“Isn’t Incarceration Better than Death?”

Katherine L. Record, JD, MPH, MA

Shortly after criticizing Massachusetts for incarcerating innocent individuals with substance use disorder (SUD) when drug rehab facilities are full, I received an email from a woman who lost her son to a heroin overdose just four months ago.

“Is preventing an overdose by detaining the SUD sufferer not a better alternative than leaving them to languish?” she asked.

She had found her 24 year-old son cold and blue, just hours after kissing him goodnight. He had been evicted from his sober living home for testing positive for drugs, but his mother did not know he had relapsed when he arrived at her front door. He was, in hindsight, a clear danger to himself – so why did his step-down house let him wander away? Why didn’t anyone call the authorities? Is jail not better than death?

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A Drug Epidemic’s Silver Lining

By Katherine L. Record

Can there be a silver lining to a drug epidemic that is so extreme it is deemed a public health emergency? As prescription opioid (painkiller) addictions drive individuals to heroin, there just might be.

Heroin use has surged recently – seizures of supply increased by nearly 70% over the last few years in New York (the epicenter for imports into the United States). In Boston, overdoses increased by nearly 80% between 2010 and 2012. This has followed a rising trend in prescription opioid addictions – 4 out of 5 users are addicted to prescription painkillers when they first try heroin. Turning to the street opioid is often a move of desperation; prescription opioids are now harder to abuse, more expensive, and harder to obtain than heroin. In other words, heroin provides a cheaper, easier to score, and stronger high.

This surge in use is changing the face of heroin; the Office of National Drug Control Policy’s director recently described the drug as a former “inner city problem” that has become classless, affecting “all populations and all ages.” To be blunt, white people – many with high paying jobs and fancy apartments – are now doing 8 to 10 bags a day.

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Introducing New Contributor Katherine Record

Katherine Record is the Senior Fellow at Harvard Law School’s Center for Health Law and Policy Innovation (CHLPI). Her work, in part, focuses on healthcare reform implementation, compliance training for healthcare providers related to consent for HIV testing and disclosure, domestic and global mental health law and policy, and implementing state electronic health record databases in compliance with federal and state privacy laws.  Prior to joining CHLPI, Katherine worked at the O’Neill Institute for National & Global Health Law at Georgetown University.  There she focused on public health law reform, firearms control, global preparation for pre-exposure prophylaxis to prevent the transmission of HIV (PrEP), and the development of the legal portion of a genetics database. Katherine received her JD, cum laude, and masters in Psychology at Duke University, her MPH from Harvard’s School of Public Health, and her BA, magna cum laude, from Georgetown University.  She is licensed to practice law in the State of New York, serves as a collaborating mentor for Boston Children’s Hospital’s Strategic Training Initiative for the Prevention of Eating Disorders, on the board of directors for Our Bodies Ourselves, as the liaison to the AIDS Coordinating Committee of the American Bar Association on behalf of the Health Law Section, and on the Harvard College Global Health Review’s Board of Advisors.

Recent Publications:

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