Public Health First:

Ending the War on Drugs in New York

Introduction

I am running for Manhattan District Attorney because our city’s approach to criminal justice reform, including drug policy, requires transformation. Today’s strategy reflects an antiquated, ineffectual “Just Say No” approach. This pursuit of punishment under the flawed War on Drugs and its severe sentencing policies¹ fail the public by ignoring public health and making our communities less safe.

In 2018, over 1.6 million Americans were arrested on drug-related charges, 86% merely for possession,² at racially disproportionate rates.³ In spite of the consistent prosecution of drug users, the War on Drugs has proven ineffective at achieving the most important goal of any sound governmental policy: minimizing harm. Treating drug use as a criminal issue instead of a public health issue has resulted in a surging number of opioid overdose deaths in New York and over 450,000 people in prison nationally for drug-related offenses,⁴ many of whom struggle with substance use disorder.⁵

These failures aren’t merely statistics, but the experiences of our family members, friends, and coworkers. Today we understand that the best way to treat substance use disorder is to build trust with people who use substances, focus on harm reduction and evidence based treatment, and provide people stability and opportunities to move forward with their lives. It is time to bring that perspective to the Manhattan District Attorney’s office.

I have been watching the system fail those struggling with substance use all my life, first growing up as a person of color in 1990s Manhattan, then later as a civil rights attorney and criminal justice advocate. In fact, the War on Drugs was my entry-point into activism; even as a 17-year-old I intuitively grasped its injustice. I joined Students for a Sensible Drug Policy and passed a student government resolution for our college campus challenging the federal policy of denying financial aid to students convicted of drug offenses. This is not a new issue for me.

My experiences have taught me that the goal of drug policy should be to reduce harm experienced by users, while listening to community concerns over drug sales in their neighborhoods. We should recognize that people enter the drug trade for a variety of reasons, including economic survival, and that drug users include people who use substances responsibly. But for those who use drugs in ways that are harmful to themselves and others, we must be prepared to invest in a long road to recovery. That means that we must look beyond jail and prison as a solution to drug use, especially in New York, where we are blessed with the resources to support people to help them turn their lives around, especially if we are to live up to the values we claim as progressive Democrats.

Finally, if we are going to end the War on Drugs, we need to start having honest conversations. Few things undermined my own trust in government more than the famous “This is Your Brain on Drugs” commercials from the 1980s, which revealed their hyperbole the first time I smoked a joint as a teenager. The reality is that we are here, with all of the negative consequences of drugs, because drugs can also offer a great deal to people: joy, relief from pain, relaxation from stress, an exploration into a new perspective, a way to feel differently than present conditions normally allow. Society may not be ready to legalize all drugs right now, but if we are going to move forward and reckon with the ravages of the Drug War, we should be honest and acknowledge that people use for a variety of reasons.

Campaign Statement of Values

There is perhaps no more universal human desire than freedom. Our nation’s history has been defined by enslaved people and immigrants, such as my parents, risking everything in its pursuit. Every time a person is locked in a cage, stripped of their freedom, we have collectively failed as a society. That is why in our office the deprivation of liberty will always be used as a last resort. This is especially important to consider as we end the War on Drugs, which has resulted in more unjust imprisonment than any American policy since slavery.

Our office will pursue compassion. Anyone who has felt the cold bars of a prison cell, watched a prison gate close behind them, or spoken to a loved one through plexiglass knows that sentencing a person to prison in New York puts them at risk of physical harm and psychological trauma, setting them deeper down a dark path rather than habilitating them. Our drug policy must always first seek rehabilitative options that are community-based.

Our office must pursue equity. Racism and economic injustice permeate each facet of the criminal justice system, especially when we look at those most affected by the War on Drugs. In many circumstances, the legality of certain drugs only depends on the color of a person’s skin. (The country’s most dangerous drug, alcohol, is legal and omnipresent.) Our office will work towards a more fair and equitable system, reducing existing inequalities in how and who we charge with drug crimes, the length of sentences and the collateral consequences of cases involving immigrants.

We believe in opportunity. The goal of justice and the desired outcome of public safety will be achieved when the cycles of harm stop, and nothing can better break those cycles than investing in peoples’ health, housing, and economic opportunities. If we can build economic pathways out of the drug trade, that will make our communities safer in the long run.

