Redistributing Harm Isn’t Harm Reduction
Addiction is compulsive repetition of a specific behaviour despite the risk to health and other adverse results. It is usually driven by the short-term gratification or other sensory reward the behaviour provides and can eventually grow to become an obsessive need that takes control of the addict’s life. As the body adapts to the behaviour and/or the substance, it results in a need for increased amounts of the behaviour or substance to achieve the original effect.
Some of the more serious addictions include alcohol, sex, food, computers and computer games, gambling and drugs including illegal, prescription and non-prescription, over-the-counter drugs.
Some consider addiction an illness; others merely the result of bad choices and bad behaviour. I suspect the truth lies somewhere in between but regardless of how it is defined, addiction is devastating to the addict, those closest to the addict – most especially family and to the broader society at large. It can lead to financial ruin, suicide, serious illness that can be fatal, and crime.
Many believe illegal drug use is responsible for the spread of diseases like AIDS/HIV and Hepatitis through the sharing of needles and that has led some to believe that the best way to deal with drug addiction is through Harm Reduction Sites like Insite in Vancouver.
I disagree. I don’t believe that you mitigate or reduce harm by merely redistributing it and in the end, that’s all that injection sites accomplish.
Nothing good comes from enabling bad behaviour and that is all injection sites do. They provide a safe place for the addict to pursue their addiction but do nothing to address the addiction itself. It would be like opening a ‘safe’ bar for alcoholics or a ‘safe’ casino for gambling addicts. The behaviour and the devastating results of that behaviour would continue to escalate leading to more harm to the addict and those in the addict’s life.
Even if you accept that illegal drug use is responsible for at least some of the spread of communicable diseases like hepatitis and HIV among addicts, the simple fact is that harm reduction centres do not guarantee any reduction in careless use of needles.
Vancouver has seen a marked decrease in the incidence of AIDS/HIV and those who promote harm reduction sites point to the injection site called Insite as proof of success but they are wrong. The reduction of HIV/AIDS in British Columbia is because it is the only province that offers highly active anti-retroviral therapy (HAART) free of charge and aggressively promotes its use.
“. . . the most compelling data to date demonstrating the soundness of the “treatment as prevention” theory, an approach conceived at the B.C. Centre for Excellence in HIV-AIDS and now being embraced worldwide.
“Treatment as prevention . . . is so successful, from Zimbabwe to Abbottsford, that policy-makers now talk openly about the possibility of freezing the epidemic in its tracks and creating an AIDS-free generation.”
I understand the concern about the spread of potentially fatal communicable diseases but I don’t believe the solution lies in a myopic view of the total harm caused by illegal drug use.
Illegal drugs have become a scourge inflicted on societies by organized crime, international drug cartels and street gangs. People, lots of people, die every year from the violent competition over territory and distribution of illegal drugs. Addicts who need ever-increasing sources of money to finance their habit often turn to crimes ranging from shoplifting, snatch and grab, break/enter to armed robbery and in some cases even murder.
Illegal drug use is a downward spiral; a road to perdition that sees families torn apart, children as helpless victims of an addicted parent and the wasted and often too-short life of the addict. It increases crime in our cities that endangers citizens, undermines economic activity and can destroy family neighbourhoods.
Harm reduction sites do nothing to mitigate any of this. They enable it.
Like Insite in Vancouver, the Ottawa proposal calls on the creation of a zone around the injection site in which police would not be permitted to enforce drug laws. In other words, a safe retail zone will be established for pushers to sell their drugs to addicts. Inevitably the zone becomes a Mecca for addicts and criminals alike which ultimately destroys the neighbourhood and increases the risk of crime in the immediate area.
One of the most insidious aspects of harm reduction sites is its name. It implies a reduction in the harm caused by the use of illegal drugs and that, coupled with providing a ‘safe’ medically supervised place to inject drugs like heroin can lead young people to believe it is safe to experiment. It promotes the idea that perhaps illegal drug use is not as serious as some try to tell them.
The simple fact is that it is too high a price to pay for the projected benefit. In Ottawa, the incidence of AIDS/HIV due to sharing of unsterilized needles is around 10%. The number one cause remains unprotected sex between men. In other words, those who promote the establishment of harm reduction sites are working to try and fix 10% of the problem by increasing exponentially all of the other associated issues and risks associated with illegal drug use.
It is small-thinking that not only ignores the potential increased harm to the community but actually throws the addict under the bus leaving him or her to deal with the ravages of their addiction in the name of reducing the spread of disease.
You cannot overcome bad behaviour by enabling it and you can’t reduce harm by simply redistributing it to others. Any strategy to combat the serious impact of illegal drug use on the individual and the community must look at everything not just one small aspect of the issue if it is to have any hope of making safer communities.
There are better ways to deal with the ravages of addiction and the threat of disease than enabling illegal drug use. True harm reduction means reducing the spread of the addiction not the spread of some of the results of the addiction. It is a complex social issue that will not be fixed with simple-minded solutions.
Harm reduction centres like that being proposed in Ottawa and Vancouver’s Insite bring little to no insight to finding those solutions.
They merely transfer the problem to others.
© 2013 Maggie’s Bear
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