Magazine article The Christian Century

After the War on Drugs: A Public Health Approach to Addiction

Magazine article The Christian Century

After the War on Drugs: A Public Health Approach to Addiction

Article excerpt

EVERY DAY in Vancouver, Canada, anywhere from 600 to 1,000 drug addicts enter a nondescript building where they can--under medical supervision--inject themselves with illegal drugs they have brought with them, usually heroin, cocaine, or methamphetamine. They know that while at the site they will be neither arrested nor judged, and as long as they are in the building they will be safe.

The program, called Insite, is the only legal supervised injection site in North America. It's located in the Downtown Eastside section of the city, a ten-block area full of single-room occupancy hotels. Drug users are visible on the street all day and often sleep in dumpsters and alleys. Business activity in the area reflects this population: there are lots of fast-food outlets and low-end shops and an open market where street vendors can obtain quick cash.

Once inside the center, first-time clients are interviewed by staff, who ask for identification and about the nature of their drug use. They are supplied with clean needles and syringes and enter one of 12 stalls surrounded by mirrors on three sides, which allow clients to be observed by nurses, who are available to minimize risk of injury. Clients then enter a lounge area. The second floor of the facility houses a detox unit and the third floor has an 18-bed long-term recovery unit. Individuals are not required to ask for these services, however.

It might seem counterintuitive to help addicts continue to use drugs this way, but officials in Ithaca, New York, are considering opening a site like Insite in their city. I was one of about 25 clergy who visited Ithaca last spring to hear Mayor Svante Myrick describe his plan to reform drug policy by doing what Insite does: focus on reducing harm, not on criminalization. Drug policy that is aimed at reducing harm reaches out to people where they are, considers every life worth saving, and expresses an unconditional rather than judgmental love. "Jesus was a harm reductionist," commented one of the pastors at the Ithaca event.

The broader context for the Ithaca effort is the widespread realization that the nation's "war on drugs" has failed. The aim of the war on drugs launched by President Richard Nixon in 1971 was to combat drug use primarily through the arrest and incarceration of drug users. After an expenditure of more than $1 trillion, it has become clear that this model has not done much to deter drug use, but it has made the United States the leading "prisoner nation" of the world, incarcerating millions of people and wreaking massive collateral damage on citizens, especially people of color.

As the failure of the war on drugs has become evident, many officials have moved toward a public health model of response. City and county prosecutors have become increasingly weary of recycling low-level drug offenders through the criminal justice system, and many have become open to the idea of "diversion": police can choose to send offenders, many of whom they already know, directly into programs for drug treatment, housing, and job training.

One such program was initiated about six years ago when a state's attorney in Vermont, T. J. Donovan, became aware that he was seeing the same faces over and over again in the courtroom. "Suddenly," he recalled, "I realized my office was creating the problem. I could just start referring these individuals into treatment." He received strong support from Vermont governor Peter Shumlin.

Five years ago, Seattle launched what has become a model of diversion. The mayor of the city, the executive of King County, city and county prosecutors and police, the public defenders association, the ACLU, and community members all committed themselves to Law Enforcement Assisted Diversion, which diverts drug users to social service programs. A follow-up study by the University of Washington showed that LEAD has led to a significant drop in the number of people caught up in the criminal justice system, a nearly 60 percent drop in recidivism, and a reduction in law enforcement costs. …

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