Finally, this campaign values truth. Our policy recommendations are evidence-based and based in honestly assessing hard truths about our communities, not scoring cheap political points.

As Manhattan District Attorney, I will end the War on Drugs when accountability, safety, and healing can be achieved smarter, more productively, and honestly. More specifically, I am committing to no longer prosecuting the possession of any controlled substance, supporting safe consumption spaces, using employment-based diversion programs, and approaching substance use through a evidence-based, public health-based lens rather than a criminal one. And we will eliminate the pernicious role of the Office of Special Narcotics Prosecutor.

The Problematic History of the War on Drugs

Drug policy represents a troubled chapter in the United States’ problematic racial history. Mind-altering substances have been used for medicinal, spiritual and recreational purposes in many cultures for millennia. However, in the late 19th and early 20th centuries, the United States criminalized opium to vilify Chinese immigrants, cocaine to target Southern Black men, and marijuana to imprison and deport Mexican-Americans. More recently, when President Nixon coined and declared the War on Drugs in June 1971, one of his top aides, John Ehrlichman admitted their perverse motives: “[B]y getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities.”⁶

The War on Drugs continues to disproportionately impact our communities of color today. The Center for American Progress reports that “between 2014 and 2016, 86 percent of people arrested for drug possession in New York City were Black and Latino.”⁷ Under pressure from policing and drug reform advocates such as VOCAL-NY and the New York Drug Policy Alliance, some progress has been made. In 2017, eight years after assuming office, Manhattan DA Cy Vance finally pledged to “exit the marijuana business.”⁸ Yet even as the number of marijuana arrests has drastically decreased, racially biased enforcement continues, with Blacks and Latinx people comprising 90% of those arrested in the 3rd quarter of 2019.⁹

A New Approach to Drug Policy

We can draw on lessons learned across the country and the world. Under Philadelphia’s newly elected District Attorney Larry Krasner, “71% of the more than 3,600 drug-possession cases resolved this year have been withdrawn, diverted or dismissed.”¹⁰ Krasner has also recently committed to a policy of withdrawing all charges for defendants who provide proof of going into drug treatment. District Attorney José Garza of Travis County, Texas, pledged to focus on diversion and stated, “Unless there is evidence that a person poses a danger to the community, I will not prosecute sale or possession of a gram or less of narcotics.”¹¹

Other jurisdictions have shifted their focus from prosecuting drug users to promoting harm reduction. The Department of Human Services in Allegheny County, Pennsylvania focused their outreach on the ten communities with the highest overdose rates, leading to a 41% decrease in overdose deaths from 2017 to 2018.¹² New York State saw a 16% reduction in opioid overdose deaths from the same year following strategies recommended by its Heroin and Opioid Task Force and implemented by county governments, such as mobile treatment, recovery centers and expanded peer services.¹³ These reductions are promising, although it bears mentioning that during this time, overdose deaths barely decreased in New York City, due in part to the regressive policies of our District Attorneys and Special Narcotics Prosecutor.¹⁴

A host of other drug policy reforms are advancing across the country. Twelve states have fully legalized recreational marijuana while an additional 21 (including New York) have legalized medical marijuana.¹⁵ Last year Denver became the first American city to decriminalize psilocybin mushrooms by de-prioritizing arrests for their sale, distribution and consumption.¹⁶ Shortly after, Oakland’s City Council passed a similar resolution to decriminalize the sale and distribution of psychedelic plants.¹⁷ Advocates in Oregon are backing Petition 44, the 2020 Drug Addiction Treatment and Recovery Act, which would remove all criminal penalties for possession of Schedule I through IV drugs.¹⁸ In Vermont’s Chittenden County, illegal possession of buprenorphine, a medication to treat opioid use disorder, is no longer prosecuted.¹⁹

The money saved from perpetuating the War on Drugs could be redirected toward harm reduction resources; since the early 1970s the United States has sunk over a trillion dollars into the War on Drugs, and continues to spend $47 billion each year.²⁰ By keeping drugs illegal, the United States forgoes the billions in tax revenue²¹ that would be generated annually if it were legalized and taxed drugs at levels comparable to alcohol and tobacco.²²

No jurisdiction has reformed its drug policy as much as Portugal, whose 2001 decriminalization of all drugs has yielded much lower drug-induced mortality rates (less than a fifth of other European countries) and the spread of infectious diseases such as HIV and Hepatitis C.²³ Across the country and the world, moving towards legalization and regulation improves health and safety.

