Philadelphia hit a new low in its high-profile struggle against opioid addiction. On Jan. 23, city officials greenlighted the creation of safe injection sites to counter an alarming number of opioid overdoses and deaths — some 1,200 in the last year alone.
District Attorney Larry Krasner even likened the plan to “God’s work.”
According to a number of studies — and to Catholic teaching — God would appear to disagree.
The deception of ‘harm reduction’
Safe injection sites are places where narcotics users can inject (or otherwise ingest) heroin, cocaine and similar controlled substances. Staff provide clean needles and basic medical attention if users overdose. Many centers offer social services and counseling referrals.
Along with needle exchanges and methadone programs, these sites are a form of “harm reduction,” a public health strategy that emerged during the 1980s to manage substance abuse. Harm reduction is essentially defeatist: it presumes that addiction can’t be cured, and that the best tactic is to minimize its damage.
Isn’t it better, you might think, to have people shooting up in plain view with fresh syringes and nurses on hand, than to have them dying on doorsteps in blighted neighborhoods?
According to some Catholics, the answer is yes. Back in 1999, the Sisters of Charity sought to operate a safe injection site in Sydney, Australia. The Vatican’s Congregation for the Doctrine of the Faith ruled against them, stating that the plan was an “extremely proximate” type of material cooperation in drug abuse.
Almost 10 years later, the Diocese of Albany opened a needle exchange program called Project Safe Point, which remains active today — though not without its critics, which include the National Catholic Bioethics Center.
In 2013, the center released a position paper declaring that the “good aim” behind a needle exchange program nonetheless “contains the evil means of heroin use: the immoral act of injecting the drug with a clean needle is the means by which the users’ health will be protected.”
In other words, when it comes to the scourge of drug addiction, you can’t make a deal with the devil — because that’s what addiction itself already is. And if we don’t grasp that from the outset, we’ll blindly pursue options like safe injection sites, which will only compound the damage of the opioid crisis.
One of the first casualties in the addiction battle is the truth. Denial and deception fuel the disease, and the movement for safe injection sites.
A Catholic response to safe injection sites
As Catholics, we’re called to witness to the truth of Christ’s redeeming love, which delivers us from every bondage — including opioids, as a number of recovered users can attest. That mission requires us to state clearly why harm reduction is neither an effective nor a morally defensible response to the opioid addiction crisis.
Safe injection sites fail in four ways:
They worsen addiction. Built on a misguided sense of compassion, the sites actually mire clients in their misery. In a 2016 BBC interview, Dr. Neil McKeganey of the University of Glasgow declared that of the 1,200 drug users he surveyed, less than five percent wanted safe injection sites. “The vast majority said they wanted help for one thing, which is to get off drugs,” Dr. McKeganey noted, calling harm reduction methods “enabling.”
They lack clinically proven “success.” According to Garth Davies, associate professor of criminology at Simon Fraser University, there’s a troubling absence of empirical data about the effectiveness of safe injection sites. Existing studies on the facilities “have never been subjected to any critical evaluation,” so that decisions about these sites “are being made in a near vacuum.”
They reinforce the criminal context of addiction. Unless the federal government decriminalizes heroin, clients will presumably continue to use street-supplied drugs at these facilities. And to fund their habits, these clients will also continue to rely on theft, panhandling, prostitution and drug dealing.
Meanwhile, the supply chain for illegal drugs will remain intact. Every year, thousands of immigrants flee countries where drug cartels force the marginalized poor to cultivate and transport illegal drugs, which are also used in prostitution and slave labor.
As the world’s biggest customer for these drugs, the United States has abetted the plight of these immigrants. By supporting the drug market, safe injection sites will actually invalidate Philadelphia’s claim to be a “sanctuary city,” while contravening Catholic social teaching on immigration and human rights.
Pope Paul VI declared that while it is “sometimes … lawful to tolerate a lesser moral evil in order to avoid a greater evil or in order to promote a greater good, it is never lawful, even for the gravest reasons, to do evil that good may come of it” (Humanae Vitae, No. 14).
Safe injection sites won’t destigmatize addiction any more than methadone clinics did. We must instead use the many proven options that effectively address the medical, psychological and spiritual aspects of addiction, while attacking its systemic causes in our society.
‘We all suffer’ when a person uses drugs
Perhaps the most concise take on the issue comes from Father Douglas McKay, the founder of Our House Ministries in Philadelphia’s Grays Ferry section — a neighborhood long plagued by substance abuse.
Having spent four decades ministering to those struggling with addiction and having lost his own brother to a crack-house overdose, Father McKay responds passionately to simplistic strategies like harm reduction. They will never suffice for so complex and heartbreaking a problem as addiction.
“We forget that if one person suffers, we all suffer,” he told me, his eyes flashing. “So if you’re letting that injection go in that person’s arm, it not only goes in his arm, but in the Lord’s arm, my arm, a kid’s arm, society’s arm.”
All of us are suffering from the opioid epidemic, in one way or another. Rather than creating safe injection sites, let’s put the needle down now — forever.