Testimony before the IL General Assembly on Marijuana Legalization, Public Health and the Cannabis Regulation and Taxation Act (SB 316, HB 2353): David L. Nathan, MD, DFAPA

grygielny Decriminalization, Drug Education, IL

January 22, 2018

David L. Nathan, MD, DFAPA President, Board of Directors Doctors for Cannabis Regulation

Good morning, Senator Heather Steans, Representative William Davis and esteemed members of the General Assembly.

My name is David Nathan. Originally from the Philadelphia area, I graduated with high honors from Princeton University. I received my medical degree from the University of Pennsylvania School of Medicine and completed my residency at McLean Hospital of Harvard Medical School.

I am a board-certified psychiatrist, and for the past twenty years I have maintained a private practice in Princeton, New Jersey, where I live with my wife and our two teenage children. I am the Director of Continuing Medical Education for Penn Medicine Princeton Health and the Director of Professional Education for Princeton House Behavioral Health. I am a Clinical Associate Professor at the Rutgers Robert Wood Johnson Medical School. On the topic of cannabis policy, I do not speak for the institutions with whom I have an affiliation. I am a Distinguished Fellow of the American Psychiatric Association, which is the highest membership honor bestowed by the APA. I have published numerous articles in the national psychiatric and lay press about a variety of topics in history and science, one of which is the legal status of marijuana.

I am the founder and board president of Doctors for Cannabis Regulation (or DFCR). With a prestigious roster of physicians, including former Surgeon General Joycelyn Elders and integrative medicine pioneer Andrew Weil, DFCR is the first and only national medical association dedicated to the legalization, taxation and – above all – the effective regulation of marijuana in the United States. DFCR has members in nearly every state and US territory, including right here in Chicago.

DFCR does not promote cannabis use. Rather, we advocate for the legalization of cannabis for adults, because effective regulation requires a legalized environment. We therefore support a core set of common-sense measures – our “Platform of Regulations” – to control the marijuana industry and protect public health.

We believe that the government should oversee all cannabis production, testing, distribution, and sales. Cannabis products should be labeled with significant detail, including (but not limited to) THC and CBD levels, dosing information and ingredients. There should be restrictions on marketing and advertising of cannabis products. Cannabis packaging and advertising that targets or attracts underage users should be completely prohibited. All cannabis products should have child-resistant packaging. There should be harsh penalties for adults who enable diversion of cannabis to minors. Taxation of the cannabis trade should be used to fund research, education, and prevention, including public information for adults on the use and misuse of cannabis and youth programs that emphasize the risks of underage cannabis use.

And since cannabis prohibition has worsened the poverty of the impoverished – particularly in communities of color – DFCR believes that the government has an obligation to rebuild the communities disproportionately affected by the war on marijuana. There are many ways this can be done, but if nothing else, we must expunge the criminal records of individuals convicted of minor cannabis crimes and ensure diversity in the cannabis industry.

Esteemed members of the General Assembly: The time has come to end the failed and harmful prohibition of marijuana in the State of Illinois.

This historic and beloved city of Chicago knows all too well the destruction brought by well-intended but sadly misguided efforts by society to control addiction through prohibitions. From the violence in the streets under Alcohol Prohibition, to the violence in the streets we see today, Chicago has paid a heavy price for the heavy-handed criminal approach to addiction, which is fundamentally a health problem, not a moral one.

Alcohol Prohibition was repealed after just thirteen years because of unintended consequences: organized crime, increased use of hard alcohol, and government waste.

So, what have we gotten from our eighty-year experiment with marijuana prohibition? Organized crime, increased use of stronger marijuana, and government waste.

And yet, Alcohol Prohibition was a success compared to our war on marijuana. Alcohol consumption decreased during the 1920s, but marijuana use has increased drastically since its prohibition. Today, 22,000,000 Americans use cannabis each month, and even more partake on a less frequent basis.

Marijuana prohibition began in the 1930s – over the objections of the American Medical Association – based on scare tactics and fabricated evidence that suggested that the drug was highly addictive, made users violent, and was fatal in overdose. We now know that none of those assertions are true. Cannabis is less addictive than alcohol and tobacco. It doesn’t make users violent, and there are no documented cases of fatal cannabis overdose. In short, from the medical standpoint, marijuana should never have been illegal for consenting adults.

