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?
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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.”
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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.
They violate Catholic teaching on illegal drugs. The Catholic Church flatly denounces the use of illegal drugs as a grave offense (Catechism of the Catholic Church, 2291).
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.
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Great work Gina. The other dirty little secret is the legalization of “medicinal marijuana” and “recreational pot” working through the Pennsylvania legislature and other states. While the tax dollars are rolling in, the black market is increasing under the cover of “recreation.” Teen usage is way up. Teen/young adult car accidents are up. Emergency room visits up. All going “Up in Smoke.” Read this Wall Street Journal for the facts: https://www.wsj.com/articles/jeff-sessionss-marijuana-candor-1515197282
Apparently, society cannot decide whether addiction is a disease, a crime, willful misconduct, or a sin. Meanwhile, people continue to die in the streets. Getting users off the streets is one way to offer them a variety of help.
Programs that “suggest” abstinence only, even one day at a time, are difficult. Harm reduction strategies such as medication assisted therapy and safe injection sites help save lives. We have to meet people where they are. Expecting sudden and perfect abstinence is like asking a couch potato to rise and run a marathon. Very few will make it. Let’s give everyone a chance.
Isaiah 58:7
“Is it not to divide your bread with the hungry And bring the homeless poor into the house; When you see the naked, to cover him; And not to hide yourself from your own flesh?”
As a person of the Catholic faith who strongly believes in the sanctity of life I was quite offended by your article “Put the Needle Down… “There’s absolutely no way of knowing how many centuries your mindset has taken us back. In addition to being raised in the Catholic faith, I am a person in long term recovery and I can attest to the fact that Philadelphia already has injection sites, they are just not SAFE INJECTION SITES. They go by other names like allies, galleries, railroad crossings, unintended use of family & public bathrooms, etcetera, etcetera, etcetera. In those places, if users overdoses they are more likely to die before real help arrives. Your recommendations of just say “No” to supervised injection sites only puts the nails in more coffins and also lessens the chances of substance users receiving the levels of attention, assistance and aid required.
Obviously there are those among us who have very little compassion for substance users. Your sensationalized title says, Put Down the Needle. “ My God, Jesus, Joseph and Mary have you ever tried Ms. Christian. Well I have tried and as we know it’s not that simple. Even FLOTUS Nancy Reagan Just Say No initiative was overly simplistic as you can in your share time research. For those people who are busy saying, “Yes, Turning On & Tuning Out” are we now forcing them back into he allies, galleries and other sides of the train tracks? If so, who is in denial about harm reduction? No I’m not advocating that anyone use drugs but the realities are many will use drugs as navigate this thing called life. Another REALITY ALERT it is not just a Philadelphia Pennsylvania epidemic it’s Worldwide. NOW if Philadelphia wants to continue It’s Recovery Capital of the World Campaign Philadelphia is going to have to take a BIG LEAP FOR SUBSTANCE USERS. We need Safe Injection Sites to minister to those that need the God you spoke of the most.
Accepting these sites is a tough one and it’s strange but it has come to this. People who use drugs really don’t need permission to get high. As it stands, somebodies’ sons and daughters have no safe place in the underground. Please do not take our Society back to that Hell. We are not defeated, we need substance users to find their travel back home and to come as they are. Or we can continue as we were as the words emphasize in the song Home is Where the Hatred Is by Gil Scott Heron,
Hang on to your rosary beads
Close your eyes to watch me die
You keep saying, kick it, quit it, kick it, quit it
God, but did you ever try
To turn your sick soul inside out
So that the world, so that the world
Can watch you die
There is one way to end all illegal drug use permanently and forever. That is to legalize all drugs. If Jesus were alive today he would be handing out clean needles at the exchange, not siding with Pharisees who promote the death of drug users. How about quoting actual scientific studies instead of expert opinion?
With a new liberal mayor and D.A. my beautiful city of Philadelphia will become a waste land of illegals, coddled criminals and drugs. A Democrat paradise like living in California. God help us.
As an addiction care specialist, I am very dubious about the Phila. program.. We should provide help in giving detox and medical care .
Thank you Gina for an excellent article. The current plan encourages drug users instead of helping them to take the first step to a cure…..and for many it takes a second or third step but help is there for the addicted.
I am most impressed by this article. On paper the ‘easiest’ addiction to treat is opioids because we know how opioids enter the brain. We do not have this knowledge for other drugs like cocaine or meth. We have highly effective medications and behavioral therapies that can treat the disorder and help patients regain a normal life. My clinics in the St Louis area treat in excess of 1000 heroin addicts a month through a combination of appropriate medical, psychiatric and behavioral therapies and all services provided on an outpatient basis. The vast majority of the patients are either coming out of the correctional system or street addicts.
Drug legalization and safe injections sites effect poor people disproportionately. In the guise of harm reduction, certain groups are attempting to legalize drugs. This would be a disaster. Harm reduction which may include giving out the opioid reversal agent Narcan should lead to harm elimination and harm avoidance. The country will do well if the treatment is standardized like all other chronic conditions and the business model that dominates the field is dismantled.
Very well said. I hope this plan is scuttled quickly, and the focus shifts to really helping those addicted.