Manhattan Needs a New Path Forward

We must end the War on Drugs here at home, and bring a public health perspective to drug use and the drug trade. If we continue to treat it as a criminal issue, the outcome is clear; we will waste taxpayer dollars arresting and housing people in jail and prison instead of investing that money in programs that can help end the cycle of harm.

As a country, we are finally moving in the right direction, beginning with the legalization of marijuana in so many states. But ending the War on Drugs means ending the broader mass surveillance of communities of color that has historically used the drug trade as its pretense.

That is why, after consulting with public health experts, formerly incarcerated leaders, service providers, criminal court attorneys, and criminal justice advocates, we are making the following bold proposals:

Proposal #1: Decriminalize Drug Possession

In our previous policy paper,²⁴ we noted that we would decline to criminally prosecute low-level drug possession cases. To be clear, that is for the possession of any drug, not only marijuana. (We clearly support the legalization and regulation of marijuana, which has been debated in Albany for years.)

While criminalizing drugs drives people to the underground, illicit market, where the quality of drugs is more dangerous, it does not decrease their use.²⁵ Instead, it simply renders users less likely to seek support. Successful harm reduction programs are built on trust between users and health providers. Especially when working with young people, we must treat users as autonomous, rational decision-makers capable of weighing risks, rewards and providing them accurate information about the drugs they use is integral to their recovery. Our current policies have resulted in a loss of life that has exceeded murder deaths in New York City over the past five years by more than threefold.²⁶ This year, scientists at the NYC Department of Health²⁷ released a study detailing how fentanyl was also responsible for the dramatic increase in cocaine overdose deaths from 2015 to 2016.²⁸ Criminalizing cocaine possession has made it harder, not easier, to pursue the origins of this deadly drug supply.

Some may ask whether it is not a bridge too far to decline criminal prosecution of drugs other than marijuana. But if our goal is to reduce the harm and risk associated with hard drugs, we must first admit that the half-century of prohibitionist policies of the War on Drugs has not worked. And of course, we reserve the right to use the full breadth of the criminal law when necessary to intervene against individuals who are maliciously harming the community. But building a relationship with drug users that cares first and foremost for their health will lead to safer communities, because healthier people are less likely to engage in problematic behavior, including criminal activities such as larceny.

Finally, the District Attorney’s office cannot do this alone. We need clear political direction from offices like the Mayor and the City Council on the role of police officers in taking New York City drug policy in a new direction.

Proposal #2: Eliminate the Office of the Special Narcotics Prosecutor

New York City is the only jurisdiction in the country to have an Office of Special Narcotics Prosecutor. That’s a distinction that must end. This office was formed in 1971 in response to concerns about increased heroin usage, and in the five decades since, it has banged a single note of “tough on crime” in response to drug usage and substance use disorder. In fact, New York has had the same Special Narcotics Prosecutor since 1998, shocking considering the evolution in society’s approach to drug policy since then. Instead, drug policy should be enforced by the city’s five democratically elected District Attorneys.

As Manhattan DA, I will withdraw support of the current Special Narcotics Prosecutor. If two District Attorneys agree with me, we can remove the Special Narcotics Prosecutor. But even on our own, we will withdraw support from the Office of Special Narcotics Prosecutor, including any material support and staff seconded to that office. Because the office itself exists through state law, I would also support legislation to disband the office and re-allocate the office’s resources to treatment and other community-strengthening programs.

Proposal #3: Promote Public Health Strategies to Fight Substance Use Disorders

We must take active steps towards reducing New York City’s intolerably high overdose death rate. In the last five years, we have lost 5,709²⁹ New Yorkers to drug overdose deaths. The consensus of health professionals and many elected officials (including DA Vance) is that safe injection sites must be part of an effective response.³⁰ As Manhattan DA, I will actively support the placement of such sites across the borough to reduce overdose deaths in Manhattan. As we indicated in Proposal #1, we will not be criminally prosecuting simple drug possession, and one way we will encourage safe injection site use is by making clear to the NYPD that they must not target users walking towards or out of such facilities. While the placement of safe injection sites will surely be controversial, as are all facility placements in New York, we must strike a balance between responding to where the crisis is most dire and soliciting community input. For example, East Harlem has the highest rate of overdose deaths in all of New York City - twice the city’s average³¹ - and the highest number of opioid treatment programs. Community members complain that this actually draws users to their neighborhoods, and oppose the creation of new treatment locations.³² Striking a balance between satisfying residents’ concerns about drug users and drug paraphernalia in their neighborhoods while providing urgent physical and mental healthcare for those who need it will require all of Manhattan’s neighborhoods to accept responsibility and collaborate on ending these preventable deaths.