While Doctors for Cannabis Regulation firmly supports the legalization and regulation of marijuana for adult use, it emphatically opposes underage recreational use of marijuana. Evidence suggests that both marijuana and alcohol can adversely affect brain development in minors. Studies of underage users show that health effects are worse when kids start younger and consume more frequently.

But cannabis prohibition for adults does not prevent underage use. For decades, preventive education reduced the rates of alcohol and tobacco use by minors, while underage marijuana use rose steadily despite its prohibition for adults. The government’s own statistics show that 80-90% of eighteen-year-olds have consistently reported easy access to the drug since the 1970s.

Opponents of legalization like to say: “This isn’t your parents’ marijuana.” And they’re right. Cannabis cultivation has led to the development of more potent strains, to the extent that illegal marijuana today is typically about three to five times stronger than it was 30 years ago. In states where marijuana is legal, the government requires potency labeling. Adult users can make informed decisions about their intake based on potency, much as people do with alcohol – say, drinking a small amount of vodka compared with two beers. But in Illinois, where it’s illegal and uncontrolled, marijuana products aren’t labeled and users consume an unknown product of unknown potency. Thus, the opposition’s claim is a medically sound argument… to legalize and regulate marijuana so that products are properly labeled with potency, ingredients and serving sizes.

Opponents of legalization say – again without evidence – that marijuana legalization “sends the wrong message” to kids. In other words, they argue that if a drug or activity is legal for adults, then kids will think it’s safe for them.

If there is an association, it is the opposite of what opponents claim. When cannabis is against the law for everyone, the government is saying that marijuana is dangerous for everyone, and kids know that’s not true. If adults can’t be trusted to tell the truth about responsible adult use of marijuana, why should kids listen to us when we say it’s harmful for them? By making a legal distinction between marijuana use by adults and minors, we demonstrate a respect for scientific evidence – and the sanctity of the law – that we would want our children to emulate.

Whether in sex education or drug education, when kids know we’re being honest with them and trust the information we’re providing, they’re more likely to take that advice seriously. And we know that preventive drug education works—the rates of underage tobacco and alcohol use have been falling for many years, even though it remains legal for adults. During that same time, underage marijuana use – which until recently was illegal in all 50 states – has risen.

Today, teen use has remained level across the nation, including in legalized states. While we cannot predict the future, there are good reasons to believe legalization may actually decrease underage use.

Now I would like to address what may be the biggest misconception about marijuana – namely, that it is a “gateway” to the use of harder drugs. We hear this repeated over and over again, and always without supporting evidence.

A study by the Institute of Medicine, the health branch of the National Academy of Sciences, concluded that marijuana “does not appear to be a gateway drug to the extent that it is the cause or even that it is the most significant predictor of serious drug abuse.”

While it’s true that users of hard drugs often tried marijuana first, they’re even more likely to have tried alcohol and tobacco. And the vast majority of those who try marijuana, alcohol and tobacco don’t go on to use harder drugs. Simply put, the fact that some people who use hard drugs also used marijuana in no way implies that marijuana causes people to use hard drugs. The marijuana “gateway” hypothesis is an archaic, misleading and oversimplified explanation of substance misuse, and it trivializes the serious discussion of how to address one of the greatest public health crises in history: our nation’s deadly opioid epidemic.

Times are changing. In 2018, even physicians who oppose legalization generally believe that marijuana should be decriminalized, reducing penalties for users while keeping the drug illegal. Although decriminalization is certainly a step in the right direction, DFCR physicians believe it to be an inadequate substitute for legalization and regulation for a number of reasons.

First, decriminalization does not empower the government to regulate product labeling and purity, which leaves marijuana vulnerable to contamination and adulteration. This also renders consumers unable to judge the potency of marijuana, which is like drinking alcohol without knowing its strength. Moreover, where marijuana is merely decriminalized, the point-of-sale remains in the hands of drug dealers who will sell marijuana – as well as more dangerous drugs – to children.

