The issue of whether to jail patients for drug possession rages on. Washington states continues to provide fertile soil for those who insist on arresting and incarcerating people with addiction and forcing them to receive addiction treatment behind bars. Seattle continues to do this, even in the face of strong opposition from the scientific medical community, who know that this simply does not work. It did not work 100 years ago and does not work now.

The Seattle Times recently ran an Op-Ed by the mayors of Everett and Marysville, 2 cities to the north of Seattle. In the article, they opined that “The prospect of jail time can help disrupt this cycle of destruction and lead someone to pursue treatment options. Jail can, in fact, be the best option, a beginning rather than an end.”

Seattle physician Collin Schenk, MD, who specializes in the treatment of addiction, wrote a response. “In their recent Op-Ed, Everett Mayor Cassie Franklin and Marysville Mayor Jon Nehring perpetuate the myth of compassionate coercion as a humane solution to the public health crisis of addiction. Their vision for merging incarceration and treatment has failed relentlessly, stretching back to the US Narcotic Farm in Lexington, Ky, that opened in 1935.”

Continue Reading

The history of the Narcotic Farm is not pretty. The author of a book about the farm wrote: “Although it began as a bold and ambitious public works project…the Farm was shut down 40 years after it opened amid scandal over its drug-testing program, which involved experiments where inmates were being used as human guinea pigs and rewarded with heroin and cocaine for their efforts.”

Dr Schenk described his misgivings about forced treatment. “In my work as an addiction medicine physician in inpatient treatment programs and medical outreach to unhoused people, I have cared for thousands of patients in recovery and with active substance use. I cannot recall a single person claiming that a carceral treatment program saved their life. More predictably, incarceration disrupts their recovery capital and reinforces their cognitive association of treatment as punishment.”

The medical literature is filled with such evidence that forcing treatment on patients with addiction does not work. A 2016 article by Werb et al in the International Journal of Drug Policy titled  “The effectiveness of compulsory drug treatment: a systematic review” concluded that evidence does not support improved outcomes from compulsory treatment, and, suggests that it may be harmful.

I fear that over the last few years, the study of science and practice of medicine has become less respected, which may be one reason that the incarceration of people with addiction continues. Anthony Fauci, MD, was widely respected as a scientist and researcher, but by his retirement toward the end of the declared COVID emergency, he was vilified and even attacked by many for his efforts to introduce science and principles of evidence-based medicine into the polarized national debate.

Unfortunately, that polarization continues on many fronts, including discussions about treating addiction in our communities. Dr Schenk ended his letter with: “Laundering incarceration as treatment is a soulless endeavor, and there is nothing innovative about it.”