Safe injection sites are but one component on a broad continuum of harm reduction services that are critical to improving public health and that I would strive to make as accessible as possible. For example, expanding access to methadone and buprenorphine, the gold standard of care, and education — in hard to reach communities has been demonstrated to be the most effective tool in treating opioid use disorder (OUD) and reducing opioid overdose deaths.³³ Other harm reduction strategies include a litany of programs such as telehealth, drug testing strips, mobile clinics, community clinics, recovery centers, managed alcohol programs, youth clubhouses, peer services, drug user health hubs and 24/7 open access centers. While these services would not be offered directly by the Manhattan DA’s office, having a District Attorney fighting for access to these services and partnering with service providers, while destigmatizing health-based approaches, would result in people having better access to care. Finally, we must practice patience in supporting peoples’ struggles with substance use disorder. Supporting people in the long road to recovery is far more effective than repeated trips to jail.³⁴

Proposal #4: Provide a Path Out of the Drug Trade for People Who Sell

We cannot discuss street-level drug enforcement policy without acknowledging that open drug trade flourishes in areas with minimal economic investment. This is deeply frustrating to many local community leaders. A smart response must recognize the economic incentives of people who sell small amounts as part of the drug trade.³⁵ The right response to those individuals, who work in dangerous conditions for paltry wages, is to direct them on a path to gainful employment rather than branding them with a criminal record that will make it increasingly harder for them to turn their lives around.

Thus, our office will explore employment-based diversion programs. For these to work we will rigorously scrutinize our partner programs to ensure that they are actually equipping these individuals, mostly young men of color, with job opportunities that are sustainable and ultimately preferable to their previous economic choices. For example, that means investing in entrepreneurial opportunities and promising industries, as opposed to menial, minimum wage work. While designing such programs should involve considerable community input, based on successful existing programs, employment areas might include the food industry, construction, security, coding, green energy jobs, and opportunities to start local businesses.

Identifying people who sell drugs for primarily economic reasons is critical, because it is well understood that not everyone in the drug trade is dealing with substance use disorder. Mandating that such individuals attend treatment as part of criminal justice diversion programs takes up valuable space, beds and resources from people actually suffering from substance use disorder.

Finally, as New York debates marijuana legalization, we strongly support legislative efforts that incorporate economic opportunities for communities that have been most harmed by the War on Drugs. This requires opportunities for entrepreneurs of color (not just national corporations), and the legal ability to work in the legal marijuana industry for people with past drug convictions. Ultimately, we believe that strong economic opportunities, coupled with the health interventions we discuss throughout these proposals, will make New York safer and healthier.

Proposal #5: Support Local, State and National Efforts to End the War on Drugs

Lastly, we must support federal, state and local efforts to end the War on Drugs, increase accessibility to safe injection sites and employment-based diversion programs. That includes our support for the following legislation and programs, some of which we have detailed elsewhere in this paper.

• Marijuana Legalization: We support Assembly Bill A01617 to legalize marijuana.³⁶ New York is still wrestling with this basic policy solution, years after legalization has taken hold in states across the country. Let’s get this done in 2020, and legalize in a way that both recognizes the harm the War on Drugs has done to communities, and gives those communities an opportunity to reap the benefits of legalization. Our office will also support a responsible path to legalization for any other drug product that currently operates in the black market.
• Support Safer Injection Sites. Leadership on implementing these sites must come from the mayor’s office, but as District Attorney, I will be a strong supporter, and push back against the inevitable scare tactics that will threaten these much needed interventions.
• Continue State Efforts to Address Overdose Deaths. Thanks to advocacy efforts from VOCAL-NY, DPA, and others, our state government has supported funding for health clinics. However, we are concerned about proposals in Governor Cuomo’s State of the State appear to use criminalization for fentanyl analogs as a primary strategy for reducing use. Furthermore, S5935/A7246B, which would increase access to lifesaving treatment (methadone and buprenorphine) for substance abuse disorder by removing prior authorization for people enrolled in Medicaid, passed the Senate and Assembly with bipartisan support³⁷ but was vetoed by Governor Cuomo in December 2019.³⁸ We hope this bill is passed in the budget next year.
• Change NYPD Responses to Drug Interventions: While our office will not criminally prosecute drug possession, our preference would be for the initial police intervention to be directed through a public health lens. Likewise, we are concerned about the NYPD investigating all overdoses as crime scenes, a practice that complicates peoples’ decision to call 911 for medical help. As with so many issues of policing, we strongly encourage New Yorkers to press 2021 mayoral and City Council candidates to adopt smart, progressive positions on these issues.
• End the Federal War on Drugs. While we must endure this national nightmare for at least one more year, we are encouraged by positions taken by leading Democratic candidates regarding the War on Drugs, driven in part by organizations like the ACLU. When we have a Democrat in the White House, we hope that person will serve as an effective partner for the groundbreaking work we will bring to Manhattan.

