May 21, 2018 Re: S 2279 SUBA - AN ACT RELATING TO CRIMINAL OFFENSES – HOMICIDE Dear Senators: We, the undersigned, are writing to request that the Senate delay a vote on S-2279 Sub A by recommitting it to Senate Judiciary Committee for further consideration. For the first time in over a decade, overdose deaths in Rhode Island declined in 2017. This decline can be credited to collaborative, evidence based public health and safety efforts. We believe that passage of S-2279 Sub A, and its focus on harsh criminal penalties, will have a deleterious effect on these efforts. Those of us who daily see patients and work in the community with those who will be affected by this bill had no opportunity to review the Sub A version or to testify on it. Unfortunately, the amendments that were proposed by the Attorney General’s Office and approved by Senate Judiciary Committee do not allay our concerns about the harmful impact of the bill’s passage on our efforts to address the state’s opioid crisis. For instance, one amendment requires that the drug be provided “in exchange for anything of value.” But it is common for people who use drugs to sell and trade drugs to support their addiction. Other times, there are small exchanges of money. The Attorney General’s Office testified that it is not the intent of the bill to prosecute lowlevel dealers or people who use drugs. However, the language provided in the Sub A does not protect these categories of individuals from prosecution. In fact, the “delivery through” clause contained in the Sub A exponentially widens who may be held culpable, with no attempt to focus on high-level drug traffickers. Further, it is important to note that almost everyone who died of an overdose in 2017 had multiple substances in their body. Examples include: heroin, hydromorphone and methadone combination; methamphetamine and opiate combination; tobacco, marijuana, methamphetamine and cocaine combination. Alcohol was a major contributor, as were benzodiazepines. Yet a drug user can face up to life in prison for distributing a substance to a friend that may have been only a small factor in the friend’s death or that the person had no idea was contaminated. Not only is it poor policy to leave such broad prosecutorial discretion to law enforcement, it sends a chilling message to the community. We know, based on decades of criminal justice based drug policy, that harsher penalties do not decrease drug using activity. So, this bill’s disturbing message will not decrease drug use, nor drug trafficking – the economics ensure this – but it will further marginalize people who use drugs and increase their fears. The undersigned, representing a broad range of medical professionals, community based organizations, and advocates working on harm reduction stand at the ready to work with you to amend S-2279 Sub A to more accurately reflect the proposed intent of convicting individuals with malicious, predatory behaviors, not low-level dealers and users. Use of a public health approach, not lengthy criminal sentences for users and small-time dealers, is essential for our state’s ability to continue to make headway on this crisis. Please refer to written testimony provided by the Center for Prisoner Health and Human Rights on April 26, 2018 outlining our general concerns with the original bill (attached), which, in light of the Sub A’s continued breadth, still remain largely applicable. We hope that you will consider and support our request. We look forward to discussing this further with you, as we know we all share the same ultimate goal. Responses to this letter can be sent to Sarah Martino at the Center for Prisoner Health and Human Rights, at Sarah.Martino@Lifespan.org, and they will be shared with the signatories below. Thank you. Signed: Organizations The Substance Use and Mental Health Leadership Council of RI Susan A. Storti, PhD, RN, NEA-BC, CARN-AP President/CEO RICARES Monica Smith Executive Director Rhode Island Medical Society Steven DeToy Director of Government and Public Affairs Protect Families First Annajane Yolken, MPH Executive Director Rhode Island User’s Union Michael Galipeau, BSW