American Medical Association Endorses Drug Decriminalization

On June 12, the American Medical Association (AMA) voted to support the decriminalization of drug possession for personal use. The vote took place during the AMA’s annual House of Delegates meeting held in Chicago, Illinois. MD/PhD candidate Ryan Englander highlighted the significance of this shift, stating, “The war on drugs is quite reminiscent of the phrase, ‘The beatings will continue until morale improves.’ We have tried for decades to criminalize our way out of a substance use crisis in this country, and it has not worked. We need to move to something different and better, something that actually works.”

New Stance on Drug Policy

Previously, the AMA Board of Trustees recommended monitoring the legal and public health effects of state and federal policies regarding drug possession reclassification. However, delegates voted 345-171 to adopt a new position advocating for the elimination of criminal penalties for drug possession for personal use as part of broader public health and legal reforms.

Evidence from Global Models

Englander cited examples from Oregon and Portugal to support the policy change. While Oregon’s attempt to decriminalize hard drugs faced challenges, Portugal’s model showed success in reducing mortality and increasing treatment access. “There are models that we can use that can work,” Englander explained.

Debate and Opposition

Not all delegates were in favor of decriminalization. Stephen Taylor from the American Society of Addiction Medicine suggested further review, stating, “There is, in fact, evidence that decriminalization can have public health benefits if it is done correctly. We would suggest that we have yet to see it done correctly.”

AMA President-elect Bobby Mukkamala expressed caution, pointing to Oregon’s mixed results: “There was no reduction in mortality and no increase in access to treatment… The board doesn’t believe it’s wise to have the AMA support policies that do not have more robust evidence behind them.”

Complex Issues in Drug Policy

Marianne Parshley, a delegate from the American College of Physicians, noted that while Oregon’s decriminalization initially showed promise, the rise in fentanyl use and associated deaths complicated the issue. “It’s complex,” Parshley said. “We need to pay attention to the fact that [the situation] doesn’t instantaneously change if you pass decriminalization and support for treatment.”

Evolving AMA Policies

The AMA’s stance on drug policies has evolved over recent years. In June 2022, the AMA updated its policy on expungement, advocating for states to implement record-cleaning services. Scott Ferguson, an AMA trustee, emphasized the importance of this change: “It simply isn’t fair to ruin a life based on actions that result in convictions but are subsequently legalized or decriminalized.”

Additionally, the AMA has shown support for research into the medical use of psychedelics for psychiatric disorders, underscoring the need for scientifically valid clinical trials to assess safety and effectiveness.

Future Implications

As the AMA moves forward with its new stance on drug decriminalization, the debate within the medical community highlights the complexities and challenges of addressing substance use issues through public health and legal reforms. The ongoing discussion will continue to shape the future of drug policy in the United States.