Contrary to popular belief, decriminalization doesn’t actually end the arrests of marijuana users. Despite New York State decriminalizing marijuana in the 1970s, New York City makes tens of thousands of marijuana possession arrests every year, with continuing racial disparities in enforcement. Finally, under a decriminalized system the government continues to prosecute and constrict the supply chain. This drives up the price of marijuana, making the untaxed illegal market more lucrative, competitive, and violent.

When we describe the days of Al Capone, we call it “Alcohol Prohibition”, but it was actually more properly called “Alcohol Decriminalization”. It was perfectly legal to obtain and consume alcohol for medical purposes or religious rituals, or if you made it at home for your personal use. So, when opponents tout decriminalization as an answer to prohibition, ask them what they think will happen if we remove penalties for consumers while prosecuting growers and sellers, and how this could be expected to work when Alcohol Prohibition didn’t.

Ladies and gentlemen, I thank you for your time and attention. I would be happy to answer your questions.

Respectfully submitted,
David L. Nathan, MD, DFAPA
609-688-0400 (phone)
609-688-0401 (fax)
601 Ewing Street, Suite C-10
Princeton, New Jersey 08540

Doctors for Cannabis Regulation. “Platform of Regulations.” Updated January 2018. https://dfcr.org/platform-of-regulations/

Legal Impact and Financial Implications: Attorney General Jeff Sessions Memo

Sanya Singh Legalization, Medical Marijuana

Elizabeth Wittemyer, Attorney At Law

Prepared at the Request of the Marijuana Education Initiative

When U.S. Attorney General Jeff Sessions decided to issue a memorandum on January 4, 2018, rescinding the Cole Memorandum, it was clear that his long-time wish to demonize marijuana and criminalize activities around the legal state markets had come to pass. I am an attorney who represents the cannabis industry, and several worried clients and colleagues have wished to discuss the issue and the possible consequences with me. The interplay of state and federal law can be confusing, especially as we consider the effects the Sessions Memo will have on the cannabis industry.

Understanding the hierarchy of the U.S. Justice Department and its authority over the states is one way to view how this interplay works. The Justice Department is an executive-branch agency that deals with crimes at the federal level and that enforces federal law. The U.S. Attorney General is a cabinet member appointed by the president and is the nation’s chief law enforcement officer for federal law. U.S. attorneys are employees of the Justice Department and prosecute federal cases brought to them by federal law enforcement agencies such as the Federal Bureau of Investigation and the Drug Enforcement Administration. The DEA investigates crimes involving cannabis. You might remember from the television show Law and Order, the DEA investigates crimes as law enforcement officers and the U.S. attorneys prosecute in federal courts the crimes brought to them by DEA officers. Marijuana is federally illegal and is classified as a Schedule I drug under the Controlled Substances Act. The DEA is the lead law enforcement agency for the domestic enforcement of the Controlled Substances Act.

The Cole Memorandum from 2013 established a new “prosecutorial discretion” regarding cannabis. It was a policy guidance to U.S. attorneys that made the cannabis industry a low prosecutorial priority in states that had legalized cannabis, as long as those states complied with the guidelines contained in the memo—namely, to protect youth and control diversion. What the Jeff Sessions Memo does is reestablish cannabis, regardless of legality within the states, as a prosecutorial priority along with all other federal crimes. In the memo, Sessions encourages the prosecution of other crimes that can be tied to cannabis, such as money laundering and violations of banking regulations. These types of prosecutions will almost certainly include asset forfeiture actions. The Sessions Memo highlights the “Department’s finite resources” and points to principles of prosecution set in 1980, taking us back to the old, failed policies of the war on drugs.

