St. Thomas Law Review


Leionah J. Noah

First Page


Document Type



When a human body ingests a lethal dose of heroin, the body goes through an enormous physiological transformation. The functions of the central nervous system begin to depress, breathing is shallowed, the pulse is weakened, and the skin turns blue or gray with dark lips and fingernails. An alert person must quickly administer naloxone, an opioid antagonist, to reverse the effects of a heroin overdose, as symptoms typically begin after ten minutes. For many, however, their lives end with an overdose, despite this outcome being preventable. This paper will establish that drug overdose deaths are preventable for an entirely different set of reasons. As the nation’s drug overdose epidemic worsens, the American Medical Association (“AMA”) issued a brief in which it stated that a handful of illicit drugs, often in combination or in adulterated forms, are becoming the driving force behind the epidemic. The AMA thus urges policymakers to take action to increase access to evidence-based care for substance use disorders, as well as for pain and harm reduction measures. Although the Department of Health and Human Services (“HHS”) publicly favors clean needle exchange programs since they slow the spread of diseases such as HIV/AIDS and hepatitis among drug users, it has yet to take a stance on supervised consumption sites and other such controversial matters of ongoing litigation that are still federally banned. Taboo or not, two safe consumption sites have since opened in Manhattan through grassroots means and are operating successfully. Drug policies in the United States appear to focus more on immediate measures, such as needle exchanges, drug testing kits, and reduced access to prescription opioids. These are effortful steps toward change, but the New Haven School of Jurisprudence approach to social problem solving reveals a deeper and more critical issue to be resolved if the United States is ever to break its pattern of drug policy failures. Drug overdose deaths appear to be the tip of the iceberg, wreaking societal havoc, while the underlying and disregarded cultural factors continue to push this devastating problem to the surface, where buzzworthy news coverage fuels quarrelsome politics over who is to blame and who should step up and fix it. Part I delineates the nation’s drug overdose crisis. Part II depicts the conflicting claimants and their different perspectives. Part III explores the past legal decisions in light of their conditioning factors to provide historical and environmental context. Part IV objectively predicts future decisions and what will happen. Part V provides appraisals for the above sections. Parts VI and VII illustrate alternatives and a proposal for what ought to happen.