1

Introduction¹

The history of policies regulating drug use in the United States has many components, making it difficult to ascertain the effectiveness of any given policy. Laws and policies attempt to regulate the distribution, manufacture, use of, addiction to, and consequences of a variety of nonlegal substances. It is a complex legal and economic system, all part of the overall criminal justice system.

One consistent finding indicates that contact with the criminal justice system regarding illicit drug use disproportionately affects individuals and communities of color. For example, individuals of color are more likely to be arrested and to receive harsher sentences when compared to the White majority group, according to keynote speaker Kassandra Frederique. Research from the nonprofit organization The Sentencing Project (2018) indicates that this is the case at every step of the journey through the criminal justice system, from arrests, to convictions, to sentencing, to incarceration rates. For example, Nellis (2016) notes that Black people are more than five times more likely to be incarcerated in state prisons. Hetey and Eberhardt (2018) analyzed police stops in Oakland, California, where Black people make up 28 percent of the population. They found that 60 percent

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¹ The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop has been prepared by the rapporteur as a factual account of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine. They should not be construed as reflecting any group consensus.

of all police stops were of Black people. A similar pattern of police stops occurs in other major U.S. cities (The Sentencing Project, 2018).

The fact that Black people are consistently overrepresented at every level of the criminal justice system for drug offenses has clear outcomes for both the individual’s health and the health of the community to which the individual belongs (Fellner, 2009). This is because of an ongoing pattern of systemic racism within the criminal justice system (The Sentencing Project, 2018). Other communities of color experience similar outcomes with the criminal justice system, including Native American and Latino/Hispanic populations (Liberman and Fontaine, 2015).

To examine the effects of drug control policies on the health of individuals and communities of color, the Roundtable on the Promotion of Health Equity held a workshop on October 8, 2018, in Washington, DC. As noted by Antonia M. Villarruel, Margaret Bond Simon Dean of Nursing at the University of Pennsylvania School of Nursing and chair of the roundtable, “We must really look at and recognize the role that the justice system [plays], as well as all of the upstream effects that drug policies have on individuals and communities.”

The workshop objectives, as defined by the planning committee, were the following:

1. Better understand how drug control policies and laws affect people and communities of color.
2. Examine the effects of race and ethnicity on drug policies in the criminal justice system.
3. Explore promising models and best practices for new ways to handle drug-related convictions in the criminal justice system.

This publication summarizes the presentations and discussions of the workshop. These proceedings reflect the observations made by workshop participants and should not be seen as representing a consensus of the workshop participants, the roundtable, or the National Academies of Sciences, Engineering, and Medicine. The statement of task used by the planning committee can be found in Appendix D.

ORGANIZATION OF THE PROCEEDINGS

Chapter 2 summarizes the remarks of two keynote speakers, Peter Reuter of the University of Maryland and Kassandra Frederique of the Drug Policy Alliance. Chapter 3 addresses law enforcement, arrests, and prosecution. Chapter 4 discusses how drug control policies are applied within the criminal justice system. Chapter 5 describes promising practices and models for changing current drug control policies. Chapter 6 includes observations from roundtable members who offered final reflections on important lessons that emerged from the workshop.