Preventing overdoses or enabling addiction?

MARY REICHARD, HOST: Coming up next on The World and Everything in It: supervised injection sites.

Opioid addiction has gripped the United States to the point that the government declared a public health emergency two years ago. 

One hundred thirty Americans die every day from opioid-related overdoses. 

And supervised injection sites are one idea for keeping addicted people from dying.

NICK EICHER, HOST: Obviously, highly controversial. But these are places where users can inject heroin and other dangerous drugs while medical professionals watch them and monitor their reactions. That way, the argument goes, they can stop overdoses before the user dies.

There are no supervised injection sites in the United States, but a group in Philadelphia is working to change that. WORLD Radio’s Anna Johansen has our story.

ANNA JOHANSEN, REPORTER: The group is called “Safehouse.” Its goal is to save lives. And it says that mission overrides any other considerations.

Rob Field is a professor of law and health policy at Drexel University. He explains the mindset behind the Safehouse approach.

FIELD: Since we know they’re going to shoot up anyway, this is a way to reduce the risks associated with that as much as possible.

Supervised injection sites don’t provide drugs. Addicts bring their own. But a team of social workers and medical professionals supervise everything else. They test the drugs, to make sure they aren’t dangerously potent. They provide clean needles to decrease the risk of infection.

FIELD: And then they would find a space where they can inject the drugs. There would be a place where they can dispose of the syringe…And there’s someone there observing the people who are using this site to check for overdoses.

If someone overdoses, a staff member can administer Narcan…a drug that reverses the effect of opioids. 

There are about 1-hundred-20 sites like this in Europe, Australia, and Canada. Field says overall, they’re successful and have saved a lot of lives. 

FIELD: There’s new evidence that they significantly reduce the risk of transmission of HIV and Hepatitis. They also reduce the risk of overdose. 

But not everyone is sold on the idea. In fact, the U-S government has a major objection.

MCSWAIN: Setting up a drug house is illegal. Normalizing the use of deadly drugs like heroin and fentanyl is not the answer to solving the opioid epidemic. 

That’s U.S. Attorney William McSwain, heard on NBC’s Philadelphia affiliate, NBC 10. Earlier this year, McSwain sued to block Safehouse from opening the site. He says it violates federal drug law. The Controlled Substances Act says you can’t open a location to distribute illegal drugs. 

But early in October, a federal judge ruled in favor of Safehouse. The judge said Safehouse isn’t promoting drug use…they’re trying to reduce it.

Karl Benzio is a Christian psychiatrist and a former addict. He says safe injection sites are logically inconsistent.

BENZIO: You’re giving a mixed message, you’re sort of…saying no, but you’re shaking your head yes to somebody. It’s not okay to use, but we’re gonna allow you to use here and we’re gonna provide safety for you to use. 

Benzio says this type of site could encourage more drug use. That’s partly because addicts have a different way of thinking.

BENZIO: Addicts have a very different mindset and a very acute reward-oriented knee-jerk kind of mindset. So whenever their dangers are removed or dramatically lessened… The addict doesn’t see it as, well, this is a way for me to stop. They just see, wow, it’s easier for me to use. 

Benzio worries that some people will start experimenting with opioids…now that they have a safe place to give it a try.       

Mark Hilbelink disagrees. He’s a pastor in Austin, Texas and runs a homeless ministry. He believes these sites are necessary.

HILBELINK: People have to be engaged at the place where they are.

Hilbelink works with addicts all the time. For him, this is just reality.

HILBELINK: Supervised injection sites…are not a preferred way for people to live, but it also gives us the opportunity to start building relationship and start meeting them where they are to help them find that preferred reality in their lives.

But Karl Benzio says we should never encourage destructive habits. 

BENZIO: There’s certainly a way to provide compassion and communicate care and love and empathy without facilitating the person’s ability to continue dysfunctional behavior. We look at Jesus, Jesus certainly, you know, went and hung out with many sinners, many people doing destructive things. He never made it easy for them to sin.

Despite the recent ruling in favor of Safehouse, it’s not the end of the legal scuffle. U.S. attorney William McSwain says he plans to appeal. He insists the justice department remains committed to preventing these sites from opening.

Rob Field says other cities are keeping an eye on Philadelphia…and it probably won’t be long before they try to open their own sites across the country. That’ll set the stage for more legal wrangling.

FIELD: It would depend on the federal prosecutor in those areas and on the judges in those areas. So it’s possible that there could be inconsistent rulings. 

In other words, a judge in Kansas might say sure, go ahead and open a safe injection site. But a judge in Oklahoma might say no, that violates federal drug law. 

No matter what happens, Karl Benzio says Christians should step up and engage the broken people in their communities … so they never need to turn to supervised injection sites in the first place.

BENZIO: Share life with them, share meals with them, share love and compassion, honor, dignity…so they can start to dig out…But I think facilitating them to do the wrong thing isn’t the right message really to ever send.

Reporting for WORLD Radio, I’m Anna Johansen.

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