--- title: Decriminalizing Opioids Will Save Countless Lives description: It is the criminalization of drugs more than the drugs themselves that causes most our problems. canonical: https://time.com/6307593/legal-weed-is-a-success-now-lets-decriminalize-opioids-and-save-some-lives/ author: Peter Grinspoon article:opinion: true article:content_tier: free article:published_time: 2023-08-23T18:54:48.000Z article:modified_time: 2026-08-04T07:50:58.305Z article:section: Ideas og:title: Decriminalizing Opioids Will Save Countless Lives og:description: It is the criminalization of drugs more than the drugs themselves that causes most our problems. og:url: https://time.com/6307593/legal-weed-is-a-success-now-lets-decriminalize-opioids-and-save-some-lives/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltd374ab96485c547c/698a3fb7db2987882c26942a/Decriminalizing-Opioids.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 2400 og:image:height: 1350 og:image:alt: New York CIty sweep of homeless encampment og:type: article twitter:card: summary_large_image twitter:title: Decriminalizing Opioids Will Save Countless Lives twitter:description: It is the criminalization of drugs more than the drugs themselves that causes most our problems. twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/bltd374ab96485c547c/698a3fb7db2987882c26942a/Decriminalizing-Opioids.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 ---  # Decriminalizing Opioids Will Save Countless Lives > Sponsored content. 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Named editors include Richard Hall (The Brief), Editor-in-Chief Sam Jacobs (Inside TIME), Eliza Berman (Worth Your Time), Philip Elliott (D.C. Brief), Justin Worland (Future Proof) and Harry Booth (In the Loop). Health Matters is written by TIME's health desk. #### How do I sign up for a TIME newsletter? Go to time.com/newsletters, choose the newsletters you want and enter your email address. There is no cost and no subscription requirement. ### Sources * TIME Newsletters: [time.com/newsletters](/c/time-nl-network-2026q3/newsletters?i=3beddb52-0ae5-42e4-9725-ffe071891654&cr=time-nl-network-2026q3-v1) ## Video: New CDC Director Mandy Cohen on Abortion, COVID-19, and More [Watch (HLS stream): New CDC Director Mandy Cohen on Abortion, COVID-19, and More](https://cdn.jwplayer.com/manifests/HNgVhsur.m3u8) (8:31)  _Published 2023-08-21. New CDC Director Mandy Cohen talks about abortion, COVID-19, public mistrust in the federal agency, and more._ by [Peter Grinspoon](https://time.com/author/peter-grinspoon/) ## Peter Grinspoon Aug 23, 2023 6:54 PM UTC  A used needle is seen on the street during a city sweep of a homeless encampment, in New York City on Sept. 22, 2022. A used needle is seen on the street during a city sweep of a homeless encampment, in New York City on Sept. 22, 2022. Andrew Lichtenstein—Corbis/Getty Images by [Peter Grinspoon](https://time.com/author/peter-grinspoon/) ## Peter Grinspoon Aug 23, 2023 6:54 PM UTC Even the most fervent drug warrior would have to concede that cannabis legalization has been a success. In thirty-eight states patients can now freely access high-quality cannabis for medical conditions that are often notoriously resistant to other treatments. In the twenty-three states in which cannabis is legal for both medical and recreational purposes, citizens enjoy the right to partake in a substance that is far safer than other recreational drugs—including and especially alcohol—without fear of prosecution. Driving fatalities have not increased and rates of psychosis (which cannabis can contribute to) have been broadly stable. Teen usage rates and rates of addiction haven’t spiked. Drug War-fueled prosecutions that were particularly devastating to Black and brown communities are [down](https://www.marijuanamoment.net/federal-marijuana-trafficking-cases-declined-again-in-2022-amid-legalization-movement-federal-report-shows/#:~:text=As%20more%20states%20have%20moved,806%20last%20year%2C%20USSC%20found.). At the same time as cannabis legalization sweeps across the country, the [opioid epidemic](https://time.com/6214811/overdose-deaths-opioid-prescriptions/) continues tragically apace. If we are serious about ending the latter it’s time to apply the lessons of the former. That may seem counter-intuitive. After all, cannabis is a comparatively safe substance and opioids are often deadly. That doesn’t make criminalization the cure. Criminalization is a formidable barrier to treatment and enhances risk on a number of fronts. I know this because of my work as a physician and because of my own hellish struggle with opioid addiction, which nearly destroyed my life. I’m one of many. We have lost more than one hundred thousand people _per year_ to opioid overdoses for the last several years. Millions of