Conclusion

New York City’s misguided drug policy has wreaked havoc on low income communities of color for a half-century. Such harm cannot be undone overnight. The Proposals we advance here are not platitudes to score political points, but evidence-based solutions to seriously address the problems associated with drug use.

In seeking accountability and ending cycles of harm, the best long-term solutions will be found in investments we make outside of the criminal justice system — investments in education, health (physical and mental), housing, and economic opportunity. It’s clear that our current approach to the War on Drugs is the wrong approach for public health and reducing drug dependency, but proliferates these cycles of harm by driving people to the shadows. The strategy we must take to address these problems in the long term is investing in people, not prisons.

As with all of our policy proposals, we welcome and incorporate feedback, especially from those who have been impacted by the system or worked within it, and will maintain this as a living document. Together, we can all build a safer and more just New York.

Read our commitment to 80% Decarceration, released in October 2019, which discusses our many reforms to pretrial detention.

Read our Sentencing Reform Policy, released in December 2019, which discusses our approach to shortening prison sentences, fixing our oppressive plea bargain system, and parole reform.

Endnotes

[1] Janos Marton, “Bringing Humanity to Prison Sentencing Policy,” December 13, 2019, https://medium.com/@janosforda/bringing-humanity-to-prison-sentencing-policy-1413b4c5ca13 (accessed December 28, 2019).

[2] Drug Policy Alliance, Drug War Statistics, http://www.drugpolicy.org/issues/drug-war-statistics (accessed December 28, 2019).

[3] United States Department of Health and Human Services, National Institute on Drug Abuse, Drug Use Among Racial/Ethnic Minorities, 2013, https://archives.drugabuse.gov/sites/default/files/minorities03_1.pdf (accessed December 28, 2019).

[4] Drug Policy Alliance, Drug War Statistics, http://www.drugpolicy.org/issues/drug-war-statistics (accessed December 28, 2019).

[5] United States Department of Health and Human Services, National Institute on Drug Abuse, Drug Facts: Criminal Justice, June 2019, https://www.drugabuse.gov/publications/drugfacts/criminal-justice#ref (accessed January 15, 2020).

[6] Drug Policy Alliance, A Brief History of the Drug War, http://www.drugpolicy.org/issues/brief-history-drug-war (accessed December 28, 2019).

[7] Ed Chung, Maritza Perez, and Lea Hunter, “Rethinking Federal Marijuana Policy,” Center for American Progress, May 1, 2018, https://www.americanprogress.org/issues/criminal-justice/reports/2018/05/01/450201/rethinking-federal-marijuana-policy/ (accessed December 26, 2019).

[8] Office of the Manhattan District Attorney, “Decline to Prosecute Policy Became Effective August 1: D.A. Renews Call on New York State to ‘Legalize, Regulate, Expunge’,” November 1, 2018, https://www.manhattanda.org/da-vance-marijuana-prosecutions-down-94-in-first-quarter-of-new-policy/ (accessed December 23, 2019).

[9] New York City Police Department, Marijuana Arrests & Summonses Reports — 2019, https://www1.nyc.gov/site/nypd/stats/reports-analysis/marijuana.page (accessed December 29, 2019).

[10] Samantha Melamed, “What Happened When Larry Krasner Quietly Began Withdrawing Almost All Drug-Possession Cases in Philly,” The Philadelphia Inquirer , December 4, 2019. https://www.inquirer.com/news/philadelphia-district-attorney-larry-krasner-drug-diversion-decriminalization-criminal-justice-reform-20191203.html (accessed December 28, 2019).

