As a good liberal, I used to oppose arresting people for using drugs. They need health care, not handcuffs, I thought. But then to my surprise and dismay, I found myself praying that my old pal Drew Goff would be arrested.
Drew, 40, was homeless, using fentanyl and also selling it. His wife, who was with him, was pregnant and had overdosed 27 times, including twice in a single day. It seemed only a matter of time before Drew killed himself or one of his customers. So Drew’s mom and I confided to each other our hope that he would end up in the relative safety of prison and get treatment there.
“It’s the only way to save his life,” his mom said wearily. And in the end, Drew himself agreed.
Drew’s journey constitutes a rebuke to liberals and conservatives alike. Drew is the third generation in his family to wrestle with addiction, and his life reflects the failure of the right’s half-century war on drugs, fought with only the criminal justice toolbox. Public health approaches were neglected, so even now the federal government estimates that fewer than one in four who need substance use treatment get it. It’s no accident that Republican-led states, while tough on crime, have some of the highest rates of drug fatalities in the country.
Yet it’s also true that Drew’s most recent tumble into addiction came in part because of a permissive liberal culture toward drugs on the West Coast. This was meant to be compassionate, but it almost killed him (and has killed many of my other friends). In Portland, a person could be arrested for drinking a beer on the sidewalk but until recently not for smoking fentanyl. Smoking cigarettes in public places was often limited or banned on the West Coast while fentanyl use was tolerated.
President Trump is right to insist on greater urgency in addressing fentanyl, and he took some important steps in his first term, such as allowing telehealth options for addiction treatment and pressing China to crack down on its chemical companies that fuel the drug trade. His threats on Mexico today seem to be leading leaders there to work harder to curb fentanyl smuggling.
Yet some of his proposed solutions seem mostly performative and might even make the problem worse. Military strikes on drug cartels on Mexican soil might freeze Mexican cooperation. Most alarming, the Trump administration and Republicans in Congress are exploring cuts in Medicaid that would probably reduce access to treatment — the strategy that arguably works better than any other.
The United States has lost more than one million people to overdoses since 2000 — more than the number of Americans lost in all wars in the past 150 years put together, including both World Wars. Yet neither Democrats nor Republicans have tackled the problem with the seriousness or nuance it deserves.
When nearly 3,000 Americans died in the Sept. 11 attacks, we reorganized the federal government and spent trillions of dollars in an (often misguided) effort to make us safer. Yet an even larger number die every week from drugs and alcohol, and we can’t even be bothered to provide effective treatment to most of those in need. This is a staggering national failure.
I’m hoping this is a time for a national conversation about a smarter drug policy. Overdose deaths have been dropping since 2022, although drugs still kill an American on average every six minutes around the clock. Fentanyl kills Republicans and Democrats alike, and both parties should be able to come together to study what works. And that leads us back to Drew.
Drew is a scion of dysfunction. His grandfather was “a professional drunk,” in the words of Drew’s dad, Rick Goff, a buddy of mine in my rural hometown Yamhill, Ore. Like Drew, Rick was smart and charming, but Rick had been arrested about 30 times before he died in 2015 at the age of 65.
Drew’s mom, Sharon Dieter, also a friend, endured sexual abuse as a child and self-medicated with drugs beginning in her early teens. She used drugs when pregnant with Drew and with his sister, Shelly — “my biggest regret,” she says — but has been drug-free for 10 years.
In that chaotic home, Drew started using drugs at 12. He stopped going to school and drifted into crime and the drug trade in McMinnville, Ore. When I printed out his criminal history recently, it ran 57 pages.
In periods when Drew is not using drugs, he’s quick-witted, gregarious and devoted to his kids; when he’s using, he’s a disaster. Early in the pandemic, he was in recovery and thriving — in retrospect, doing too well. “I keep getting checks from the government,” Drew told me on one visit to his McMinnville apartment then. He said he received a total of $56,000 in unemployment and Covid relief payments, and he began buying things on installment plans.
“Seventy-five-inch TV, brand-new couches, beds,” he recalled. “We had Amazon rolling through every day.” (My quotes from Drew omit an obscenity that he sprinkles liberally in conversation.) He says the wave of money was one reason he resumed using drugs: He was buying everything else, so why not narcotics?
Soon he and his wife, Sydney, were using drugs again and were homeless, and Drew was selling drugs to afford their own. In another reflection of West Coast leniency, they also shoplifted on an industrial scale.
“Me and Sydney probably stole $30,000 or $40,000 worth of stuff from Target, and maybe $20,000 or $30,000 from Lowe’s over a year,” Drew told me. “Shopping carts full of $300 coffee machines and bikes,” which they resold to pawn shops.
Drew said that they carefully chose which stores to steal from, avoiding those like Walmart that they thought would send security guards after thieves. They preferred places like Target where, he said, the policy was not to pursue them.