others continue to limp through their miserable addicted lives. The police and the courts have become the de facto first responders to a public health scourge, when it should be doctors, addiction specialists, and other healthcare professionals on the front lines. I’m fifteen years into recovery. I have helped hundreds of other doctors who were addicted, and I have treated thousands with addiction over the decades_. I’ve come to realize that it is the criminalization of drugs more than the drugs themselves, that causes most our problems._ ### More From TIME Specifically with opioids, it is the _illegal_ nature of street opioids that is killing people. Currently, people with untreated addiction or undertreated chronic pain—increasingly common problems— are forced to buy their opioids on the street to obtain relief from their pain or their soul-crushing withdrawal symptoms. The street supply of most drugs is now contaminated with fentanyl, as well as [xylazine](https://time.com/6164652/xylazine-overdose-crisis/), and many other deadly adulterants. Only a small fraction of the overdoses stem from the use of legally prescribed opioids, with the vast majority arising from illegally bought contaminated drugs. **_Read More:_**[ **_We Can Prevent Opioid Overdoses If We Change How We Think About Them_**](https://time.com/6304772/preventing-overdose-deaths-harm-reduction-essay/) We’ve known that legal or decriminalized drugs are safer than those bought in the underground market since the early 20th century when we launched our disastrous experiment with alcohol prohibition. Those years—from 1920 to 1933—saw a proliferation of poisonings from a tainted supply. In much the same way, the illegality of opioids has fatally tainted the street supply. By contrast, cannabis that is bought from dispensaries is screened for molds, heavy metals and pesticides, and is labeled; it is safer. When one buys any drug from a street dealer there are no controls, checks, regulations or recalls. For the buyer this was once a roll of the dice. Now, with the risk of fentanyl laced drugs, it is more a game of Russian roulette. It is my conviction that if opioids were decriminalized and accessible, very few would be dying from fentanyl. A recent study in _The American Journal of Public Health_ lends evidence to the idea that law enforcement is contributing to the carnage from opioids. The authors were able to prove the following hypothesis, We tested the hypothesis that law enforcement efforts to disrupt local drug markets through routine supply-side interdictions—as measured by police seizures of opioid- and stimulant-related substances—are [associated](https://ajph.aphapublications.org/doi/10.2105/AJPH.2023.307291) with increased spatiotemporal clustering of fatal and nonfatal overdoses, as well as increases in EMS naloxone administration, in the area surrounding the seizure. The over-involvement of law enforcement in the drug realm harms in indirect ways as well, with billions of dollars being wasted on militarized police units that could be far better spent on addiction treatment. With this money, we also could be offering patients a pathway out of their addicted lives by providing healthcare, jobs training and housing, such as they have been doing in Portugal since they decriminalized drugs, with overall success. This can’t be done in the ‘free for all’ manner of cannabis dispensaries as opioids have much more potential for harm and need to be more strictly regulated. The dispensing of opioids should be part of a treatment regimen. The access could take the form of government-controlled stores. Potentially, people could present a card from their doctors. The access would have to be very low threshold for patients, in order to circumvent the illicit market. According to a study by the Rand Corporation, there is good evidence for heroin assisted treatment (HAT) from Europe and Canada, Evidence from randomized controlled [trials](https://www.rand.org/pubs/research%5Freports/RR2693.html) of HAT in Canada and Europe indicates that supervised injectable HAT—with optional oral methadone—can offer benefits over oral methadone alone for treating OUD among individuals who have tried traditional treatment modalities, including methadone, multiple times but are still injecting heroin. An often-overlooked benefit of the legalization of cannabis is that it has allowed for more open and truthful communication between doctors and patients. Patients can now freely discuss their use with doctors. The result is greater safety and open discussion about potential misuse. Opioid users would stand a better chance of getting potentially life-saving help if they could candidly discuss their concerns with doctors and healthcare providers. We now have good tools, such as medications that can help people