[11] Jose Garza, “Substance Abuse as the Public Health Crisis It Is,” https://www.joseforda.com/substance-abuse, (accessed December 28, 2019).

[12] Aubrey Whelan, “The Pittsburgh Area Knocked Its Drug Overdoses Down by 40% Last Year. Why Can’t Philly Do the Same?,” The Philadelphia Inquirer, December 9, 2019, https://www.inquirer.com/health/opioid-addiction/opioid-overdoses-philadelphia-pittsburgh-naloxone-20191209.html (accessed December 28, 2019).

[13] Caitlyn Murphy, “NYS Sees First Drop in Opioid Overdose Deaths in 10 Years.” WENY News, December 9, 2019, https://www.weny.com/story/41427039/nys-sees-first-drop-in-opioid-overdose-deaths-in-10-years (accessed December 28, 2019).

[14] Nolan Hicks, “Fatal Overdoses in NYC Tick Down, but Opioid Crisis Rages On.” New York Post, August 27, 2019, https://nypost.com/2019/08/26/fatal-overdoses-in-nyc-tick-down-but-opioid-crisis-rages-on/ (accessed December 28, 2019).

[15] “State Marijuana Laws in 2019 Map,” Governing the Future of States and Localities, June 25, 2019, https://www.governing.com/gov-data/safety-justice/state-marijuana-laws-map-medical-recreational.html (accessed December 28, 2019).

[16] Tom Jackman, “As Legal Marijuana Booms, Denver Votes on Decriminalizing Hallucinogenic Mushrooms,” The Washington Post, May 6, 2019. https://www.washingtonpost.com/crime-law/2019/05/06/legal-marijuana-booms-denver-votes-decriminalizing-hallucinogenic-mushrooms/ (accessed December 28, 2019).

[17] Kayla Epstein, “Oakland Decriminalizes ‘Magic Mushrooms’ and Other Natural Psychedelics,” The Washington Post, June 5, 2019, https://www.washingtonpost.com/nation/2019/06/05/oakland-decriminalizes-magic-mushrooms-other-natural-psychedelics/ (accessed December 28, 2019).

[18] Noelle Cromble, “Signature Gathering Begins for Oregon Initiative to Decriminalize Small Amounts of All Drugs,” The Oregonian, December 5, 2019, https://www.oregonlive.com/politics/2019/12/signature-gathering-begins-for-oregon-initiative-to-decriminalize-small-amounts-of-all-drugs.html (accessed December 28, 2019).

[19] Xander Landen, “Push to Decriminalize Buprenorphine Stalls Until Next Year,” VT Digger, June 3, 2019, https://vtdigger.org/2019/06/03/push-decriminalize-buprenorphine-stalls-next-year/ (accessed January 15, 2020).

[20] Drug Policy Alliance, Drug War Statistics, http://www.drugpolicy.org/issues/drug-war-statistics (accessed December 28, 2019).

[21] Jeffrey A. Miron & Katherine Waldock, “The Budgetary Impact of Ending Drug Prohibition,” Cato Institute, 2010, https://www.cato.org/sites/cato.org/files/pubs/pdf/DrugProhibitionWP.pdf (accessed December 29, 2019).

[22] Legalization would generate tax revenue of roughly $46.7 billion annually if drugs were taxed at rates comparable to those on alcohol and tobacco. Approximately $8.7 billion of this revenue would result from legalization of marijuana, $32.6 billion from legalization of cocaine and heroin, and $5.5 billion from legalization of all other drugs.

[23] “Portugal Country Drug Report 2019: Drug Laws and Drug Law Offences,” European Monitoring Centre for Drugs and Drug Addiction, 2019, http://www.emcdda.europa.eu/countries/drug-reports/2019/portugal/drug-laws-and-drug-law-offences_en, (accessed December 29, 2019).
In 2016, Portugal attributed only 4% of new HIV diagnoses to intravenous drug use whereas the United States reported 10%.

[24] Janos Marton, “Bringing Humanity to Prison Sentencing Policy,” December 13, 2019, https://medium.com/@janosforda/bringing-humanity-to-prison-sentencing-policy-1413b4c5ca13 (accessed December 28, 2019).