“It was easy,” Drew said. “We just go in and grab stuff and walk out.”
There’s a conservative narrative that the West Coast problems are self-inflicted, a result of a culture of tolerance toward drugs and crime. We West Coasters should acknowledge that there’s some truth to that.
Oregon decriminalized possession of small amounts of hard drugs in a 2020 referendum, and Drew says that the lack of penalties played a role in his decision to return to drugs. “The benefits outweighed the consequences for me,” he said.
Likewise, his sister, Shelly, who had been clean for nine years, resumed using heroin in 2024 and told me that decriminalization was also a factor for her: “If I knew that I would go to jail for it, I wouldn’t have done it,” she told me.
After decriminalization, drug overdoses soared — fentanyl overdose deaths in the Portland area rose sevenfold from 2020 to 2023 — and by 2023, drug deaths there were rising more quickly than anywhere else in the nation. Public sentiment shifted: Democrats and Republicans united to reimpose criminal penalties for drug possession effective in September 2024. But by then, Shelly was again in the grip of addiction.
On the West Coast, we didn’t just decriminalize hard drugs; we also ratified drug use as an acceptable lifestyle choice. One billboard, funded by the San Francisco city government, showed a group of healthy-looking young people partying and laughing. “Do it with friends,” the billboard advised.
The aim is a worthy one, to destigmatize drug use in order to improve outreach and save lives, but the implication is that cool people have fun with drugs.
Dwight Holton, executive director of Lines for Life, a Portland-based organization that aims to prevent addiction, draws an important distinction. “It’s not OK to stigmatize drug users,” he told me. “It is imperative to stigmatize drug use.”
From San Francisco to Seattle, we missed that. We were outraged by secondary smoke but oddly tolerant of fentanyl.
Holton noted the focus in blue cities on harm reduction, such as needle exchanges and distribution of naloxone to bring people back from opioid overdoses. That saves lives. But, he added, “the best harm reduction is prevention,” and that comes in part by establishing norms against drug use.
I’m a fan of harm reduction, but it was accompanied by a reluctance to judge people’s choices that went too far. Civil commitment to an institution is very difficult, and another Yamhill friend of mine with a history of substance use froze to death while homeless in a tent. How could we have been so thoughtless and cruel to defer to her “autonomy”?
So if Trump is serious about tackling addiction, what could he do?
Above all, he could oversee a major push to get more people into effective, sustained treatment. Drew’s journey offers some clues to what can help.
In the summer of 2023, Drew hit bottom. He was homeless on the streets of Eugene, Ore., selling fentanyl for a motorcycle club that terrified him. He had lost custody of all five of his children because of drugs and crime, including a baby born to Sydney in this period. He had pawned everything he had and felt perpetually sick.
So when there was a police raid of his encampment, Drew walked up to the officers and told them that he had outstanding warrants. “I felt like I was lucky when I got to go to jail,” he told me.
It’s an indictment of our society that sometimes the surest way for someone like Drew to get help is to get arrested. Policing can be oppressive; it can also be lifesaving.
Drew’s court-assigned lawyer, Mark Pihl, thought he might win Drew an acquittal. But Drew was ready for incarceration. “If I don’t go to prison and get into treatment, I’m probably going to die,” he remembers telling Pihl. His trial was rapid.
“I’m guilty of everything,” Drew advised the judge, as documented in the official courtroom recording. Drew also asked the judge for immediate sentencing.
“I just want to be able to do treatment and start something positive while I’m in prison,” he told the judge, who obligingly sentenced him to 15 months. “Thank you, your honor,” Drew replied.
Treatment is far from perfect: People relapse all the time, and some programs are more focused on raking in money than on providing effective care. Still, it would be a scandal if only one in four Americans with broken legs got care, so why do we accept that only one in four with addictions get treatment?
Too often, someone calls a hotline and is told there will be a space in two weeks, which seems a lifetime away. We don’t tell the person with the broken leg to call again in two weeks, yet addiction is far more likely to be fatal.
Or the person seeking treatment has a beloved dog that the program can’t accommodate. Or has problems with private insurance or Medicaid approval. Obamacare in theory requires plans to cover substance use treatment, but too often insurance companies create hurdles to getting it or resist longer programs that are more effective. I’ve talked to people who were told that they weren’t using heavily enough to qualify; they could get help only if they ramped up their narcotics consumption.
Here’s what we need: a national hotline that people can call that will steer them to effective, evidence-based treatment right away, with a place for their dog and a service that will gather their possessions if necessary and put them in storage. Prisons and jails, which offer widely varying programs, should also step up their treatment initiatives.
