Losing the War on Opioid Addiction: “Tough on Crime” Policies Often Ineffective and State Rules for Prescription Drug Monitoring Programs Raise Privacy Concerns

by Vins
Published: Updated:

In recent efforts to combat the deadly opioid epidemic many states have turned to “tough on crime” policies; however, these policies have not proven to be an effective. German Lopez of Vox.com reported on “tough on crime” policies that have been passed since 2011, the year opioid crisis was declared an epidemic. Lopez found that 16 states have passed laws that could lead to sentence increases for offenses involving opioids. Steps such as these will go over well with a public that sees addiction as the fault of the individual, but these polices are in direct conflict with the stances taken by lawmakers to stop mass incarceration.

Noting that opioid addiction in the US claims nearly 100 lives every day, Lopez detailed how treating the current opioid epidemic in ways comparable to previous drug crises will lead to a worsening crisis. Lopez provided examples of addiction medication and treatments that have been successful in fighting opioid addiction (such as naloxone) but noted that states’ budgets might prevent them from being used. Lopez wrote that this in turn contributes to “tough on crime” policies that “have hidden or delayed costs in the form of prison expenses down the line.” Tough on crime policies also appeal to state leaders who want to demonstrate a public willingness to fight the inaction that has characterized much of the broader US response to the opioid epidemic.

Federal anti-drug spending has two main tracks: 1) law enforcement and 2) treatment, according to Lopez. Law enforcement programs have received three billion more dollars in funding than treatment programs, despite experts advocating that treatment programs are more effective. His report cited an estimate that some 650,000 people will die from opioid overdoses in the next decade.

“Tough on crime” policies are not the only way that states are trying to tackle the opioid epidemic. In fact, all fifty states have launched prescription-drug monitoring programs, or PDMPs, as Beth Schwartzapfel reported for the Marshall Project. A PDMP is a database that allow for the tracking of certain prescription drugs. PDMP’s are state run and as Schwartzapfel stated: “are widely regarded as an essential tool to stem the opioid epidemic.” However, PDMP’s have what Schwartzapfel and others call a “chilling” effect. Although these databases are intended to alert doctors or pharmacists to patients who may be seeking pills from multiple prescribers (so-called “doctor shopping”), in 21 states and the District of Columbia law enforcement officials also can access these databases. As Schwartzapfel reported, a 2016 Scripps News investigation found that, in those states alone, law enforcement viewed over 300,000 patients’ prescription histories during a two year period. Accessing PDMPs requires a warrant in 27 states. But, as Schwartzapfel noted, federal courts in Utah and Oregon recently ruled that the Drug Enforcement Administration “can access information in those states’ PDMPs without a warrant, even over the states’ objections.” In defense of patients’ privacy, some doctors turn away patients seeking attention for addiction—“problem” patients as they are often referred to—if they fear law enforcement scrutiny.

The opioid epidemic has gained corporate media coverage because of its deadly toll in human lives. However, much of this coverage has lacked depth, focusing instead on President Trump’s dramatic statements. Coverage of PDMPs took an uptick when Missouri passed legislation, and, for example, the Washington Post has published several pieces that mention PDMPs. Yet this coverage has not addressed how debilitating PDMPs can be for people seeking treatment. Instead establishment coverage has focused on what PDMPs entail for physicians. The other significant factor shaping news coverage is the negative stigma attached to addiction. Addiction is often framed in terms of individual weakness or failure, instead of as a public health issue.


German Lopez, “The New War on Drugs,” Vox, September 13, 2017, https://www.vox.com/policy-and-politics/2017/9/5/16135848/drug-war-opioid-epidemic.

Beth Schwartzapfel, “Guess Who’s Tracking Your Prescription Drugs?,” The Marshall Project, August 2, 2017, https://www.themarshallproject.org/2017/08/02/guess-whos-tracking-your-prescription-drugs.

Student Researcher: Anthony Marocco-Cuellar (North Central College)

Faculty Evaluator: Steve Macek (North Central College)