Making drug use a crime makes HIV prevention, treatment more difficult

published on May 15, 2017 by Johns Hopkins University Bloomberg School of Public Health in Science Daily

Systematic review finds overwhelming evidence supporting negative health effects related to the so-called ‘War on Drugs’

The criminalization of drug use has a negative effect on efforts to prevent and treat people with HIV, suggests a review of published research conducted by the Johns Hopkins Bloomberg School of Public Health and the University of British Columbia.

The findings, appearing May 14 in The Lancet HIV, suggest that the so-called War on Drugs, which called for stiff penalties for possession of illegal drugs, has been unsuccessful in reducing drug use and has put thousands of people in jail who might be better served through drug treatment. The United States, for example, is in the midst of an unprecedented crisis of opioid use and abuse and, in many parts of the world, HIV rates are being driven up by the unmet HIV prevention and treatment needs among people who inject drugs.

The use of injection drugs continues to be a key driver of the global HIV epidemic, with 51 percent of new HIV cases in eastern Europe and central Asia occurring in people who inject drugs, according to the Joint United Nations Programme on HIV/AIDS.

The researchers systematically reviewed 106 peer-reviewed studies published between Jan. 2006 and Dec. 2014 on criminalization and HIV prevention or treatment among people who use injection drugs.

“More than 80 percent of the studies evaluating the criminalization of drug use demonstrated worse health outcomes among those targeted by these laws and their communities at large,” says one of the study’s leaders, Stefan Baral, MD, MPH, an associate professor of epidemiology at the Bloomberg School. “The evidence that criminalization helps is weak at best and the vast majority of studies show that criminalization hurts when it comes to health, economics and society-at-large.”

According to the nonprofit Drug Policy Alliance, more than 1.5 million drug-related arrests are made every year in the U.S., the overwhelming majority for possession only, yet levels of drug use remain high. Previous research estimates that 56 to 90 percent of people who inject drugs will be incarcerated at some point in their lives. The new research suggests that alternative strategies and policies need to be put in place to attempt to limit the harms associated with drug use, including infectious disease, overdose and the inability to find employment due to a drug arrest.

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