DRUG DELIVERY RESULTING IN DEATH (DDRD) CHARGES IN CONTEXT: THE
OVERDOSE CRISIS, PUBLIC HEALTH, AND DDRD PROSECUTIONS
Presenters:
• Jeremiah Goulka, Senior Fellow, Health in Justice Action Lab, Northeastern University School of Law
• Lisa Newman-Polk, Esq. LCSW, lawyer and social worker • Joshua Vaughn, Staff Reporter, The Appeal
Jeremiah Goulka, LL.B., JDHealth in Justice Action Lab
Northeastern University School of Law
No conflicts to declare
Conflict Declaration
2
Surge of DDRD Charges Over Time
3Source: http://healthinjustice.org/drug-induced-homicide
DDRD Statutes
4Source: www.pdaps.org
Uneven Geographic Distribution
5Source: http://healthinjustice.org/drug-induced-homicide
Uneven Geographic Distribution
6Source: http://healthinjustice.org/drug-induced-homicide
Who is targeted by statute v. enforcement discretion?
Undermines Good Samaritan laws Disparate impact Denial of MOUD may violate ADA,
Rehabilitation Act, and 8th Amendment Fatal reentry Does not reduce drug use or drug crime Undermines LEAD / PAARI-type programs
Who is targeted by statute v. enforcement discretion?
Undermines Good Samaritan laws Disparate impact Denial of MOUD may violate ADA,
Rehabilitation Act, and 8th Amendment Fatal reentry Does not reduce drug use or drug crime Undermines LEAD / PAARI-type programs
Statutes: Targeting Traffickers “Only”
9
Enforcement Discretion:The Myth of the “Dealer”
10Source: http://healthinjustice.org/drug-induced-homicide
Who is targeted by statute v. enforcement discretion?
Undermines Good Samaritan laws Disparate impact Denial of MOUD may violate ADA,
Rehabilitation Act, and 8th Amendment Fatal reentry Does not reduce drug use or drug crime Undermines LEAD / PAARI-type programs
Good Samaritan Laws Most states have them, but not federal gov’t Vary in what crimes get immunity Vary on arrest, charge, and prosecution▪ PA only charge and prosecution
Only Vermont and Delaware include overdose death Limited information and media coverage
Enforcement Gets Media Exposure
13
14
Enforcement Gets Media Exposure
DDRD Media Mentions
15Source: http://healthinjustice.org/drug-induced-homicide
Consequences of Enforcement: Less Helpseeking
16Source: Latimore and Bergstein, IJDP (2017)
Kung, Lok and Beletsky (2019)
Excess overdose deaths in states with DDRD enforcement versus those without
Who is targeted by statute v. enforcement discretion?
Undermines Good Samaritan laws Disparate impact Denial of MOUD may violate ADA,
Rehabilitation Act, and 8th Amendment Fatal reentry Does not reduce drug use or drug crime Undermines LEAD / PAARI-type programs
Enforcement Discretion Tells a Racist Tale
19
Health in Justice (2017)
(N = 611)
Drug War Disparities Continue
20Source: http://healthinjustice.org/drug-induced-homicide
Who is targeted by statute v. enforcement discretion? Undermines Good Samaritan laws Disparate impact Denial of MOUD may violate ADA, Rehabilitation Act, and 8th
Amendment Fatal reentry Does not reduce drug use or drug crime Undermines LEAD / PAARI-type programs
see HIJ, Drug-Induced Homicide Defense Toolkit see DPA, An Overdose Death is Not Murder see Legal Action Center
Contact
22
Jeremiah [email protected]
www.healthinjustice.org
http://www.healthinjustice.org/
American Suffering
23
Structural Determinants:- Occupational injury- Protracted military conflict - Overweight and obesity- Lifestyle- Built environment- Diet - Environmental/metabolic- Cultural attitudes/stigma- Etc.
Supply-side narrativeOverprescribing
▪ Lack of education, info▪ Underuse of alternatives▪ Diagnostic challenges▪ System, patient pressure
Doctor shopping, diversion, “pill mills,” other rogue actsPharmaceutical industry, insurance industry, regulatory capture
25
Prescribing limits, guidelines PDMPs authorizations and mandatesPill-mill laws and trafficking enforcement Prosecution of unscrupulous prescribers,
dealersReformulation of prescription drugs Withdrawal of prescription drugs?
Three phases1.Prescription opioids2.Heroin/black market 3.Synthetic contamination
Source: New York Times (2017), National Center for Health Statistics, Centers for Disease Control and Prevention
Fentanyl & Other Synthetics
Heroin
Rx Opioids
Chart1
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
Heroin
1842
1779
2089
2080
1878
2009
2088
2399
3041
3278
3036
4397
5925
8257
10574
12989
15446
Sheet1
HeroinSeries 2Series 3
20001,8422.42
20011,7794.42
20022,0891.83
20032,0802.85
20041,878
20052,009
20062,088
20072,399
20083,041
20093,278
20103,036
20114,397
20125,925
20138,257
201410,574
201512,989
201615446
Chart1
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
Series 1
782
957
1295
1400
1664
1742
2707
2213
2306
2946
3007
2666
2628
3105
5544
9580
20145
Sheet1
Series 1Series 2Series 3
20007822.42
20019574.42
200212951.83
200314002.85
20041664
20051742
20062707
20072213
20082306
20092946
20103007
20112666
20122628
20133105
20145544
20159580
201620145
Source: Williams et al, To Battle The Opioid Overdose Epidemic, Deploy the ‘Cascade of Care Model’ Health Affairs Blog (2017)
Source: Case & Deaton, 2015