President Project Weber/RENEW Colleen Daley Ndoye Executive Director ACLU of Rhode Island Steven Brown Executive Director Rhode Island Center for Justice Jennifer Wood, Esq. Executive Director Drug Policy Alliance (National) Lindsay LaSalle Center for Prisoner Health and Human Rights Josiah “Jody” Rich, MD Bradley Brockmann, JD Mental Health Association of Rhode Island Ruth Feder Director Rhode Island Public Health Institute Amy Nunn, ScD Director Ocean State Coalition of Recovery Housing Brian Sylvestre President OpenDoors RI Nick Horton Students for a Sensible Drug Policy Betty Aldworth Executive Director Behind the Walls Committee at DARE - Direct Action for Rights and Equality Sophia Wright National Lawyers Guild of RI James Vita Medical Professionals, Researchers, and Advocates (In all cases, affiliation for identification purposes only) Jasjit S Ahluwalia, MD, MPH, MS Professor, Behavioral and Social Sciences Center for Alcohol and Addiction Studies Brown University Sara Becker, PhD Assistant Professor, Behavioral and Social Sciences Brown University Heather Gaydos, MSW Reentry Project Director Center for Prisoner Health and Human Rights Jeffrey Bratberg, Pharm.D Clinical Professor URI, College of Pharmacy Kristina Jackson, PhD Professor, Department of Behavioral and Social Sciences Lundy Braun, PhD Professor of Medical Science Brown University Christopher Kahler, PhD Associate Director, Center for Alcohol and Addiction Studies Brown University Stephen Kogut, PhD, MBA Professor of Pharmacy Practice URI, College of Pharmacy Peter Brunn Founder & Director, New Day Campaign Ashley L Buchanan, DrPH, MS Assistant Professor URI, College of Pharmacy Cyril O. Burke III, M.D. Geoffrey Capraro, MD Assistant Professor of Emergency Medicine Alpert Medical School, Brown University Megan Clingham, Esq. RI State Mental Health Advocate Seth Clark, MD Suzanne M. Colby, Ph.D. Professor of Psychiatry and Human Behavior Alpert Medical School, Brown University Amy Ferguson, MSW RI Coalition for the Homeless Michael Fine, MD Peter Friedmann, MD Andrew Horwitz, JD Assistant Dean for Experiential Education Roger Williams University School of Law David Lewis, MD Founder, Center for Alcohol and Addiction Studies Alexandria Macmadu, MSc Research Project Director Center for Prisoner Health and Human Rights Brandon Marshall, PhD Associate Professor, Epidemiology Brown University Rosemarie Martin, PhD Assistant Professor, Behavioral and Social Sciences Brown University Sarah Martino, MPA Senior Project Director Center for Prisoner Health and Human Rights Michelle McKenzie, MPH Senior Project Director The Miriam Hospital Cris Monteiro, L.Ac. Providence Community Acupuncture Peter Monti, PhD Director, Center for Alcohol and Addiction Studies Brown University James Padbury, MD Professor of Pediatrics and Perinatal Biology Alpert Medical School, Brown University Brandi Parker Cotton, PhD Assistant Professor URI, College of Nursing Lisa Peterson, LMHC/LCDP/LCDCS/MAC Caroline Picker, LAc. Providence Community Acupuncture Susan Ramsey, PhD Associate Professor, Psychiatry and Human Behavior Alpert Medical School, Brown University James Shelton, LAc. Providence Community Acupuncture Megan C. Smith, MSW Outreach Program Manager The House of Hope CDC Karen Tashima, MD Professor, Medicine Alpert Medical School, Brown University Melissa Tiernan, LAc. Providence Community Acupuncture M. Catherine Trimbur, MD John Trimbur, PhD Rahul Vanjani, MD Assistant Professor, Medicine Alpert Medical School, Brown University Zoe Weiss, MD Steven Williamson, PhD Professor, Department of Political Science URI Ira Wilson, MD, MSc, FACP Professor and Chair, Department of Health Services, Policy and Practice Brown University School of Public Health Professor of Medicine at the Alpert Medical School Medical Students, Alpert Medical School Eloho Akpovi, MS Pranav Aurora Vivian Chan Katherine Cicolello Joseph DiZoglio Jr. Ligia Fragoso Delgado Sarah Frantz Christopher Halline Damilola Idowu Sarah Kler Rebecca Raymond-Kolker Andreas Lazaris Liliana Luna-Nelson Denise Marte Meghna Nandi Matthew Perry Christiana Prucnal Srav Puranam Radhika Rajan Paul Wallace