addicted to opioids, known as Medications for Opioid Use Disorder (MOUD), including methadone and buprenorphine (Suboxone), that can affect a fifty percent reduction in deaths from overdoses. Yet, we don’t have the medical infrastructure or social safety nets to provide this care to more than 10-20% of patients who need it. We are nibbling at the edges, first with clean needles, now with ‘safe injection facilities’—where people suffering from opioid addiction can use opioids in a medically monitored setting, and recently, with over-the-counter [Narcan](https://time.com/6203115/narcan-how-to-use-opioid-overdose/), which can transiently reverse an opioid overdose. These measures are not enough. It is time to legalize opioids and reroute resources from prosecution to treatment and support services. The War on Drugs, which we’ve been suffering from for more than a half century, was never truly about drugs. Rather, it was a fabricated moral panic to help control and subjugate certain sectors of our population, mostly people with brown and black skin. It has been quite effective for this nefarious purpose, but it also has resulted, among other harms, in our current opioid crisis. We do not need to continue fighting this war that we have already lost. Law enforcement are exactly the wrong people to be involved with the drug issue, except in cases of impaired driving or violent behavior. We would be a lot better off if we extrapolated our soaring success with legal cannabis into the opioid realm, and focused our attention, on resources, on treatment not punishment. Let’s legalize, or at least decriminalize, opioids, and let’s start saving lives. ## Transcript [00:00] Data is the oxygen that powers our ability to respond to threats [00:04] and so if we don't have access to that data we are not as [00:08] strong enough asset to respond to threats. [00:10] So we definitely do need more work to do. [00:14] Both the build the pipes on connecting all these different [00:18] data sources but also to have the authority to say you we need [00:21] to we need to do this in order to protect our country and to [00:24] have a national security asset that can respond to those threats. [00:41] One of the issues I think that people are grappling with right [00:45] now and the agency isn't mistrust in science in general. [00:49] But I think in the CDC in particular, [00:51] I'd love to get your perspective on that perspective. [00:54] Both coming from the outside as Secretariat in North Carolina [00:58] and now that your director how you how you plan to address [01:02] that will first, I think trust is absolutely foundational. [01:06] I think change happens at the pace of trust it. [01:10] So it it underlies, everything that we do and I will say, [01:12] as Health and Human Services, secretary for North Carolina. [01:15] We called out and named trust as Central to how we responded [01:21] to the covid crisis. [01:22] We thought about it every day and we measured it importantly. [01:25] And what we saw over the course of leading through that crisis, [01:29] we saw trust actually increase in the department that Iran which [01:34] was different than what we were seeing and some other parts [01:36] of the country. [01:36] And I think We were able to build trust, [01:40] cuz we focused on three things. [01:41] One, we focus on really building relationships to, [01:45] we were incredibly transparent. [01:47] We use Simple communication. [01:49] We did 170 press conferences. [01:51] I think an 18 months. [01:52] So we were answering questions all the time because we were [01:55] learning new things and then third, we made sure that folks [01:58] were knowing that we were performing every day for them, [02:01] that we were delivering, the vaccines were the tests that they [02:04] needed to protect themselves. [02:06] So we focus on those three aspects. [02:08] We talked about it and we measured it. [02:10] So I think we, we did a great job in North Carolina. I'm [02:13] hoping to bring those that work in those lessons at 2 to the [02:16] work here at CTC. [02:22] How concerned are you about the increasing hospitalizations [02:26] from covid? Be cuz you know since we're not tracking cases, [02:29] so much anymore. [02:30] Opposition's is like a good litmus test for, [02:33] you know, like severe case there are people getting sick or from [02:35] from their infections. [02:37] How concerned are you about that? [02:38] Trend. So we are seeing hospitalizations go up for here in August [02:42] of 2023. And it's reminding us that we are living with code. That's [02:46] right. It is not gone. [02:48] And that means we need to continue to Avail ourselves of the [02:51] tools that protect us. [02:53] Vaccines testing and treatment. [02:55] Luckily, we have more tools than ever before