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“Harm-reduction” advocates do little more than pass out drug supplies to the sick and dying.
Erica Sandberg September, 2020
San Francisco has a serious drug problem, particularly among its homeless population. Roughly 8,000 people live on the city’s sidewalks or in its alleyways, public parks, and playgrounds. People with needles in their arms and legs, holding glass pipes and lighters, are a regular sight. Users go limp in doorways and tents, or they career about, dazed and distraught, or angry and violent. Dealers selling heroin, Fentanyl, methamphetamine, and crack are ubiquitous.
So, too, are the advocates for “harm reduction,” which holds that widespread drug use should be accepted but its worst effects mitigated. Organizations such as the San Francisco AIDS Foundation, the Harm Reduction Coalition, the Drug Users Union, and even the Department of Public Health, in partnership with The DOPE Project, focus almost exclusively on “safe drug use.” In fact, the Drug Users Union’s goal is “to create a safe environment where people can use & enjoy drugs as well as receive services.” This attitude led to today’s humanitarian crisis: thousands of people living on San Francisco’s streets, languishing in an endless cycle of homelessness and addiction.
Every day of the week, nonprofits and churches such as Glide Memorial partner with the city to distribute drug use supplies to addicts at designated pick-up points. With an empty backpack, I visited three such spots recently in a single afternoon.
Through open doorways, friendly workers asked what I needed. They suggested items and eagerly gave me what asked for—needles (what size?), naloxone (do you know how to use it? Here, let me show you!), rubber tourniquets to pop my veins, little metal cookers for my dope, sharps containers, sheets of foil and straws for Fentanyl, and mounds of alcohol pads, gauze, and bandages. My backpack was soon bursting; I collected 170 needles.
Not one person asked if I was interested in treatment. No one discussed detox or gave me a flyer with listings for local 12-step meetings. No one inquired about my physical or psychological wellbeing. I could have anything I wanted—except for help getting off drugs.
The idea of harm reduction seems noble. Access to clean needles reduces diseases like hepatitis and HIV, and naloxone can bring overdosing people back from the brink of death. Carefully monitored methadone-maintenance programs can return individuals struggling with opiates to a more stable life.
Harm reduction has mutated from ameliorating the collateral negative effects of addiction to promoting drug use as a positive lifestyle choice. Yet the lives of San Francisco’s addicts clearly aren’t improving. They’re sicker, more numerous than ever, and dying in staggering numbers. The body count is rising from Fentanyl, the highly potent synthetic opioid that has become the substance of choice. Last year’s 441 overdose deaths represented a 70 percent increase, and 2020 will likely be another record-breaking year.
Still, true believers carry on, convinced that they’re doing right by helping addicts do more drugs. It’s an unconscionable position. All people deserve a chance to live free of the substances preventing them from a healthy, self-sufficient life. They need someone to say, “I believe in you; let me help you escape addiction,” not, “You’re a drug user, let me help you remain an addict.”
Question the self-described experts, though, and you’re dismissed as a rube, even as their grand experiment—the giant petri dish of San Francisco—is evidence that they’ve failed.
Condoning illegal drug use means accepting everything that accompanies the business: human trafficking, sexual exploitation, political corruption, and environmental disaster. Recognizing these connections is essential. It’s why we condemned the ivory trade and child labor. Why do we now give a nod to illegal drugs that perpetuate some of the worst crimes known to man?
We can change course and focus on recovery. Options exist. The Salvation Army Harbor Light Center gives homeless individuals and families a place to stay while they pursue sobriety; the San Francisco Adult Probation Department’s reentry division gives newly released prisoners up to a year in residential drug-treatment programs. It’s time to invest in organizations like Community First Village in Austin, Texas, which recognizes that possession of controlled substances is illegal and provides permanent housing to the chronically homeless—with a work requirement. Residents are expected to abide by the law and take advantage of on-site rehabilitation and counseling. Such organizations give more to those they help by expecting more of them.
Drug addicts need a lifeline, not a millstone. For those who doubt that it’s time to push back against harm-reduction advocates who do little more than throw fresh needles, fentanyl foil, and meth pipes at the sick and dying, I have a suggestion: come to San Francisco and have a look around.
Further Resources
- ‘Harm reduction’ drug policies are destroying San Francisco
- Drug Policy – Changing the Narrative: Prevent Don’t Promote
- Drug Use, Stigma & Proactive Contagions to Reduce Both.
