Drug Policy and the Church, Day 4: Harm Reduction

Needle Exchange, by Danielteolijr. From Wikimedia Commons

How should we treat people who use drugs? There are two general schools of thought. The first is that users “should” experience all the negative consequences of their drug use: poverty, homelessness, illness, pain and suffering—in order to coerce them into better behavior. Actions or policies that are not geared toward total abstinence are considered “enabling.” We often call this “tough love.” This is an individualistic approach, and it is what we as a society have been trying for centuries. It doesn’t work.

The second school of thought accepts that drug use happens and is part of human society. While drug abuse does harm to people and society, this approach is about harm reduction: helping people avoid some of the worst consequences of drug use, empowering them to make their own choices about what will ultimately make them happy and productive, and giving drug users a voice in designing policies that will help them. It looks at addiction as a systemic problem exacerbated by poverty, hunger, poor relationships, and homelessness—and not just as the cause of those things. Harm reduction might be providing clean needles to heroin users to reduce the spread of HIV, or giving community organizers training in the use of naloxone to prevent deaths by opioid overdose. It might even mean giving people a safe place to use drugs so that they are not robbed or sexually abused by others, where they can be prevented from harming themselves or others.

I need to distinguish between harm reduction and enabling. Parents of adults, for example, are not obliged to provide their sons or daughters with a safe space to get high, especially if that drug use impacts their ability to earn a living or pay for their own upkeep. In such cases, firm boundaries may be most appropriate. Enabling is making excuses or being dishonest about the harm caused by drug abuse. Harm reduction acknowledges harm and reduces it.

It’s worth asking, though, why a society that has plenty of homes sitting empty (often due to foreclosure) and more than enough food cannot provide food and shelter for all of its citizens. When people who abuse drugs have secure housing and enough food, they are better able to curb their addictive behaviors. Homeless persons who use drugs are better able to get clean and sober if they have a safe place to live. This shouldn’t be surprising! Abraham Maslow talked about a hierarchy of needs. Food, clothing, and shelter are prerequisites to long-term decision making. Making these needs contingent on socially-acceptable behavior—as our current policy does—is a set up for failure.

As I said Tuesday, I tend to believe that people will thrive under the right conditions. Sure, there is a nature and nurture argument to be made about whether our environment determines our destiny, or whether our will and character do. But living things have a built-in drive toward living—not self-destruction, and when we see large numbers of people failing to thrive, it is an indicator that something is wrong in the environment. We do not blame plants for failing to grow without sunlight, or babies for failing to grow without love!

I believe there is more than enough suffering in the world that occurs naturally, but that we—as individuals and a society—manufacture more than necessary. This is a somewhat Buddhist way of describing what Charles Wesley called “our bent to sinning.” It is not so much a moral or judgmental statement as a practical one: we do harm to ourselves. We do not participate in the abundant life God designed us to live.

For followers of Jesus Christ, our primary task is figuring out what embodied love looks like in our world. The Wesleys came up with three general rules for the people they called Methodists: Do no harm, do good, and stay in love with God. While I think there are situations where “tough love” and boundary setting are necessary and appropriate, I think Christians have to be the public voice of “do no harm” in policy discussions. For too long, we have chosen “tough love” over genuine love, and this attitude has lent influence to both white supremacy and greed.

Prayer:
God of Abundant Life, help us live according to your present abundance instead of imagined scarcity. Teach us to do no harm.


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