By Sean Fogler and Carla Sofronski , Pennsylvania Capital-Star
In 2021, over 5,300 Pennsylvanians lost their lives to a preventable drug overdose. Pennsylvania policy makers and local government officials have led the charge in fueling this historic public health crisis.
While there are many factors contributing to this horrific toll, Pennsylvania’s criminal legal system stands alone in its failed response to addressing drug use, addiction, and overdose.
Drug use, addiction, and overdose are, of course, a significant challenge within the criminal legal system. 85 percent of the prison population has an addiction or were jailed for a crime involving drugs or drug use.
People recently released from incarceration are forty times more likely to die from an opioid overdose, and access to FDA approved medications (buprenorphine and methadone) for opioid use disorder in Pennsylvania’s correctional settings and drug courts is severely limited.
The United States jails more people than any other country in the world and Pennsylvania is ranked in the top ten with the sixth highest prison population among fifty states.
Our jails are deadly, for people who use drugs, those with substance use disorders, and even for people in recovery. Drug use and addiction are fueled by isolation and trauma, experiences embedded within our criminal legal system. In many county jails people die.
Recently, in Blair county, a 43-year old man, arrested for possession of drug paraphernalia and trespassing, was found dead alone in his jail cell.
In Northampton County Prison, an inmate died of a heroin/fentanyl overdose. Another man died of a fentanyl overdose in the Montgomery County Correctional Facility. Shockingly, many of these deaths go unreported, misrepresenting the realities of our correctional system.
We cannot ignore the fact that the criminal legal system punishes people in perpetuity, unleashing thousands of collateral consequences that exacerbate drug use, addiction, and overdose death.
Pennsylvania has a mass incarceration crisis, with close to 178,000 people under supervision, the second highest percentage of people on probation and parole in the nation. Of this group, the single biggest driver of mass incarceration in PA is incarcerating people for technical violations.
A technical violation is breaking a rule or condition of probation but not committing a new crime. Examples include, missing an appointment, not obtaining employment, and, most frequently, drug use. In fact, up to half of all technical violations that lead to resentencing are related to drug use. And the most common outcome is county jail.
One powerful solution to address drug use and addiction in the criminal legal system is harm reduction. This approach sees and values the whole person exactly as they are, with dignity, and as a complex human with the capacity for growth and change.
It also empowers the individual to make ‘any positive change’ and take responsibility for their life, while reducing the risks associated with drug use and overdose.
Harm reduction educates, informs, and helps people thrive, and It’s an important pathway to recovery. Some counties have already implemented evidence-based harm reduction practices such as, opting not to arrest for low-level drug and paraphernalia possession or the distribution of clean syringes, which Pennsylvania continues to criminalize, and fentanyl test strips.
Other counties have decided to incorporate co-responder programs that aim to address the root causes of substance use and mental health issues or use pre-arrest diversion programs, where police assist in referrals to treatment, peer support, and other resources instead of jail.
Pennsylvania now has a real opportunity to build a system that centers the health and wellness of people who use drugs, those with addictions, and people in recovery. The recent allocation of $2.2 billion in opioid settlement funds is an opportunity to expand prevention, treatment, recovery support services, and harm reduction efforts that save lives.
It is imperative that our local leaders pass legislation informed by science, invest in evidence-based strategies, and change the criminal legal policies and practices that continue to hold people back and make recovery the expected outcome of a drug and/or alcohol use disorder.
Sean Fogler is a physician living in long-term recovery, co-founder of Elevyst, a public health consulting group, and co-chair of the Health Justice for Pennsylvania Coalition. Carla Sofronski is the Co-Founder and Executive Director of the PA Harm Reduction Network. Carla brings her own knowledge as a person with lived experience navigating the criminal legal system and who has lost family members to preventable overdose deaths.
Photo of Allegheny County Jail by Jake Dabkowski.
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