“Give Me Liberty or Give Me Death”—For People Who Use Drugs, It’s Literal
“Give me liberty or give me death!”
Sunday, March 23, 2025 marks 250 years since Patrick Henry’s famous declaration. As America approaches its 250th birthday in 2026, R Street is celebrating our founding-era principles and how they intersect with today’s policy challenges. Explore more from our policy teams.
When Patrick Henry spoke that now-infamous line, “Give me liberty or give me death,” he likely intended it as hyperbole, a metaphor, and a call for people to ask themselves what they value. The specifics of what he meant are less clear. Did he want to avoid succumbing to economic shackles in exchange for peace? Was it about tolerating an authoritarian state in order to avoid conflict? Or was it the notion that without individual freedom—which comes from true bodily autonomy—life may not be worth living at all?
Today, 250 years later, Henry’s words can be taken literally for some people. In 2024, an estimated 87,000 Americans died of a drug overdose. Some 480,000 die annually from exposure to combustible cigarette smoke. If we deny these individuals the liberty to protect themselves—their bodies, their health, their lives—they will continue to die.
Substance use can be a risky endeavor. Too much alcohol scars the liver. Smoking tobacco causes cancer. Opioids depress breathing, causing the overdose deaths that have become too familiar to too many Americans over the past decade. On some level, we as a society have decided that at least some use of certain substances—alcohol, tobacco, caffeine—is acceptable. Maybe it is our respect for the Declaration of Independence, which highlights our right to pursue happiness. But essential to that right to pleasure is the right to keep ourselves as safe as possible.
With legal substances, the government helps preserve people’s ability to protect themselves by ensuring the supply is contaminant-free and potency is consistent, predictable, and clearly labeled. For people who prefer the intoxicants our society has chosen to prohibit, not only is the supply itself deadlier, but the government often stands in the way of people’s ability to offset potential harms.
Programs that distribute clean syringes prevent infectious disease transmitted by sharing injection equipment. But more than 10 states still ban them. Methadone, the gold-standard treatment for opioid use disorder, prevents withdrawals and reduces illicit drug use as well as criminal behavior. Yet the federal government refuses to allow its prescription outside of restrictive opioid treatment programs. Fentanyl test strips give people insight into what drug they are about to use, providing life-saving information in the midst of an overdose crisis. Nonetheless, they remain illegal in four states. Products like e-cigarettes slash cancer risk for people who consume nicotine. Still, governments ban them while leaving far more deadly combustible products on the shelves.
These tools are part of a practical approach to substance use. Harm reduction recognizes that while people sometimes do things—perhaps in the pursuit of happiness—that come with risks, they still have the right to protect their lives, well-being, and livelihoods.
When the government prohibits proven harm reduction solutions, they are not discouraging drug use. They are treading on bodily autonomy, dramatically undermining people’s liberty, and as a consequence, their right to life.