Stanford
Stanford-Lancet Commission on the North American Opioid Crisis
Justice System

Domain 4: Maximizing the benefit and minimizing the adverse effects of criminal justice system involvement with people who are addicted to opioids

Policies are available that maximize the benefit and minimize the adverse effects of criminal justice system involvement with people who are addicted to opioids.

The Commission therefore makes the following recommendations:

Offer addiction-related health services during and after incarceration

  • Recommendation 4a: Addiction-related health services, including all approved medications, should be available to all incarcerated individuals who have opioid use disorder, including during the high-risk period surrounding discharge.

Do not incarcerate individuals for simple possession or use of illicit opioids

  • Recommendation 4b: Policies of incarcerating individuals for illicit possession of opioids or drug-related equipment (e.g., syringes) intended for personal use should be abandoned because they present significant public health risks without offsetting public health or public safety gains.

End collateral penalties for drug-related crimes

  • Recommendation 4c: “Collateral penalties” for addicted individuals who have committed drug-related crimes should be abandoned because they hamper the ability of individuals to achieve and maintain recovery from addiction.

End penalties for substance use during pregnancy

  • Recommendation 4d: State and federal officials in the USA should abandon policies that punish opioid use, opioid use disorder, or opioid agonist therapy during pregnancy.