We also need more addiction telemedicine, which can cut treatment costs, allow people to avoid wait lists and particularly help those in rural areas. Stephanie Strong, a co-founder of a telehealth company called Boulder Care, says that with a simple phone call, it can get people into treatment immediately. Telemedicine options were widely introduced during Covid and should be made permanent and broadened.
Treatment is a bargain as far as health care goes. It doesn’t require $500,000 CT scanners or $25,000-a-year medications. A daily dose of methadone can cost less than $1.
Dr. Andrew B. Mendenhall, president of Central City Concern, a Portland nonprofit, says that the organization can take a homeless person who is using fentanyl and provide a six- to eight-month stay in recovery housing with a full course of outpatient treatment for about $35,000. Half graduate from the program and move on to a better place — so how can we not give more people that chance to reclaim their dignity?
Not surprisingly, one published study found that medication-assisted treatment results in savings of $25,000 to $105,000 per person.
Yet even where treatment is readily available, some people need nudges. That’s why Drew’s mom and I were praying that he’d be arrested. “He’s got to go to jail or prison in order for him to stop,” she told me.
What I’ve seen is that the fundamental leniency in recent years on the West Coast — toward drugs, toward shoplifting and toward homelessness — didn’t actually improve the well-being of those in desperate need. Our liberal compassion backfired: Instead of helping Drew, it endangered him.
The implication is that we should be less dogmatic and navigate a middle path. The right reaches instinctively for criminal sanctions, and the left for supportive harm reduction, but an effective toolbox requires both sticks and carrots.
“There’s a role for the criminal justice system,” Keith Humphreys, a drug policy expert at Stanford University, told me. The challenge, he said, is to use it as a lever to induce people to change behavior.
Granted, prisons often are drug bazaars, and imprisonment itself is a dangerous tool. Upon release from prison, users are at elevated risk of overdosing, because their bodies may no longer be accustomed to fentanyl. And one study found that police seizures of drugs lead to more overdose deaths, perhaps because users must find new suppliers, whose drugs may be more potent.
Yet prison, combined with treatment, can also be lifesaving. It has worked for Drew. He did wonderfully in his treatment program behind bars, and when he called me periodically from prison he sounded far more happy and alive than he had on the street. “I’ve got my son back,” Sharon told me.
Drew was released last year, found a job and has reconnected to one of his sons. Over the summer, Sydney joined him in recovery: She had been bear-sprayed and brutally beaten by a gang that stole her drugs, and she too hit bottom. Drew drove to pick her up.
Drew is rebuilding his life. He started a small moving company, Minute Movers. He has been driving since he was 13 but never had a driver’s license. Now he has one and for the first time is legal and insured. Treatment has worked very well for both him and for society, and others should have access to such a path — and the threat of jail may be a necessary inducement.
Drew made poor choices, but there’s plenty of blame to go around. Conservatives resisted the social safety net that might have helped him in childhood, and liberals coddled him with a nonjudgmental tolerance that mired him in addiction. Whatever our politics, we all need a rethink.
Debates about drug policy often miss the most important need of all: intervening early to prevent trouble. The best time to have helped Drew would have been when he was a child, living in a chaotic home and experimenting with drugs. Or, better yet, a generation earlier, when his mom was a young teenager beginning to self-medicate. Or even a generation before that, when his grandfather was on the path to alcoholism.
“It’s got to start in grade school,” said Sharon, who now works as a peer counselor for an excellent program called Provoking Hope that tackles addiction.
Of the children who rode with me on my old No. 6 school bus in Yamhill, more than one-third are now dead from drugs, alcohol or suicide. That’s because I’m from a rural, working-class area where the mills closed and the factory jobs went away.
Taxpayers spent huge sums imprisoning my old pals and then, a generation later, imprisoning their children; soon we will be paying to imprison their children’s children. It would have been far more sensible and humane to invest in my friends when they were young: addressing their traumas, ensuring that they could read, helping them graduate from high school and learn a trade. We failed them before they failed us.
We know what works, because many programs have excellent evidence of effectiveness in lifting children up. OneGoal. Vision to Learn. Success for All Foundation. Communities in Schools. Reading Partners. Per Scholas. CASA. Big Brothers Big Sisters of America. Reach Out and Read.
Those programs might have been able to reach the young Drew, helping him become, say, a pharmacist rather than a drug dealer. The question isn’t can we afford programs to help needy kids, but how can we possibly not afford them?
“No epidemic in the history of the world has ended by waiting for people to become really sick and then throwing a lot of resources at them,” Professor Humphreys said. Without more focus on prevention, he said, “we’re going to keep doing this stuff we’re doing now forever.”
We have a path forward, but it will require the left and the right to shed dogma and focus simply on what works. We’ve managed that with bipartisan policies that have sharply reduced tobacco use, and now let’s do the same with drugs.
The post We Thought We Were Compassionate, but We Were Too Permissive appeared first on New York Times.
