The Drug Problem: Problems and Solutions for Local Policymakers

Charles Fain Lehman

Manhattan Institute | 2022

While most Americans have focused on the Covid-19 pandemic, the nation’s other great epidemic has continued to burn. Drug overdoses now claim the lives of over 100,000 Americans every year, a rate that appears likely to continue or grow for the foreseeable future. While the crisis once was concentrated predominantly in rural, white communities, the introduction of novel synthetic opioids, particularly fentanyl, into the illicit drug supply has spread overdoses across urbanizations.

Today, small-town and big-city leaders alike desperately need tools to fight back against the drug crisis. It can often seem as though drug policy is outside the ambit of local leaders, who lack the capacity to go after international traffickers or spend trillions of dollars on care. But local government, as the closest entity to the front lines of the crisis, plays a vital role in addressing it.

This paper, therefore, explores options for local policymakers to respond to the drug crisis. In particular, it considers six frequently discussed local-scale policies:

  • Naloxone access and distribution
  • Investing in treatment capacity
  • Drug court programs
  • Wastewater tracking
  • Supervised consumption sites
  • Drug market interventions

For each policy, this paper examines the evidence, offers estimates of costs, and provides caution where necessary. The overall goal is to give local policymakers a better understanding of what tools they have to more effectively tackle the other health crisis in their communities.

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