Meghan Peterson1, Josiah Rich2, Alexandria Macmadu3, Ashley Q Truong4, Traci C Green5, Leo Beletsky6, Kimberly Pognon4, Lauren Brinkley-Rubinstein7. 1. School of Public Health, Brown University, Providence, RI, United States; Center for Prisoner Health and Human Rights, Providence, RI, United States. Electronic address: Meghan_peterson@brown.edu. 2. Center for Prisoner Health and Human Rights, Providence, RI, United States; Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States; Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States. 3. Center for Prisoner Health and Human Rights, Providence, RI, United States; Department of Epidemiology, School of Public Health, Brown University, Providence, RI, United States. 4. Center for Prisoner Health and Human Rights, Providence, RI, United States. 5. Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States; Rhode Island Hospital, Providence, RI, United States. 6. School of Law and Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States; University of California San Diego School of Medicine, La Jolla, CA, United States. 7. Department of Social Medicine, University of North Carolina, Chapel Hill, NC, United States; Center for Health Equity Research, University of North Carolina, Chapel Hill, NC, United States.
Abstract
BACKGROUND: As overdose deaths have increased in the United States, some lawmakers have explored punitive, "supply-side" interventions aimed at reducing the supply of fentanyl. While a rationale of seeking to protect people who use drugs is often given to justify harsh sentences for fentanyl distribution, there is no research to our knowledge on perceptions of the effect of drug-induced homicide laws among people who use drugs. METHODS: We conducted semi-structured, qualitative interviews with 40 people with opioid use disorder (OUD) who were enrolled in a medication for addiction treatment (MAT) program in a unified jail and prison system in Rhode Island on attitudes surrounding increased sentences for distribution of fentanyl, including recently enacted drug-induced homicide laws. Codes were developed using a generalized, inductive method and interviews analyzed in NVivo 12 after being coded by two coders. RESULTS: Most participants stated that drug-induced homicide laws would not be an effective strategy to stem the overdose crisis. We identified key themes, including discussions surrounding the autonomy of people who use drugs, widespread fentanyl prevalence as a barrier to implementation of drug-induced homicide laws, discussions of mass incarceration as ineffective for addressing substance use disorders, feelings that further criminalization could lead to violence, criminalization as a justification for interpersonal loss, and intention as meaningful to categorizing an act as homicide. CONCLUSIONS: Findings highlight the importance of centering the experiences of people with OUD in creating policies surrounding the overdose epidemic, potential unintended health consequences of drug-induced homicides laws such as deterrence from calling 911 and increased violence, and how drug-induced homicide laws may undermine advances made in expanding access to OUD treatment for people who are criminal justice-involved.
BACKGROUND: As overdose deaths have increased in the United States, some lawmakers have explored punitive, "supply-side" interventions aimed at reducing the supply of fentanyl. While a rationale of seeking to protect people who use drugs is often given to justify harsh sentences for fentanyl distribution, there is no research to our knowledge on perceptions of the effect of drug-induced homicide laws among people who use drugs. METHODS: We conducted semi-structured, qualitative interviews with 40 people with opioid use disorder (OUD) who were enrolled in a medication for addiction treatment (MAT) program in a unified jail and prison system in Rhode Island on attitudes surrounding increased sentences for distribution of fentanyl, including recently enacted drug-induced homicide laws. Codes were developed using a generalized, inductive method and interviews analyzed in NVivo 12 after being coded by two coders. RESULTS: Most participants stated that drug-induced homicide laws would not be an effective strategy to stem the overdose crisis. We identified key themes, including discussions surrounding the autonomy of people who use drugs, widespread fentanyl prevalence as a barrier to implementation of drug-induced homicide laws, discussions of mass incarceration as ineffective for addressing substance use disorders, feelings that further criminalization could lead to violence, criminalization as a justification for interpersonal loss, and intention as meaningful to categorizing an act as homicide. CONCLUSIONS: Findings highlight the importance of centering the experiences of people with OUD in creating policies surrounding the overdose epidemic, potential unintended health consequences of drug-induced homicides laws such as deterrence from calling 911 and increased violence, and how drug-induced homicide laws may undermine advances made in expanding access to OUD treatment for people who are criminal justice-involved.