St. Thomas Law Review


Keelia Lee

First Page


Document Type



This Article will argue for the abandonment of the current criminal justice system as it relates to drug offenses and for its replacement with a medical model to address the healthcare problem of addiction. The medical model approach calls for complete decriminalization of all controlled substances coupled with better rehabilitation and reintegration policies. This Article argues the criminalization of drugs has targeted minorities under the guise of keeping communities safe. It will look at the differences between the United States and Portugal, a country that has implemented the medical model, while also analyzing recent legislation in the United States addressing drug policy. The Article will then defend the medical model by concentrating on the benefits of the system and the strong incentives stemming from recent events behind moving away from the criminal justice system.

Part I will describe the opposing models for approaching crime, comparing the prevailing punitive system that the United States has adopted with a nonpunitive approach known as the “medical model.” The punitive system, using law enforcement to control drug addiction requiring a goal of near “zero tolerance” of drugs will be referred to as the “punishment model.” Section I.A will focus on the history behind the criminalization of drugs, concentrating on the war on drugs and the popular Tough on Crime policies. This section will highlight the racial undertones behind these laws, focusing on the political and societal pressures driving the enactment of stricter laws with harsher punishments. Section I.B will discuss the resulting systemic issues that have stemmed from the criminalization of drugs, particularly how it disproportionately affects minority communities. This section will emphasize the failure of using the prevailing penal system to address addiction. Section I.C will describe the use of the medical model to address drug offenses, using Portugal as a leading example of the success of the system. Part II will address the recent shift away from Tough on Crime policies towards Smart on Crime initiatives. Section II.A will highlight the rise of Smart on Crime initiatives, describing the motivations behind the movement. Section II.B will reject prevalent Smart on Crime initiatives that focus on the reformation of the criminal justice system, such as the First Step Act of 2018, providing an overview and analysis of the Act and explaining the limitations of acts similar to it. Part III will propose the total reformation of drug law in the United States by adopting a medical model like Portugal, arguing that the benefits to adopting the medical model far outweigh the incremental benefits associated with gradual reformation of the criminal justice system. Section III.A will provide an overview of the incentives driving the switch to a medical model, including a discussion on recent global events. This section will touch on how the global pandemic has pushed forward the need for a better healthcare system and how protests have brought to light the fundamental need to change the policing system. Section III.B will discuss the limitations to this approach. This proposal will argue for the decriminalization of all controlled substances and for the substitution of the criminal justice system with a medical model system that can better address broader healthcare needs.