going into these [02:59] next season and we're going to have a new booster that comes [03:03] out in the middle of September. [03:04] So we have the tools, we just need to use them but I'd say [03:07] about the current level, I'm not concerned right now but you [03:11] know, we're going to continue to watch that. [03:13] If you saw the highest number of hospitalizations [03:15] we had last year is about 45,000 for about ten thousand [03:20] right now. So we're much lower than we were. [03:22] The peak last year but we have to keep Vigilant than making [03:26] sure that were using the tool to protect ourselves. [03:28] If you're going to hear us talk a lot about vaccines testing [03:32] and treatment, that things are safe and effective. [03:34] If we have great test, that can rapidly identify what you have [03:37] and then treatment that works, but you have to use it right [03:39] away. [03:43] Can we look at some of the big health issues especially [03:45] in the past year that, you know, [03:47] the country is facing? [03:48] I think women's reproductive Health has been really a Hot Topic [03:52] with some of the restrictions that have been placed on choices [03:55] that women have regarding contraception and abortion. [03:57] What role does the CDC has in ensuring that we would continue [04:03] to have access to as many healthy and, [04:06] you know, evidence-based choices as possible. [04:09] The mission of the CDC is to protect and improve health. [04:13] And in order to be able to do that, [04:15] we need to make sure that folks have access to the tools that [04:19] can keep them healthy at all moments of their life, [04:22] whether they're thinking about becoming pregnant during their [04:25] pregnancy. Or even after when they're young mom and we have a [04:29] lot of data and best practices and evidence that we can bring [04:33] to bear to show that when we work with Mom, [04:35] so that they are getting pregnant when they are ready and want [04:38] to meeting that they have access to contraception. [04:41] So they're not getting pregnant if it's not. [04:43] Right time for them and their family. [04:44] That means babies have better outcomes as do Mom. [04:47] And just this week, we've seen another blow in in the form of [04:51] the the appeals court decisions, you know, [04:53] backing the Texas judge's ruling on Meet the Press Stone. [04:57] It remains available, but this is going to be debated in the [05:01] court. How much of an impediment is that this is something [05:04] that there is good science behind and yet we're looking, [05:09] you know, to a whole different system. [05:11] The legal system to kind of decide whether women can have access [05:14] to it or not as a as a physician and as a public health [05:18] leader, how does that strike you? [05:21] So disappointed that we are here and that we are having the conversation [05:27] to revisit whether or not women should have access to health [05:31] care when they need it. [05:32] I will say as both a mom of two daughters a physician and now [05:37] the director of the CDC know I'm going to continue to make sure [05:40] that we are working to make sure women has access to Care when [05:43] they need it, that they have medical treatment when they need [05:46] and that's all parts of their life. [05:49] The issues. I think that has impart led to the mistress [05:52] in the skepticism of the agency in science and journal was the [05:55] politicization of Health. [05:57] It became a political rather than a scientific issue. [06:01] You know, based on strong scientific evidence. [06:04] As secretary North Carolina, did you see some of that in your [06:08] own State? And as you saw it on the national level, [06:11] what concerns you had, and also how you plan to address that [06:15] now is director of CDC. [06:16] Well, I think it's always important for us to have good discourse [06:20] and good dialogue. [06:20] I think it's important when we're wrestling with heart issues [06:23] that we hear from different folks. [06:25] But what we want to make sure is that that dialogue is respectful. [06:28] I saw that in North Carolina, credibly good, [06:31] relationships across the aisle. [06:33] I worked for a Democratic governor but we had a super majority [06:35] of Republicans in our state legislature. [06:38] But we had good relationships and I think it's because we were [06:42] willing to answer questions that we were transparent, [06:44] folks knew that they could get me on the phone to answer questions [06:47] and I was happy to do. [06:48] It doesn't mean We always agreed on every issue, [06:50] but we were able to have that respectful dialogue as I get to [06:55] know members of Congress and in my new role. [06:57] And that's what I see as well as having building those relationships [07:00] being available to answer their questions and focusing on the [07:04] places where I see a lot of consensus. [07:06] And I do see consensus on making sure we have an asset for our [07:11] country, that is identifying threats and responding quickly [07:15] to them. So, if we haven't a new virus or a new chemical, [07:18] or what have you that, we are able to respond quickly. [07:21] So I see a lot of consensus around having that ass. [07:25] I also see a lot of consensus on addressing mental health. [07:29] We all know that mental health unfortunately has seen, [07:33] you know, a lot of challenges that happens in any crisis whether [07:36] it's a hurricane or a pandemic. [07:38] And so I feel a lot of consensus on coming together to think [07:42] about ways to address that. [07:43] I was just talking to a couple of members of Congress and how [07:46] do we work together and suicide, prevention, [07:47] for example. [07:49] In the third area consensus. I [07:51] really see it around young families thinking about, [07:54] how do we get Upstream from some of the issues? [07:57] We see John thring whether that's diabetes or mental health [08:00] issues in addiction. [08:02] There are ways proven ways with evidence that we know, [08:05] we can prevent we know that we are a stronger country if we are [08:09] healthy and what does it take to become that? [08:11] So those are the areas you're going to hear me focus on right? [08:14] Making sure we have that asset to respond to threats that we address [08:18] our mental health issues, and that we're also doing the prevention [08:21] to make us the healthiest country, we possibly can be ```json [{"@context":"https://schema.org","@type":"OpinionNewsArticle","@id":"https://time.com/6307593/legal-weed-is-a-success-now-lets-decriminalize-opioids-and-save-some-lives/","mainEntityOfPage":{"@type":"WebPage","@id":"https://time.com/6307593/legal-weed-is-a-success-now-lets-decriminalize-opioids-and-save-some-lives/"},"headline":"Decriminalizing Opioids Will Save Countless Lives","datePublished":"2023-08-23T18:54:48.000Z","dateModified":"2026-08-04T07:50:58.305Z","description":"It is the criminalization of drugs more than the drugs themselves that causes most our problems.","url":"https://time.com/6307593/legal-weed-is-a-success-now-lets-decriminalize-opioids-and-save-some-lives/","keywords":["health","freelance"],"thumbnailUrl":"https://static.time.com/v3/assets/bltea6093859af6183b/bltd374ab96485c547c/698a3fb7db2987882c26942a/Decriminalizing-Opioids.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","author":[{"@type":"Person","name":"Peter Grinspoon","jobTitle":null,"url":"https://time.com/author/peter-grinspoon/"}],"articleSection":"Ideas","image":[{"@type":"ImageObject","url":"https://static.time.com/v3/assets/bltea6093859af6183b/bltd374ab96485c547c/698a3fb7db2987882c26942a/Decriminalizing-Opioids.jpg?branch=production&width=1200&quality=75&auto=webp&crop=1200:675&height=675","width":1200,"height":675,"headline":"New York CIty sweep of homeless encampment","caption":"New York CIty sweep of homeless encampment","creditText":"Andrew Lichtenstein—Corbis/Getty Images","representativeOfPage":true}],"publisher":{"@type":"Organization","name":"Time","url":"https://time.com/","logo":{"@type":"ImageObject","url":"https://time.com/images/logo.png","width":528,"height":156},"foundingDate":"March 3, 1923","sameAs":["https://www.facebook.com/time","https://www.instagram.com/time/?hl=en","https://twitter.com/time","https://www.pinterest.com/timemagazine"]}},{"@context":"https://schema.org","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"item":{"@id":"https://time.com/section/ideas/","name":"Ideas"}},{"@type":"ListItem","position":2,"item":{"@id":"https://time.com/tag/health/","name":"health"}},{"@type":"ListItem","position":3,"item":{"@id":"https://time.com/6307593/legal-weed-is-a-success-now-lets-decriminalize-opioids-and-save-some-lives/","name":"Decriminalizing Opioids Will Save Countless Lives"}}]},{"@context":"https://schema.org","@type":"VideoObject","name":"New CDC Director Mandy Cohen on Abortion, COVID-19, and More","description":"New CDC Director Mandy Cohen talks about abortion, COVID-19, public mistrust in the federal agency, and more.","thumbnailUrl":"https://cdn.jwplayer.com/v2/media/HNgVhsur/poster.jpg?width=720","uploadDate":"2023-08-21T21:07:16.000Z","contentUrl":"https://cdn.jwplayer.com/manifests/HNgVhsur.m3u8","embedUrl":"https://time.com/6307593/legal-weed-is-a-success-now-lets-decriminalize-opioids-and-save-some-lives/","duration":"PT8M31S","potentialAction":{"@type":"SeekToAction","target":"https://time.com/6307593/legal-weed-is-a-success-now-lets-decriminalize-opioids-and-save-some-lives/?jw_start={seek_to_second_number}","startOffset-input":"required name=seek_to_second_number"}}] ```