[25] “Drug Policy Profiles — Portugal,” European Monitoring Centre for Drugs and Drug Addiction, June 2011, http://www.emcdda.europa.eu/system/files/publications/642/PolicyProfile_Portugal_WEB_Final_289201.pdf (accessed December 29, 2019).
In 2007, six years after decriminalizing drugs, Portugal’s use of cannabis and cocaine amongst young adults aged 15–34 years old were both approximately half of the European average, 6.7% vs 12.1% and 1.2% vs. 2.1%, respectively.

[26] New York City Police Department, Citywide Historical Data: Seven Major Felony Offenses 2000–2018, https://www1.nyc.gov/assets/nypd/downloads/pdf/analysis_and_planning/historical-crime-data/seven-major-felony-offenses-2000-2018.pdf (accessed December 29, 2019).

[27] Michelle L. Nolan, Sindhu Shamasunder, Cody Colon-Berezin, Hillary V. Kunins, and Denise Paone, “Increased Presence of Fentanyl in Cocaine-Involved Fatal Overdoses: Implications for Prevention.” Journal of Urban Health 96, №1 (2019): 49–54 (accessed December 30, 2019).
In 2016, 42,249 drug overdose deaths involved opioids 10,375 overdose deaths involved cocaine. Of those, 40.3% involved synthetic opioids.

[28] United States Department of Health and Human Services, National Institute on Drug Abuse, Fentanyl and Other Synthetic Opioids Drug Overdose Deaths, May 29, 2018, https://www.drugabuse.gov/related-topics/trends-statistics/infographics/fentanyl-other-synthetic-opioids-drug-overdose-deaths (accessed December 30, 2019).

[29] New York City Department of Health, Unintentional Drug Poisoning (Overdose) Deaths Quarters 1–3, 2018, January 2019, https://www1.nyc.gov/assets/doh/downloads/pdf/basas/provisional-overdose-report-third-quarter-2018.pdf (accessed December 30, 2019).

[30] Jennifer Ng, Christy Sutherland, and Michael R. Kolber, “Does Evidence Support Supervised Injection Sites?,” Canadian Family Physician 63, №11 (2017): 866–866 (accessed December 29, 2019).

[31] New York City Department of Health, “Health Department Announces Drug Overdose Deaths Decreased in 2018 for the First Time in Eight Years Following Historic Investments.” News release, August 26, 2019, https://www1.nyc.gov/site/doh/about/press/pr2019/drug-overdose-deaths-decreased-in-2018-for-first-time-in-eight-years.page (accessed December 29, 2019).

[32] Rachel Holliday Smith, “With a New Clinic on Way, Neighbors Decry ‘Overburdened’ Harlem,” The City, September 27, 2019, https://thecity.nyc/2019/09/harlem-overburdened-with-clinics-neighbors-complain.html (accessed December 29, 2019).

[33] The Pew Charitable Trusts, The Case for Medication-Assisted Treatment, February 1, 2017. https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2017/02/the-case-for-medication-assisted-treatment (accessed December 29, 2019).

[34] Joanna Bernstein, “A Three-Quarter Home in Pittsburgh Was a Key Stop in My Recovery from Opioid Addiction,” PublicSource, August 13, 2019, https://www.publicsource.org/three-quarter-home-pittsburgh-recovery-from-opioid-addiction/ (accessed December 28, 2019).

[35] Alyssa Stryker, “Rethinking the ‘Drug Dealer,” Drug Policy Alliance, December 17, 2019. http://www.drugpolicy.org/drugsellers (accessed December 28, 2019).

[36] A.B. A01617B, 2019–2020 Legislative Session (New York, 2019). https://assembly.state.ny.us/leg/?default_fld=&bn=A01617&term=2019&Summary=Y&Actions=Y&Text=Y&Committee%26nbspVotes=Y&Floor%26nbspVotes=Y

[37] Sheila Hand, “Another Voice: New York Needs to Enact Law Saving Lives of Drug Users,” The Buffalo News, December 26, 2019, https://buffalonews.com/2019/12/26/sheila-hand-draft/ (accessed December 30, 2019).

[38] Bethany Bump, “Cuomo Veto of Addiction Treatment Bill Angers, Confounds Activists,” Albany Times-Union, January 2, 2020, https://www.timesunion.com/news/article/Cuomo-veto-of-addiction-treatment-bill-angers-14946086.php (accessed January 3, 2020).