As a young man I worked at an agency that served people living with HIV and AIDS, in the era before effective HIV treatment was possible. Most of our clients were former (or not so former) heroin users.

To remain in our job training and placement program, because we were state funded and had to comply with state laws, our clients had to test regularly negative for opioids.

All of our clients were highly motivated to not use heroin, but the nature of addiction made that very difficult sometimes. Our program director was forced to dismiss some really good people who fell short of perfection in not using.

I’ll never forgot the major lesson I learned working there. Most heroin users are harmed far more by society and its stigmatizations and punishments then they are by actually using heroin.

Almost none of our long-term heroin-using clients suffered major medical problems resulting from heroin, aside from HIV. Almost all of them had huge problems resulting from society’s reactions to heroin.

They had all been marginalized and criminalized, forced to the edges of society, and shuffled in and out of prison or jail. Most of them owed their HIV positive status to that stigmatization, to their inability to find or pay for clean works.

Even today, now that HIV can be easily treated, and now that new cases are on the decline across the board, heroin users remain uniquely at risk because of their criminalized status.

The war on drugs has done nothing for our society except create a criminalized class of people.