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Lisa Peterson: We need to rethink how we approach substance use



The House District 68 Democratic Primary Candidate Forum held on January 28, 2019 was generally comprised of the usual questions, with each candidate providing a snapshot of their policy platform in response.

But when it came to how June Speakman and Richard Ruggiero would help address the overdose crisis in Rhode Island, things got… interesting. Ms Speakman proposed expanding access to medication assisted recovery, treatment, and education. Mr Ruggiero echoed her response, but went on to state that he “will not support” efforts to legalize cannabis in the state, adding that it is “ridiculous that we are even talking about that.” He then referred to studies about the health risks of tobacco, and without linking this evidence to cannabis, concluded that legalization would cause serious health problems. At the end of a heated exchange, he threw up his hands and stated “well we might as well legalize it and let everyone get sick.” Attendees exchanged looks and laughed softly before the moderator moved forward with the next question.

For her part, Ms Speakman indicated that she would support legislation to legalize cannabis in Rhode Island, with proper vetting and thoughtful implementation. She shared a personal story about her father’s use of medicinal cannabis during his terminal battle with cancer, highlighting the difference in his quality of life and ability to engage with his family once this medication replaced the morphine that, “made him go very far away.” She also noted that, as a college professor, she is quite cognizant of the fact that cannabis is already in the hands of young people, and that legalization and regulation would actually create a stronger safety net than currently exists.

This debate was more than a mere difference of opinion. Mr Ruggiero’s perspective is, unfortunately, still shared by many in our legislature and our communities. It is also based in the same fear-based rhetoric long peddled by proponents of the “War on Drugs” and memorialized in the cult classic piece of propaganda called Reefer Madness. It would be laughable were it not so dangerous.

In fact, studies have shown that opioid use and related overdose rates are lower in states where cannabis has been legalized. This is very much part of the conversation we need to have about stopping the preventable deaths of our friends, neighbors, and loved ones. Additionally, there is some evidence indicating that legalization and regulation makes it more difficult for individuals to access it before reaching the legal age. That finding is not unexpected, given the impact an open and legal market has on the business of illicit exchanges of any product.

Alcohol is a socially acceptable drug, in spite of well documented health and public safety concerns when misused. Yet we embrace the drinking culture while simultaneously stigmatizing many other types of substance use; at best, this is arbitrary and at worst, it is systemically racist. Despite changing attitudes about cannabis, the Democratic Candidate Forum illustrates how far we still have to go.

In the 1930s, national leaders intentionally spread unsubstantiated claims that cannabis led to violence, and began using the Spanish term ‘marihuana’ to link these fears to the newly arriving immigrants from Mexico. Sound familiar? It should. We have been basing laws and public policy on xenophobia and unwarranted fears for centuries. The 20th century manifestation was the “War on Drugs” and it has led to mass incarceration, destroyed families and communities, and cost billions of dollars.

And it hasn’t worked. Period.

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As with the legalization of cannabis, it’s time that we rethink how we approach people who use any substance in a way that promotes health and safety over stigma and systemic racism. This session, legislation will be introduced to reclassify simple drug possession as a misdemeanor. As demonstrated in several other states, including neighboring Connecticut, this reform reduces recidivism and saves money on incarceration – money that can then be used to support treatment, which saves lives. It is one small step towards truly aligning our policies with the recognition that substance use disorder is a treatable medical condition, not a criminal act.

We are in the midst of a public health crisis. This is not a partisan talking point, it is a state of emergency. We must elect legislators who are willing to collaborate with experts, listen to the evidence, and challenge their own internal biases to develop effective interventions that will save lives. We need leaders who are willing to take common-sense approaches and move beyond outdated rhetoric. Rhode Island has too much to lose by continuing the same wrong policies.

About the Author

Lisa Peterson is a licensed therapist with over twenty years of experience helping individuals substance use disorders. She is Co-Chair of the Substance Use Policy, Education, and Recovery PAC.