The United States is in the midst of an extraordinary public health crisis due to drug overdoses. There were nearly 64,000 overdose deaths in 2016, mostly due to opioids; that is more than the number of homicides by firearms and deaths in automobile crashes combined. The overdose epidemic is overwhelming every aspect of the nation’s health care system from emergency medical services to the coroner’s office.
In the midst of this unprecedented crisis, President Trump is proposing a broad new law enforcement policy that will include the death penalty for some drug dealers. Though the president has heralded the policies of the Philippines and Singapore, which execute drug dealers (and, in the case of the Philippines, sometimes do so extrajudicially), White House staff said on Sunday that “The Department of Justice will seek the death penalty against drug traffickers when appropriate under current law.”
But there is zero evidence that this would be a good social policy.
The risk of arrest, a trial in which the death penalty is on the table and an eventual execution would hardly be a major worry to someone who faces death on a daily basis.
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The street-level dealers, the ones who actually hand over the drugs in exchange for cash, already lead dangerous lives. They often carry weapons; they face the daily risk of injury or death from rival drug dealers, desperate customers, and encounters with law enforcement. The risk of arrest, a trial in which the death penalty is on the table and an eventual execution would hardly be a major worry to someone who faces death on a daily basis.
And heroin dealing works on a hierarchical business model: Street level dealers are supplied through intermediaries, who receive heroin through a complex supply chain run by kingpins who may not even reside in the United States. Street level dealers are essentially entry level employees of large illicit businesses: They are infinitely replaceable. Every drug dealer taken off the streets is immediately replaced. Even large-scale law enforcement operations that remove caches of drugs and “middlemen” have little impact on the flow of drugs and the rate of overdose deaths.
Plus, few peer-reviewed, credible studies actually support the thesis that the death penalty actually works as a deterrent for any future crime, let alone a drug dealing crime. This is one of the reasons that both death sentences and executions in the United States have been declining for nearly two decades.
Plus, few peer-reviewed, credible studies actually support the thesis that the death penalty actually works as a deterrent for any future crime, let alone a drug dealing crime.
There are other reasons as well. The litigation costs for a capital murder trial are so high that rural communities (which have been hard hit by the opioid crisis) can hardly afford to prosecute one, let alone many. The application of capital punishment has been fraught by racial biases. Lethal injection — the technique used in 98% of executions, which requires the intravenous injection large doses of various drugs — has failed on several occasions in recent years.
The opioid epidemic is a public health emergency and requires a public health response. The response must include not only legislation, but also funding of prevention and an expansion of treatment programs. (The proposal reportedly will seek money for an advertising campaign designed with the input of President and Melania Trump, and ask Congress to pass legislation to allow Medicaid to cover residential treatment for opioid addiction, but much of the proposal related to increasing law enforcement resources.)
To the extent that President Trump seeks to punish those individuals who saturated our country with narcotics, it is worth pointing out that the sharp rise in heroin use was preceded by a long, national campaign by the pharmaceutical industry to increase prescription narcotic use for treatment of a multitude of chronic and acute pain disorders. I doubt that President Trump, a lifelong, enthusiastic supporter of capital punishment, will seek to prosecute or execute any pharmaceutical sales representatives or executives.
I doubt that President Trump, a lifelong, enthusiastic supporter of capital punishment, will seek to prosecute or execute any pharmaceutical sales representatives or executives.
The president’s proposal is ultimately nothing more than a distraction. Tackling the drug overdose crisis will require a major investment in public health infrastructure in the United States, where 175 people are dying of drug overdoses every day. An estimated 15 to 20 people died while I was writing this opinion piece. A young man overdosed and died in my neighborhood three weeks ago.
“Death penalty for drug dealers” is a good sound bite, but an expensive and ineffective policy for the most severe epidemic to affect our country in a generation.
Jonathan I. Groner, MD is a practicing pediatric surgeon and a Professor of Surgery at The Ohio State University College of Medicine. He has written extensively about the ethics of health care professional participation in capital punishment in the United States, and has provided expert testimony about lethal injection executions in several civil cases.