhelming majority were young black and Latino men, despite lower use rates than young white men.
I now find myself warning my patients, especially young men of color, about the heightened legal risks of marijuana use, whether for medical purposes or not. I think about the war on drugs and how it has set my patients back. How incarceration can cripple a person’s life. How a struggling family is shattered after another hit from the criminal justice system. I think of how the individual’s family no longer can provide support to their friends and neighbors because they are barely holding on themselves. I think of how the war on drugs has created a stigma where mothers, fathers and children cannot discuss their addictions and therefore don’t receive the help they need. The war on drugs has been shown to be ineffective (at best) and I am concerned we will fall right back from where we came in an effort to “make America great again.”
My heart bleeds for my patients who have shown incredible growth and perseverance who might have their legs taken out just as they were finding solid ground. For what? Our leaders are set to repeat the same failed drug war policies under the guise of “cleaning up” communities. I hope I am proven wrong and the new administration heeds the lessons learned during the previous four decades of the war on drugs. But in the meantime, I will warn my patients that things can change instantly in this unpredictable era in which we now find ourselves. I will also advocate for policy reform that will keep my patient’s feet firmly planted on the path forward, like Canada’s recently unveiled national legalization for those 25 years and older, Governor Cuomo’s efforts to decriminalize marijuana in New York (although the provision was not included in the final budget legislation) and Senator Booker’s recent bill that would re-schedule marijuana under the Controlled Substances Act, which also reinvests in communities most harmed by the war on drugs. In the meantime, I’ll do everything I can and hope none of my patients become another victim of the war on drugs.