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The criminal justice reform movement took hold in this country over the last decade. It was a many-pronged approach that included a push to lower criminal penalties, to legalize or reduce punishment for illicit drug crimes, to limit enforcement of property crimes and driving offenses, and to encourage pre-trial release and alternative courts and sentencing. The movement also embraced harm-reduction strategies, particularly for drug offenses. It was powerfully successful, even in conservative states like Indiana. We saw “reform” in all these areas.
Recently, however, the pendulum has begun to swing back nationwide. Criminal enforcement is up and bail reform and sentencing alternatives are being rejected or scaled back. Even harm-reduction strategies are losing popularity. Calls to “remove the stigma” and the liberalization of drug use are on the wane.
Except in the Indiana Senate.
Recently, Indiana senators voted 33-13 to extend the state’s syringe exchange programs for another decade. The primary argument in favor of such programs is that they reduce the infection rate for HIV. There is evidence to support this claim. However, there are serious negative externalities as well.
As a case study on the harmfulness of harm-reduction policies, consider Canada’s British Columbia. In 2020, they began what they call the “safer supply” program. Under this program, doctors expanded authority to write prescriptions for fentanyl — not just for things like pain during surgery but for recreational use by addicts. The program was later expanded to allow doctors to prescribe fentanyl to minors for recreational use without parental knowledge or consent. In 2023, the province legalized all drug possession entirely.
These Canadians are also fans of safe injection sites, which are government supervised drug dens where users can go to shoot up. Some safe injection sites were even modified to safe inhalation sites where needle-shy users can go to inhale vaporized fentanyl.
Utterly predictably, these policies have been disastrous. British Columbia has one-eighth of Canada’s population but accounts for one-third of all overdose deaths. The leading cause of death among 10-18-year-olds (you read that correctly) in British Columbia is drug overdose. Since these policy changes, BC doctors have prescribed 22,418,000 doses of opioids to around 5,000 patients in the province. That’s an average of 4,483 doses per person. Obviously, a large amount of illegal drug diversion is occurring, as well.
Given all this bad news, British Columbia Premier David Eby recently said, “I was wrong on drug decriminalization and the effect that it would have.” He further noted, “What it became was a permissive structure that, in the effort to reduce stigma, that it was OK to use drugs anywhere, resulted in really unhappy consequences not just in British Columbia but other jurisdictions that attempted this.”
Admittedly, Indiana’s syringe exchange program is nowhere near as progressive as the policies in British Columbia. Yet it is promoted in the same misguided spirit and with similar consequences. A recent study by Analisa Packham with the National Bureau of Economic Research found that while syringe exchange programs may reduce HIV transmission, they “increase rates of opioid-related mortality and hospitalizations,” especially in rural areas.
Now consider a counter example: the campaign against cigarette use in the United States. The fight against smoking took a multifaceted approach. Advertising campaigns showed the link to cancer, tobacco companies were banned from advertising on television, states and plaintiffs’ lawyers aggressively pursued litigation against tobacco companies, and efforts were made to increase the cultural disapproval and stigma of smoking. It worked. In 1965, 42% of adults in the U.S. smoked. By 2021, that number was down to 11%.
In contrast to the successful anti-tobacco campaign, Indiana and other governments have de-emphasized the harmful effects of opiate use, run ad campaigns to “remove the stigma” and removed barriers to use with programs like syringe exchange. Commenting on this approach, social psychologist Rob Henderson sarcastically quipped on social media platform X, “If the anti-tobacco movement had handed out free “safer” cigarettes, destigmatized smoking and created more spaces to light up without stigma or judgment, they would have successfully reduced smoking. Sadly, they instead went with using stigma + judgment and look what happened.”
The tide has started to turn on the criminal reform movement, but its pull remains strong. A strong majority of Indiana senators just voted to continue one of the movement’s prized wins for the next decade in our state. They voted for “a permissive structure that, in an effort to reduce stigma, that it was OK to use drugs anywhere.” As in British Columbia, it will result in more “really unhappy consequences.” We’ll learn the lessons of British Columbia and the anti-tobacco movement – just not for a while, apparently.•
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Houchin is the Washington County Superior Court judge in Salem. He also is the publisher of Judex, a Substack newsletter on conservative judicial issues at judex.substack.com. Opinions expressed are those of the author.
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