Though U.S. attorneys seem to have little appetite to initiate prosecutions against legal cannabis businesses, the same cannot be said of the DEA. In fact, the DEA has always had a Domestic Marijuana Eradication/Suppression Program aimed at completely eradicating cannabis in the United States. According to the Department of Justice Fiscal Year 2016 Budget submitted to Congress, the DEA spent millions of dollars on marijuana eradication efforts, including anti-legalization education programs. Although the cannabis industry blames the DEA for refusing to reschedule cannabis from its present Schedule I status, it is the Department of Health and Human Services that has the legal responsibility to make scientific and medical determinations regarding drug scheduling. The head of HHS Tom Price resigned in a cloud of scandal in September 2017. The president has nominated Alex Azar, a former pharmaceutical company executive, to fill the position, and Mr. Azar’s confirmation hearing began January 9, 2018. As cannabis is a competing product to pharmaceuticals, it is highly unlikely that a former representative of the pharmaceutical industry, which holds one of the most powerful lobbies in Congress, will consider rescheduling marijuana. With Azar as head of HHS, the pharmaceutical industry would have even more control over our federal agencies in their quest to demonize cannabis, with Jeff Sessions leading the charge.

The Rohrabacher-Blumenauer amendment (formerly the Rohrabacher-Farr amendment) is part of the federal budget established by Congress and has been included in every annual federal budget appropriations since 2014. The amendment prohibits the use of federal funds to supersede legal medical marijuana state laws. What many people do not realize is that the amendment primarily protects medical marijuana and not recreational marijuana. This year, Congress has been unable to agree on the budget and has limped along by making continuing resolutions to keep a government shutdown at bay. The last continuing resolution was on December 22, 2017, and it extended the previous budget to January 19, 2018. The Senate appropriations included the Rohrabacher-Blumenauer amendment; the House version did not after Attorney General Jeff Sessions lobbied against its inclusion. It is unclear what will happen to the amendment amid the many other fights over the budget, including immigration, defense, and domestic programs. Even if the Rohrabacher-Blumenauer amendment is included in the next appropriations bill, the rescission of the Cole Memo places the recreational marijuana industry at particular risk.

Federal law supersedes state law, “preempting” state laws that conflict with federal laws. With the Cole Memo, the Obama administration allowed states to experiment with legalization of cannabis, in essence, “promising” not to bring a preemption action in federal court that would shut down a state’s legalization of marijuana. Although many legal scholars argue that the states that have legalized have relied on this federal discretion to their detriment, and therefore there are now legal defenses to a preemption action, the legalized states’ courts are not friendly to cannabis. State law cannot legalize what is illegal under federal law. In several court cases, acts that are legal under state marijuana laws were not protected by the courts owing to the illegality of the act under federal law, and this has led to seizures of inventory and loss of jobs. Cannabis businesses must be very careful in seeking relief in the state courts and should instead opt to negotiate, mediate, or arbitrate disputes whenever possible. Although recreational cannabis stands in particular danger because of its relative lack of credibility compared to medical cannabis, the entire legal cannabis industry is at risk.

As we experience the devastating opioid crisis, with thousands of lives lost, the Jeff Sessions Memo begs reason and common sense. President Trump declared the opioid epidemic a national emergency; however, no new federal funds were allocated to address the crisis. Medicaid is under attack and will be cut back; by how much is the only question. States, facing budget shortfalls, have cut treatment programs throughout the nation. First responders dealing with opioid overdoses are vicariously traumatized by the horror they experience every day and their resources are stretched to the point of breaking. Our courts, overwhelmed with opioid-related crime cases, have few options to deal with the social ill of addiction through the criminal justice system. We are losing our family, friends, and neighbors every day to opioids. Yet, rather than spend federal money on prosecuting feel-good doctors, pill mills, and foreign actors to attempt to reduce the opioid epidemic, Jeff Sessions will devote the Department of Justice’s finite resources to prosecuting a drug that no one dies from. In fact, research shows the promise of cannabis as an effective treatment in reducing the need for opioids.

The question is, therefore, one of where to direct our government’s limited resources. Do we spend federal dollars prosecuting opioids or prosecuting cannabis? Do we spend federal dollars on anti-legalization education or on education that will help our youth make healthy choices around legalization? Education programs such as those of the Marijuana Education Initiative, which provides reality-based education for youth regarding marijuana, are the initiatives that our tax dollars should fund. Now is the time to press our elected representatives to set the nation’s priorities straight.

