The opioid crisis continued to dominate 2018 headlines—and impact the criminal justice system. Sixty-five percent of all incarcerated individuals meet the criteria for a substance use disorder, but only 11 percent of incarcerated people who need treatment are receiving it.
The federal government is split on a solution to the crisis: while the National Institutes of Health continued to study public health approaches, launching the Helping to End Addiction Long-term (HEAL) Initiative in April, and the Centers for Disease Control and Prevention mobilized resources for the counties in greatest need, the Department of Justice promoted a return to “war on drugs”-era policies like stricter punishments for drug offenses.
Outside the walls of jail and prison, overdoses are taking a toll on public health generally: the average life expectancy in the United States decreased in 2018, a trend “largely driven by deaths from drug overdose and suicide,” according to the Centers for Disease Control and Prevention. Local activists are fighting for alternatives to incarceration for people with substance use issues, as well as for safe injection facilities: places where people who choose to consume drugs can do so with clean, safe equipment, and in the presence of medical personnel who can assist in case of an accidental overdose. State governments are finding themselves caught in the middle: California Governor Jerry Brown recently vetoed a bill passed by the California legislature legalizing safe injection facilities—just one month after Deputy Attorney General Rod Rosenstein made it clear the federal government would aggressively prosecute those involved with such operations. But it’s clear that something must be done, and soon. On an average day in 2018, 115 people in the United States died from a drug overdose involving opioids.