Safe Consumption Sites Are the Only Way To Stem the Tide of Drug Overdoses

The so-called War on Drugs, which began in the administration of Richard Nixon, has been ongoing in America for more than 50 years. Putting aside the fact that Nixon began his war on drugs primarily as a means for incarcerating Black and brown Americans (especially for simple marijuana possession), the War on Drugs has failed by every metric imaginable. We spend roughly five times as much incarcerating people with substance use disorders as it would cost us to treat them, and the return on that expenditure has been meager at best. The economy loses an estimated one trillion dollars per year (about five percent of G.D.P.) in lost productivity, health care costs, and criminal justice expenditures, among other things. More ominously, thanks to the recent wave of an opioid crisis that was initiated by our legal drug industry and our faulty regulatory apparatus, more than 100,000 Americans, an all-time high, died from drug overdoses last year. Life expectancy is declining in the United States for the first time in generations largely as a result. Drug use is soaring and drugs being purchased on our streets are more lethal than ever thanks to the introduction of fentanyl into just about every type of pill and powder that is manufactured and sold by drug dealers, for whom fentanyl is cheaper to produce and easier to transport than heroin. Fentanyl is so potent that a typical car trunk filled with fentanyl would be enough to kill every single American. Think about that figure for a moment — and you realize that trying to interdict fentanyl shipments, wherever they might originate, is a game only for fools. However, there is a solution to this problem which has been used in Portugal and Switzerland for almost two decades: The time has come for our society to treat substance abuse like a public health crisis. We need to repeal outdated laws that push too many people into jails and prisons and not enough into recovery; invest in treatment so that those who want and need help can get it; and replace abstinence-based policies with ones grounded in reality in order to minimize the worst effects of drug abuse. This would include providing users with clean needles so that they don’t contract or spread H.I.V. or hepatitis C and giving them overdose reversal medications like naloxone. However, the most significant step we can take is to promote supervised consumption, which is standard in Portugal and Switzerland, so that if users overdose, they don’t die. Supervised consumption programs also entail assisting drug-dependent persons with receiving access to housing and basic medical and mental health care so that they can live in relative stability even when they are not abstinent. In short, we need to replace the futile goal of eradication with the concept of what is known as harm reduction. Yes, we realize that some people adamantly are opposed to this point of view. But given that their solution has a proven track record of five-decades of failure, we suggest that a different way of looking at the problem of drug abuse in our country is worth trying.