Californians debate the potential outcomes of harsher drug possession penalties

Other posts falsely suggested that people cannot become addicted to prescription opioids.

This past week, several articles and social media posts discussed a recently approved California ballot measure that will enact harsher penalties for drug possession and theft. Some posts in favor of the measure said that the state should also eliminate harm reduction programs, claiming without evidence that this would reduce drug use and crime. Other articles and posts discussed the grocery store chain Kroger’s $1.37 billion settlement due to its alleged involvement in the opioid crisis. Posts debated whether Kroger should be held accountable, and some expressed stigmatizing attitudes toward people with opioid use disorder.

In light of these conversations, communicators may reiterate that harm reduction programs save lives and do not increase drug use or crime in the communities they serve. Messaging may also share information about OUD and resources for people who may be struggling with it.

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What’s trending nationally in conversations about opioids

California voters recently approved Proposition 36, which will allow felony charges and longer prison sentencing for possession of certain drugs and for thefts under $950 when the person has two prior drug or theft convictions. However, people who plead guilty to felony drug possession and complete treatment can have charges dismissed. The proposition also imposes harsher sentences for drug-related crimes like fentanyl trafficking. Proposition 36 rolls back provisions from a 2014 ballot measure, which reduced penalties for drug possession and certain theft convictions and prevented thousands of people from serving prison time for nonviolent offenses. After the new proposition passed, conversation spread in news articles and across multiple social media platforms. Many popular posts celebrated the news and claimed that Proposition 36 will end California’s “drug problem,” although research shows that harsher sentencing for drug-related crimes is not associated with reduced drug use. Some posts also advocated for the elimination of harm reduction programs, suggesting without evidence that this would reduce local crime. However, some social media users spoke out against Proposition 36, with some lamenting the higher incarceration rates that could result from this measure and others doubting that it will reduce crime and drug use. A comment on a Facebook post about the proposition read, “Harsher punishment is the exact same thing as telling your teenager they are grounded for a solid month. no electronics and they have to do outside chores. People will do what they want regardless.”

On November 4, a coalition of 30 states announced the completion of a $1.37 billion settlement with Kroger over the grocery store chain’s supposed role in the opioid crisis. Most money from the settlement will go toward state programs for people with OUD, and Kroger pharmacies will also be required to implement stricter monitoring of suspicious prescriptions. A Facebook post about the settlement received approximately 1,000 reactions and 300 comments as of November 14. Some comments expressed skepticism that people can become addicted to prescription medication. Others suggested that pharmacists should not be held accountable for the opioid crisis, stating that people who use drugs are solely to blame and demonstrating stigmatizing beliefs about people with substance use disorder.

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Recommendations for public health professionals

Each week, the Infodemiology.com team will provide messaging recommendations in response to some of the trending narratives outlined above. These helpful tips can be used when creating content, updating web and FAQ pages, and developing strategy for messaging about opioids.

In response to ongoing confusion about the benefits of harm reduction programs, messaging may emphasize that harm reduction programs like syringe services programs do not increase drug use or crime. Instead, these programs have been shown to prevent overdose deaths and reduce the spread of infectious diseases. Harm reduction programs also connect people who use drugs to treatment if and when they are ready. Research shows that new users of SSPs are five times more likely to enter drug treatment programs and three times more likely to stop using drugs than those who do not use SSPs. Sharing information about local harm reduction programs is recommended.

Conversations about prescription opioids provide an opportunity to explain that these medications are highly addictive and that anyone who takes prescription opioids can become addicted to them. The CDC says that ways to prevent OUD include prescription drug monitoring programs, educating health care providers about prescribing guidelines, and educating patients about the risks of prescription opioids as well as how to safely store and dispose of them. Communicators may share tips for patients who are prescribed opioids to reduce their risk of developing OUD, suggest non-opioid pain management options, outline the signs of OUD, and share resources for people with OUD—such as local harm reduction programs and SAMHSA’s National Helpline, which connects people to treatment. Ensuring that all materials covering OUD and other substance use disorders avoid stigmatizing language is also recommended.