Tunnel Vision at the Sentencing Commission: Why Public Health, Science, and Medicine Deserve a Permanent Seat at the Table

The U.S. Sentencing Commission’s 2024–25 amendment cycle revealed a troubling contradiction: What started as an effort to reform the harsh drug guidelines ended with the Commission enhancing the punishment for certain fentanyl offenses—seemingly on Department of Justice say-so alone. Despite statutory mandates to use evidence-based approaches, the Commission did not invite the views of outside public health experts and ignored decades of research showing that increased sentences do not reduce drug misuse or overdose deaths. To fulfill its statutory responsibility to incorporate evidence-based approaches and reflect advancements in human knowledge, the Commission must institutionalize multidisciplinary perspectives and move beyond the tunnel-vision approach that has driven mass incarceration for decades.