America’s Favorite Antidote: Drug-Induced Homicide in the Age of the Overdose Crisis

Nearing the end of its second decade, the overdose crisis in the United States continues to claim tens of thousands of lives. Despite the rhetorical emphasis on a “public health” approach, criminal law and its enforcement continue to play a central role among policy responses to this crisis. A legacy of the 1980s War on Drugs, statutory provisions that implicate drug distributors in overdose fatalities are on the books in many U.S. jurisdictions and federally. This Article articulates an interdisciplinary critique of these “drug-induced homicide” laws at a time of their increased popularity, expanding scope, and aggressive prosecution. That these policy mechanisms are deployed under the banner of overdose prevention invites a critical public health lens to their reexamination. After tracing the trajectory of the overdose crisis, this Article examines the role of drug-induced homicide laws as exemplars of U.S. drug policy’s reliance on criminal law to address problematic substance use. An empirical analysis of publicized drug-induced homicide cases documents a rapid and accelerating diffusion of prosecutions in many hard-hit jurisdictions; pronounced racial disparities in enforcement and sentencing; and broad misclassification of friends, partners, family members, and others as “dealers.” In addition to crowding out evidence-based interventions and investments, these policies and prosecutions run at direct cross-purposes to public health efforts that encourage witnesses to summon lifesaving help during overdose events. At a time of crisis, drug-induced homicide laws and prosecutions represent a false prophecy of retribution, deterrence, and incapacitation. These findings support further efforts to demobilize criminal law and criminal justice actors from responding to drug-related harms in the U.S. as elsewhere

Bundling occupational safety with harm reduction information as a feasible method for improving police receptiveness to syringe access programs: evidence from three U.S. cities

<p>Abstract</p> <p>Introduction</p> <p>In light of overwhelming evidence that access to sterile injection equipment reduces incidence of injection-attributable bloodborne disease without encouraging drug use, many localities have authorized sterile syringe access programs (SAPs), including syringe exchange and pharmacy-based initiatives. Even where such interventions are clearly legal, many law enforcement officers are unaware of the public health benefits and legal status of these programs and may continue to treat the possession of injection equipment as illegal and program participation as a marker of illegal behavior. Law enforcement practice can impede SAP utilization and may increase the risk of needlestick injury (NSI) among law enforcement personnel. Many SAPs conduct little or no outreach to law enforcement, in part because they perceive law enforcement actors as unreceptive to health-promotion programs targeting drug users.</p> <p>Case description</p> <p>We report on a brief training intervention for law enforcement personnel designed to increase officer knowledge of and positive attitudes towards SAPs by bundling content that addresses officer concerns about infectious disease and occupational safety with information about the legality and public health benefits of these programs. Pilot trainings using this bundled curriculum were conducted with approximately 600 officers in three US cities.</p> <p>Discussion and evaluation</p> <p>Law enforcement officers were generally receptive to receiving information about SAPs through the bundled curriculum. The trainings led to better communication and collaboration between SAP and law enforcement personnel, providing a valuable platform for better harmonization of law enforcement and public health activities targeting injection drug users.</p> <p>Conclusion</p> <p>The experience in these three cities suggests that a harm reduction training curriculum that bundles strategies for increasing officer occupational safety with information about the legality and public health benefits of SAPs can be well received by law enforcement personnel and can lead to better communication and collaboration between law enforcement and harm reduction actors. Further study is indicated to assess whether such a bundled curriculum is effective in changing officer attitudes and beliefs and reducing health risks to officers and injection drug users, as well as broader benefits to the community at large.</p

Advancing Human Rights in Patient Care: Practitioner Guides

Health systems can too often be places of punishment, coercion, and violations of basic rights—rather than places of treatment and care. In many cases, existing laws and tools that provide remedies are not adequately used to protect rights.This Practitioner Guide series presents practical how-to manuals for lawyers interested in taking cases around human rights in patient care. The manuals examine patient and provider rights and responsibilities, as well as procedures for protection through both the formal court system and alternative mechanisms in 10 countries.Each Practitioner Guide is country-specific, supplementing coverage of the international and regional framework with national standards and procedures in the following:ArmeniaGeorgiaKazakhstanKyrgyzstanMacedoniaMoldova (forthcoming)RomaniaRussia (forthcoming)SerbiaUkraineThis series is the first to systematically examine the application of constitutional, civil, and criminal laws; categorize them by right; and provide examples and practical tips. As such, the guides are useful for medical professionals, public health mangers, Ministries of Health and Justice personnel, patient advocacy groups, and patients themselves.Advancing Human Rights in Patient Care: The Law in Seven Transitional Countries is a compendium that supplements the practitioner guides. It provides the first comparative overview of legal norms, practice cannons, and procedures for addressing rights in health care in Armenia, Georgia, Kazakhstan, Kyrgyzstan, Macedonia, Russia, and Ukraine.A Legal Fellow in Human Rights in each country is undertaking the updating of each guide and building the field of human rights in patient care through trainings and the development of materials, networks, and jurisprudence. Fellows are recent law graduates based at a local organization with expertise and an interest in expanding work in law, human rights, and patient care. To learn more about the fellowships, please visit health-rights.org

Drug-Induced Homicide: Challenges and Strategies in Criminal Defense

Nearing the end of its second decade, the crisis of fatal opioid-involved overdoses in the United States has gone from bad to worse. In 2017, approximately 72,000 people died of a drug overdose in the United States. Overdose is now the leading cause of death for people under fifty. There is broad agreement that reducing opioid overdose deaths requires wider distribution of the opioid antidote naloxone, rapid scale-up in evidence-based treatment, and reducing the stigma associated with substance use and addiction. However, progress on these and other vital public health interventions remains abysmally slow. Meanwhile, there is a new and growing trend in enforcing drug-induced homicide and similar laws in overdose death cases. Originally intended to implicate dealers in accidental drug overdoses, such charges were rarely brought until recent years. Just since 2010, however, media coverage of prosecutions based on such provisions has spiked at least threefold, from 363 in 2011 to 1,178 in 2016

Stigma as a fundamental hindrance to the United States opioid overdose crisis response.

Alexander Tsai and co-authors discuss the role of stigma in responses to the US opioid crisis

A Plague of Magnetic Spots Among the Hot Stars of Globular Clusters

Six decades and counting, the formation of hot ~20,000-30,000 K Extreme Horizontal Branch (EHB) stars in Galactic Globular Clusters remains one of the most elusive quests in stellar evolutionary theory. Here we report on two discoveries shattering their currently alleged stable luminosity. The first EHB variability is periodic and cannot be ascribed to binary evolution nor pulsation. Instead, we here attribute it to the presence of magnetic spots: superficial chemical inhomogeneities whose projected rotation induces the variability. The second EHB variability is aperiodic and manifests itself on time-scales of years. In two cases, the six-year light curves display superflare events a mammoth several million times more energetic than solar analogs. We advocate a scenario where the two spectacular EHB variability phenomena are different manifestations of diffuse, dynamo-generated, weak magnetic fields. Ubiquitous magnetic fields, therefore, force an admittance into the intricate matrix governing the formation of all EHBs, and traverse to their Galactic field counterparts. The bigger picture is one where our conclusions bridge similar variability/magnetism phenomena in all radiative-enveloped stars: young main-sequence stars, old EHBs and defunct white dwarfs.Comment: Author's version of the main article (23 pages) and Supplementary Information (22 pages) combined into a single pdf (45 pages). Readers invited to read the Nature Astronomy Published version available at this url: https://www.nature.com/articles/s41550-020-1113-