Destigmatizing Drug Use Has Been a Profound Mistake

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The image on the billboard that appeared in downtown San Francisco in early 2020 would have been familiar to anyone who’d ever seen a beer commercial: Attractive young people laughing and smiling as they shared a carefree high. But the intoxicant being celebrated was fentanyl, not beer. “Do it with friends,” the billboard advised, so as to reduce the risks of overdose.

The advertising campaign was part of an ongoing national effort by activists and health officials to destigmatize hard-drug use on the theory that doing so would lessen its harms. Particularly in blue cities and states, that idea is having a moment. The general message carried by the San Francisco billboard appeared as well in the New York City health department’s “Let’s Talk Fentanyl” campaign, which last year told subway riders, “Don’t be ashamed you are using, be empowered that you are using safely,” and further counseled them to “start with a small dose and go slowly.”

The nationally influential goes further: It lauds many as “harm reductionists” who should be respected and left alone by authorities (because the arrest of a trusted dealer might cause users to seek the drug from an unfamiliar source). A prominent subset of academics provides intellectual support for these initiatives, theorizing that stigma against drug use is ethically wrong and also worsens public health.