Hail to the Harm Reduction Commission

By backing supervised drug consumption sites, they voted to save lives

THE GOVERNOR’S HARM REDUCTION COMMISSION’S endorsement of supervised drug consumption sites is a game-changing step towards effective drug policy, especially concerning problematic drug use.

Government commissions often serve as convenient burial grounds for controversial approaches such as supervised drug consumption sites, where people who use drugs can do so in relative safety. And with representatives from politics, drug treatment, drug use, and law enforcement thrown together, this commission had the potential to be a divisive, un-productive black hole.

Instead, it was a respectful, informed round table which raised every hard question about these sites and came out with a positive acknowledgment of their life-saving potential.

This is particularly impressive, as each step our nation has taken to loosen prohibition’s puritanical stranglehold, such as the gradual legalization of marijuana or needle exchanges, has run into bad science, scare tactics, and catch phrases; the most recent of which is that supervised consumption sites “normalize” drug use.

In fact, because most illicit drug use is not “normal,” but furtive, stigmatized, and isolated, it is predictably and unnecessarily dangerous. Bringing drug users into professionally supervised clinics with supportive linkage to treatment avoids some of the street scene’s dangerous anarchy, especially given Fentanyl’s hair-trigger, sudden-death power.

No one who has visited a supervised consumption site would believe for a minute (nor is there any evidence to support the claim) that these spaces encourage drug consumption. These sites don’t normalize drug use so much as they normalize drug users. To portray this as a threat reveals a disturbing depth of animosity and fear—and explains why it has been so hard to take even modest steps forward.

Expect, then, the immediate road ahead to be bumpy; not just because of issues like insurance, siting, scale, and funding, which have been solved over 100 times in 11 countries, but also because of the gravitational pull of that resentment and fear.

It took a diverse commission some time to overcome that pull. But it did.

In addition to saving lives and preventing disease, then, the singular achievement of these safe consumption sites is to repudiate our punitive approach to people who use drugs. The sites represent an embrace rather than the hostile abandonment of those with drug dependence. And once such compassion is no longer a third rail issue for politicians; once police guide people to these sites, as they do in Canada, a life-affirming spear is driven through the heart of our punitive drug prohibition.

Safe consumption sites legitimize a vision in which impacted individuals are seen in medical rather than criminal terms. That vision is their potential; and for unrepentant drug warriors, that vision is their threat.

To its credit, and not without struggle and introspection, the Harm Reduction Commission produced an evidence-informed report guided by the need to transcend the stigma and hopelessness which have poisoned our approach to those with addictions. They were clearly moved by the life-affirming vision that informs safe consumption sites  throughout the world. They took a very large and courageous step, one that will save lives. And change the lives it saves.

Meet the Author

Mark Eisenberg

Writer and M.D., SIFMANOW.org
Meet the Author

Bill Fried

Retired, Law Enforcement Action Partnership
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The good, hard work immediately ahead involves doing right by those who will use or abut those spaces—finding the best practices to ensure the safety of all, regardless of preconceptions or federal threats.

With the glaring exception of Gov. Charlie Baker, it is heartening to see politicians, police, and policy makers work up the courage to address the problem. And so gratitude and congratulations are in order, as we take the next step and create a wave of support for safe consumption sites so powerful that even the governor will surf it bravely.

Mark Eisenberg, M.D.; Bill Fried; and Jim Stewart write for SIFMANOW.org, a volunteer organization representing medical and public health professionals and other citizens.