To learn more about the misinformation surrounding marijuana and the opioid epidemic check out our blogs The Truth and Marijuana and Opioids:   Sorting Through the Misinformation  

Attorney General Sessions Threatens States Over Marijuana Legalization

Rev. Alexander E. Sharp Legalization, Medical Marijuana

via Flickr

We have long known that US Attorney General Jeff Sessions does not approve of marijuana, not to mention any drug. (His office refuses to answer the question of whether he drinks alcohol.)  He has famously said that “good people” don’t use marijuana.

On January 4, he implicitly threatened states that have legalized marijuana for medical or recreational use.  He rescinded an Obama-era memo, issued in 2013, which had signaled considerable leeway for states even though marijuana is illegal under federal law.

His timing was ironic.  He issued his memo the day before the Vermont House of Representatives was scheduled to vote to legalize marijuana through legislative action.  Indeed, they did so on January 5th, and the Vermont Senate did the same a week later. Apparently, as one of my advocacy colleagues said, “They did not get the memo.”

Other states where legalization has been recently approved by ballot initiative—most notably Massachusetts and Maineseem for the most part undeterred by the Sessions memo.

In Colorado, one of the first two such states (Washington was the other) to legalize marijuana in 2012, the response has verged upon anger.  US Senator Cory Gardner (R-CO) feels betrayed.  During Mr. Sessions’ confirmation hearing as attorney general, Sen. Gardner asked for and received assurances that no such action would be taken.

There are two reasons why I think we should be not only bemused but angry at what the Attorney General has done.  The first is that we have long passed the point of wondering whether cannabis as medicine has value.  It clearly does.  It is now a reality in 29 states containing over 60% of the U.S. population.

Respected medical journals document that marijuana offers relief for patients with cancer and multiple sclerosis and severe chronic pain.  An article entitled, “Talking About Marijuana—In Church” in the January 3 issue of The Christian Century notes that marijuana is important to older folks because “it appears to be particularly helpful in coping with the myriad side effects of other drugs.”   Are these not “good people”?

It is not clear yet what the consequences of the Sessions memo will be, but it may make life more difficult for the providers of medical marijuana.  For this, he should be condemned.  (We provide the opportunity to TAKE ACTION.)

The second reason for anger starts with the fact that we are in the midst of a national opioid health crisis. Mr. Sessions should use the resources of his office to prosecute those in the medical community who have helped to create and continued to fuel this epidemic. When it comes to medical marijuana, he should recognize the promise of marijuana as reducing the need for opioids.

Attorney General Jeff Sessions by all accounts likes his job because it enables him to pursue “law and order” policies of the 1980s which he is now in a position to impose. When it comes to marijuana, he is wrong.

Martin Luther King Jr’s Dream: Civic and Economic Justice

Rev. Alexander E. Sharp Decriminalization, Racial Inequality, Reparations


Almost 50 years after the assassination of Dr. Martin Luther King Jr., it is only natural to wonder what he might teach us in these profoundly troubling days.  It is worth remembering that, especially in the last three years of his life, his most strident calls were for economic justice.

“I have a dream today that my four little children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character.” As the minister and scholar Michael Eric Dyson reminds us, these 34 words are more famous than anything else King ever said.  These are the words we carry in our hearts.  But this was far from the full message.

It is now commonplace to observe that the United States is the prison capital of the world.  We incarcerate more people per capita than any other nation on earth, with Russia a not so close second.  This monstrous reality has fallen most heavily on African Americans and Hispanics.

While he did not live to see that our criminal justice system would become perhaps the leading civil rights issue of our day, Dr. King knew intuitively what must happen if we are ever to move beyond Jim Crow: civil rights laws alone could not address three centuries of racism and economic exploitation.

He was killed in Memphis, where he had gone to lead a strike of sanitation workers, and his next destination was to be Washington D.C. where he was mobilizing a Poor People’s Campaign.

Three weeks before the end of his life, he spoke of how in the 1860s Americans had been given land if they moved west to build their economic future even as blacks remained slaves.   Listen to Martin Luther King in this video.  He is tired, impatient, even close to anger.

Anticipating a Poor People’s Campaign, he said, “Now when we come to Washington in this campaign, we are coming to get our check.”  Is this not a call for reparations?