- Help! I Need to Stop This!
- 30 Years of Harm Minimisation – How Far Have We Come?
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“Overall, the research consistently finds that sexual victimisation is associated with problem alcohol and other drug use. While earlier work established the association, more recent research has shown that child sexual abuse, in particular, is a general risk factor for problem substance use.”
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Harms of Prescription Opioids – TGA is finally starting the Fix!
Governments have now quantified just some of the short and long term harms of misuse of prescription opioids, particularly in the OST (Opioid Substitute Treatment) Arena. It is way past time to look at evidence-based and successful drug-use exiting recovery therapies.
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“Compared to many, my childhood was a cakewalk. Because your childhood beat you around and left you in pain doesn’t mean that you’ll continue the cycle. Let your hurt be the source of your greatest compassion, the deepest love and understanding. You can do anything.
Walk through it, don’t numb or hide.
It’s been twenty-eight years since I stopped drugs and dedicated myself to a spiritual path, but those hard drugs I did, the heroin, cocaine, and meth, they hurt me bad, it took a long time to really recovery from ‘em. I hope for you that you don’t waste your energy there.
Even the Weed. Man, I was way too damn young for that Shit, it made growing up a more difficult challenge that it needed to be. For years and years, I made the mistake of trying to run away, before I learned to surrender, accept my pain as a blessing, trust in the love, and let it change me.”
Acid for the Children, ‘Flea’ – Bassist and co-founder Red Hot Chilli Peppers
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Family dinners build relationships, and help kids do better in school.
Eating together was a small act, and it required very little of us—45 minutes away from our usual, quotidian distractions—and yet it was invariably one of the happiest parts of my day
Using data from nearly three-quarters of the world’s countries, a new analysis from the Organization for Economic Cooperation and Development (OECD) found that students who do not regularly eat with their parents are significantly more likely to be truant at school. The average truancy rate in the two weeks before the International Program for International Student Assessment (PISA), a test administered to 15-year-olds by the OECD and used in the analysis as a measure for absenteeism, was about 15 percent throughout the world on average, but it was nearly 30 percent when pupils reported they didn’t often share meals with their families.
Children who do not eat dinner with their parents at least twice a week also were 40 percent more likely to be overweight compared to those who do, as outlined in a research presentation given at the European Congress on Obesity in Bulgaria this May. On the contrary, children who do eat dinner with their parents five or more days a week have less trouble with drugs and alcohol, eat healthier, show better academic performance, and report being closer with their parents than children who eat dinner with their parents less often, according to a study conducted by the National Center on Addiction and Substance Abuse at Columbia University.
In her book Eating Together, Alice Julier argues that dining together can radically shift people’s perspectives: It reduces people’s perceptions of inequality, and diners tend to view those of different races, genders, and socioeconomic backgrounds as more equal than they would in other social scenarios..
How then do we eat better, not just from a nutritional perspective, but from a psychological one as well?
“To eat is a necessity, but to eat intelligently is an art,” said the 17th-century writer François de La Rochefoucauld. What “intelligence” means in the context of eating is debatable. There are those who obsess over their food—where it is sourced, if it is organic, the nebulous desire for culinary “originality”—who are known in the U.S. as “foodies” and in France as generation Le Fooding, both of which are the hipsters of cuisine, moneyed and sometimes picky. But this doesn’t seem quite like “intelligence” as de La Rochefoucauld meant it.
Perhaps to “eat intelligently,” one needs only to eat together. Although it would be nice to eat healthily as well, even take-out makes for a decent enough meal, psychologically speaking, so long as your family, roommates, or friends are present.
It’s incredible what we’re willing to make time for if we’re motivated. (Although we often end up just a bit too squeezed to make it to the gym in the morning, we can still find time to go to the movies after work.) Perhaps seeing eating together not as another appointment on a busy schedule, but rather as an opportunity to de-stress, a chance to catch up with those whom we love then, could help our children do better in school, get in better shape, and be less likely to abuse drugs and alcohol. Eating together also led children to report better relationships with their parents and surely relationships between adults can similarly benefit.
CODY C. DELISTRATY is a writer and historian based in Paris. He has worked for the Council on Foreign Relations, UNESCO, and NBC News. (July 2014)