American Medical Association Officially Endorses Drug Decriminalization: We Need 'Something That Actually Works'

In a landmark decision, the American Medical Association (AMA) voted this week to support the elimination of criminal penalties for drug possession for personal use, marking a notable shift in the organization’s approach to addressing the substance use crisis in the U.S.

“The war on drugs is quite reminiscent of the phrase, ‘The beatings will continue until morale improves,'” said Ryan Englander, an MD/PhD candidate from Hartford, Connecticut. “We have tried for decades to criminalize our way out of a substance use crisis in this country, and it has not worked. We need to move to something different and better, something that actually works.”

Delegates voted 345-171 to adopt the new policy, which calls for the “elimination of criminal penalties for drug possession for personal use as part of a larger set of related public health and legal reforms designed to improve carefully selected outcomes,” reported MedPage Today.

Oregon And Portugal: Unique Examples Of Decriminalization

Englander pointed to Oregon's recent struggles and Portugal’s successes. In 2020, Oregon became the first state in the nation to fully decriminalize drugs though recently reversed that policy, which Englander called “instructive, but so is the [experience of] Portugal, where that country decriminalized or removed penalties for personal possession of drugs for personal use, and they were actually able to get people into treatment, and mortality did drop. So there are models that we can use that can work.”

Stephen Taylor, MD, MPH, representing the American Society of Addiction Medicine (ASAM), supported the new policy. “There is, in fact, evidence that decriminalization can have public health benefits if it is done correctly. We would suggest that we have yet to see it done correctly in the U.S.,” he said.

Varying Views

AMA president-elect Bobby Mukkamala, MD, voiced concerns about the lack of robust evidence supporting broad decriminalization. “Our policy must reflect the evidence, and currently, the evidence does not support broad decriminalization,” Mukkamala said.

Marianne Parshley, MD, a delegate for the American College of Physicians from Portland provided a nuanced perspective. She acknowledged that while Oregon’s experiment had challenges, the simultaneous introduction of fentanyl significantly impacted mortality rates. “The walking back of the Oregon law was actually a way to get bipartisan support in the legislature for more funding and program support for drug treatment efforts,” Parshley explained. “We need to pay attention to the fact that the situation doesn’t instantaneously change if you pass decriminalization and support for treatment.”

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Photo: Courtesy of AMA