For most Americans, the idea of reparations is a non-starter.  It seems at best impractical. But consider the perspective of African Americans who cannot get a job due to a marijuana arrest on their records as we move to the legalization of marijuana. They are witnessing young white men creating businesses to sell a substance that blacks went to jail for possessing.

The growing marijuana industry as an argument for reparations is a small slice of a much deeper problem. Even if we cannot devise a clear-cut reparations policy as such, it is worth keeping front and center the idea of helping people overcome the challenges of almost three centuries of oppression.  Ta-Nehisi Coates tells us why: “Perhaps no number can fully capture the multi-century plunder of black people in America…But I believe that wrestling publicly with these questions matters as much – if not more than – the specific questions that might be produced.”

In this, he is surely right.  Let us remember today that as King called for the brotherhood and sisterhood of us all, he knew this could not be achieved without economic justice. If only to help us discuss this fundamental truth, it worthwhile to discuss what society can and should do in the way of reparation.

Dr. King surely would have approved.





Audio and Full Text- Community Healing in the Aftermath of the War on Drugs: Sermon by James Kowalsky

Sanya Singh Faith Perspectives, Legalization


Thank you all for inviting me here to be a part of your service. Thanks to Cathy for bringing this topic, which is near and dear to my heart, to your congregation.

My name is James. I’m Jewish and we like questions. So, I’m going to start this sermon with a few questions for you to consider. Many of these questions don’t have absolute answers. They are questions we should ask ourselves so that we know where we stand and try to figure out how these beliefs we hold, impact the action we are willing to take.

What does a drug user look like?

For many of us when we picture what a drug user looks like we imagine someone looking dirty and disheveled, living on the streets with beer bottles or needles scattered around their body. We picture a desperate and dangerous criminal, willing to harm anyone in order to feed their addiction. We picture a person of color, most likely someone who’s black. Where do these images come from? What drives the belief that this characterizes what a typical drug user looks like? As it turns out, these images don’t match the reality of drug use.

In a study published in the Journal of Alcohol and Drug Education in 1995, a survey asked people to envision a drug user and describe that person. 95% of respondents described a black person. This is the case despite that fact that the majority of people who use drugs in our country are white. African-Americans make up about 15% of the people who use drugs, roughly equal to their proportion of the general population.

When we picture who a drug user is, we don’t readily think of the successful people who have used drugs—executives, scientists, writers, musicians, politicians, Presidents. It would be inaccurate to say that people who use drugs or have used drugs are bad people, or are unproductive members of our communities. In fact, the overwhelming majority of people who try a drug—any drug—will not have a serious problem with that drug in their lifetime. Yet, this image of a drug user as a failure and threat persists.

When we hear the term “drug user” we often think of a small group of drugs: cocaine, heroin, methamphetamine. We don’t think about the complete list of drugs—legal and illegal—that people use. So, it begs the question…

What is a drug?

In general, we would define a drug as a substance that we put into our bodies that alters our mood or physiological state; the caffeine we use to help us get out of bed at the start of the day; the medicine we take to control our blood sugar, blood pressure, or moderate other symptoms that may prohibit us from taking care of business; the glass of wine we use to unwind after a long day at work. All of these are substances we put into our body to alter the way we think and feel.

What impact would it make if, instead of thinking about drug users as “other” or “those people”, we all thought about ourselves as drug users? How would that affect the way we approach drug use in our communities? Why, when we hear the term drug user, don’t we picture a successful white person drinking alcohol? What impact does it have on people’s mindset to picture a black criminal, injecting heroin, and to meld these images together when we hear the words, drug user?

If we want to change the way we treat people who use drugs and the impact their use has on them and in our communities, we have to address the internal bias and prejudice that we’ve built up over our lifetime.

This does not mean that drugs are not harmful.

Certainly, all drugs have the capacity to harm people. Partially, we have a skewed perspective of drug users because the people who are most negatively impacted by their use, are inherently more likely to need help and encounter systems like hospitals, treatment programs, and law enforcement. However, we’ve exaggerated the likelihood of harm in order to scare people away from trying drugs. This approach is effective for some but it leaves all the people who will experiment, without any idea that there are more or less harmful ways of using any drug.

