United States | May 31, 2014 at 11:56 am

From Courtrooms to Clinics

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In 2010, the Wisconsin legislature ground to a standstill as Democratic senators fled the state to stall a change in collective bargaining laws. Partisan tensions ran so high that voters successfully petitioned for ten recall elections, a record in American politics. Over seventy percent of the congresspersons serving at that time are still in office, but where Wisconsin’s legislators were once divided, they now stand united behind a series of bold changes to the state’s drug laws. Faced by growing heroin abuse rates statewide, the state has joined with others like Washington and Hawaii in overhauling its drug policy. The broad scope of these changes reveals a shift in political will towards treating addiction as an issue of public health, and makes Wisconsin a useful case study of drug reform.

State Rep. John Nygren has led the legislative push, sponsoring the four bills passed into law. Each of the four bills traversed committee hearings and floor debate without receiving a single negative vote, underscoring the sense of urgency in the state. “Legislators vote on things that are important to our areas,” Nygren explained in an interview with the HPR. “All my colleagues were aware of this problem, either through personal experience, through their court systems they interact with, or their law enforcement, and they were supportive.” Abuse rates in Wisconsin bear out his explanation: in 2008, the state’s Department of Justice handled 207 cases of heroin abuse across 28 counties. By 2013 this number had increased five-fold to 1,056 cases across 57 counties.

Comprehensive Reforms

Nygren’s reforms address drug abuse at every stage of the problem, focusing on increasing prevention, mitigating overdose, and expanding rehabilitation.

First, the laws seek to reduce abuse of prescription drugs, which are often a gateway to more dangerous substances. Pharmacists are now required to verify the identity of individuals receiving Schedule II and III drugs, which have medical use but are easily habit-forming. The laws also call for an expansion in drug-takeback programs to safely dispose of unfinished prescription drugs before they can be misused.

Second, the laws seek to minimize deaths from overdose with a pair of Good Samaritan provisions. The first grants some legal immunity to drug abusers who summon emergency personnel to cases of overdose. The second allows police officers and firefighters with training in use of the anti-overdose drug naloxone to administer it in emergencies without legal liability.

Finally, the laws seek to ease the process of rehabilitation. First, they recalibrate sanctions for violations of parole and probation, establishing a graded system of punishments. These new “swift and certain” policies, modeled after effective approaches in other states, attempt to minimize impacts of sentencing on the violator’s employment and reward parolees for cooperating. To keep pace with the rising rate of drug abuse, the laws also order the creation of two new opioid treatment facilities.

Inspecting the New Model

The philosophy underlying these reforms is a fundamentally new one. Where the response to drug abuse has traditionally been severe criminal sanctions, Wisconsin is joining a group of states shifting the issue from the courtroom to the clinic. Good Samaritan laws strip the state of its ability to prosecute individuals for violating the law in an attempt to save more lives. Further, the provisions that expand the ability of police officers to receive medical training shift their role from enforcers to first responders. Finally the adoption of “swift and certain” sanctions conveys an ethos of compassionate punishment, meant to respond to wrongdoing without preventing social reintegration.

If experience from other states is indicative, legislative reform needs to be paired with aggressive awareness campaign to succeed. When the state of Washington passed its own amnesty laws in 2010, a survey found about one-third of opiate users and less than one-fifth of police officers knew about the reforms a year later. Good Samaritan laws rely on a well-informed citizenry so that drug abusers know they can call for help without consequence and police officers act consistently with the new laws.  There is reason to believe that outreach will make a concrete difference: once informed about the amnesty laws, eighty-eight percent of opiate users indicated that they would call for help in an emergency.

Fortunately, the Wisconsin Department of Justice is hard at work on publicity, running a statewide awareness campaign called the Fly Effect, in addition to distributing information about drug take-back days and supporting community anti-drug programs. The Fly Effect campaign primarily targets teenagers and young adults through conventional media such as TV and radio ads, but also through more modern outlets, such as mobile banner ads and YouTube videos.

Past publicity efforts in Wisconsin seem to have been successful; despite filling the 19th most prescriptions in 2011, Wisconsinites returned the 3rd most prescription drugs in 2014 on National Drug Take-Back Days. The only Americans who outperformed them were Californians and Texans, who live in the two most populous states. The reason for Wisconsin’s abnormally high participation in drug reclamation is an unstudied question, the answer to which will certainly help structure reforms in other states.

Wisconsin is not the first of states to reform its drug laws, nor will it be the last. In its willingness to explore and adopt best practices from other states and high degree of public participation, Wisconsin can serve as model for future reformers to study.

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