A quick story, when a friend of mine was a teenager he decided that he wanted to try marijuana for the first time. He bought $25 worth, a quarter of an ounce, from someone at school. Not knowing any better he put all of what he had bought on a sheet of computer paper, rolled it up like a cigarette, taped it shut, and smoked it. We can agree that smoking computer paper and tape isn’t good for you. I tell this story to say, the risk of harm from using a drug is much greater when you don’t know what you’re doing. The risk becomes even more serious when using a drug that can be lethal if used incorrectly.

On the other hand, when a person doesn’t know what they are using is a drug, because it’s legal or provided to them by a doctor, there is also a great risk. Alcohol isn’t a drug, it’s a beverage. Vicodin isn’t a drug, it’s medicine. Marijuana isn’t a drug, it’s a plant. In all these cases, it can be both of these things! Not knowing that also makes harm more likely.

But, if any drug can cause harm, why do we still use them? To put it simply, people use drugs for a reason. A rabbi I spoke to once generalized the reasons for using drugs as an attempt to feel more present in a moment or to disconnect. We might use drugs to feel more connected with a group of people, to enhance an activity like a meal or concert, to deepen our thinking or sense of spirituality associated with a religious ritual.

Indigenous cultures have traditionally used psychedelic drugs for these spiritual purposes. In Judaism, we have several holidays connected with drinking wine. It is considered a good deed to make a blessing over wine in order to mark the beginning of Shabbat. On Passover we celebrate our exodus from slavery by retelling the story and drinking four full glasses of wine. On Purim, a Jewish scholar Rava was said to have taught that we should drink wine until we cannot tell the difference between the face of Haman and Mordecai, our enemy and our friend.

But, we also use drugs to distance ourselves from negative feelings—physical pain, boredom, anxiety, loneliness, despair. The person who uses heroin to seek relief from intense physical pain; or uses alcohol to drown out traumatic memories and racing thoughts so they can fall asleep at night; the person who uses cocaine to overcome their crippling social anxiety and enable connection with other people. Whatever reason we use drugs for, we do not do it as a means to harm ourselves but as a way of obtaining some sort of benefit from our use.

Our relationship with any drug—legal or not—can range from harmful to helpful. There are a number of factors beyond the drug itself that impact whether or not we experience harm from using it. Environment matters. Journalist Johann Hari talks about harmful use being a product of disconnection. Dr. Gabor Mate talks about addictions being rooted in painful experiences. Norman Zinberg points to the combination of three sets of factors he calls drug, set, and setting—factors related to the drug and how it’s used, the individual and their circumstances, and the environment they use in. Most people would agree that when we’re using drugs, we are more likely to experience harm from them if we don’t have a strong support system around us. We also know that experiencing trauma in early childhood increases the likelihood that people will have a harmful relationship with drugs.

Yet, we live in a country that demonizes the drug user—they are a person who has made bad decisions and must live with the consequences. We see drug use as an individual choice and an individual problem. We try to interrupt that problem by punishing their bad choices and isolating people from everything that is familiar to them.

But, what child chooses to be neglected or abused? What person chooses to be left without a support system when their parent or caregiver dies? Nobody chooses the circumstances that often precede harmful relationships with drugs. But, it’s far simpler to point to the individual and never consider the environment that they come from. That way, we don’t have to think about how poverty, a poor education system, a lack of economic opportunities, unstable housing, or growing up in a neighborhood where you regularly witness community violence, all make it more likely that people will have a harmful relationship with drugs. In fact, it is these circumstances, not drug use, where African-Americans are disproportionately represented.

Just as our environment affects our relationship with drugs, our environment is impacted when we use drugs in a harmful way. Responsibilities are ignored—work doesn’t get done, friends and family members are neglected or taken advantage of. But, we’ve tried to punish our way out of the harms caused by drugs for 100 years. And it hasn’t worked. Instead, escalating punishment and extreme isolation have exacerbated the harm.

Much like drug use itself, punishment and isolation don’t just impact the individual. They damage the environment as well; they take the parent away from their child, remove brothers and sisters from families. By removing community members, we promote disconnection and thereby increase the likelihood of harmful drug use for the people left behind.

Nowhere is the failure of our current approach more apparent than in the dramatic spike in drug overdose death. This issue is particularly timely, as August 31st was International Overdose Awareness Day. We can’t punish our way out of harms like overdose death. We need a better way.

We need to shift away from focusing our energy on trying to eliminate drug use altogether. That is and always has been an unrealistic goal. Drugs have been used for thousands of years, across continents and cultures. Drugs are a part of our lives and we all have relationships with them. We need to focus on the harms we consider most egregious and address them instead.

We’ve tried, what some would call, a tough love approach for too long. It’s time we just try love. We need to shift from seeing harmful drug use as an individual problem that we solve with punishment, to a community problem that we solve with healing.

What does it mean to move away from punishment and to focus on healing? Focusing on healing means that we promote people’s ability to be healthy and safe, connected to a support system and in control of their lives.

One approach that does just that, and is gaining traction, is called harm reduction. Harm reduction is the practice of using drugs in less risky ways. When we drink responsibly, we are practicing harm reduction. We eat food before drinking, drink water, we practice moderation and limit our total number of drinks, we don’t drive when we’ve had too much to drink. These are all harm reduction choices we regularly make. As we make harm reduction choices with alcohol, we can make similar choices with other drugs. If you never know there’s a safer way to do something, you’re more likely to make a harmful choice.

Beyond this individual practice, harm reduction is a philosophy—a belief in the human rights of people who use drugs. Harm reduction promotes the idea that regardless of what a person puts in their body, they should not be denied their basic human rights. In the programs that I’ve worked for, we use harm reduction in a practice called Housing First. We don’t deny people access to the human right of housing simply because they use drugs. We provide that resource to people who need it because they are homeless. Once they are housed, we surround them with a support system to help them make positive changes. Sometimes those changes are related to their drug use but sometimes not; sometimes it’s about addressing other physical or mental health concerns; sometimes it’s about pursuing meaningful activities like education, volunteering, or employment; sometimes it’s about reconnecting with elements of their support system that they may have lost along the way. The essential part of this approach is that people who use drugs are afforded the right to choose for themselves what’s most important to them.

As members of a faith community, your congregation has a unique opportunity to offer connection and healing to people in need. Matthew 11:28 tells us, Come to me, all you who are weary and burdened, and I will give you rest. The church has long been a place where people have sought out sanctuary. Extend an olive branch to the people who experience the severe consequences of drug use.

Too often, people who struggle with their drug use don’t seek out help, because they think that love and support will only be available to them if they are ready to stop using altogether. We need to dispel the myth that belonging to this community is contingent on abstinence from all drugs. Because it’s not. We know that because we’re all here.

Many people in this room use drugs in one form or another. Nobody is checking people’s medication cabinets to decide who’s allowed to pray here. There is no breathalyzer taken at the door. Your morning coffee doesn’t stop you from being able to connect with this sermon—on the contrary, it probably helps. Our drug use doesn’t stop us from practicing our faith.  Our drug use doesn’t prohibit connection and belonging. What is it about our world that makes people who use drugs think otherwise?

We need to throw open our doors to people, wherever they are and whatever they come to us with. Our love and support cannot be contingent on their choice of whether or not to continue using.

Instead of focusing on trying to get people to stop using drugs, we can focus on trying to understand how and why they are using drugs. In order to understand people, we need to be willing to listen.

Healing happens in relationships. We should focus on building a connection with people. Learn about their lives. Find out about their story, ask them about their hopes and dreams, ask them about what’s missing in their life. Almost certainly, one of the things they’re missing is someone who’ll ask those questions and respectfully listen.

Remember, that person who is struggling is likely trying to disconnect from some source of pain. Give them love, give them connection, give them rest, help them heal, and you will help our communities heal.


Thank you again for having me here today. If you’re interested in learning more about the policies that impact people who use drugs in our state and in our country, I bought a sign-in sheet for an organization called Clergy for a New Drug Policy. They are an interfaith organization that envisions a society driven by the values of mercy and compassion and advocates for alternatives to our current War on Drugs.