A safe place to inject drugs
Our view: Md. should consider (but not rush into) legalizing ‘safe injection sites’
Lawmakers are considering a bill in the General Assembly that only a few years ago would have been thought a dangerously radical proposal: legalizing the creation of so-called “safe injection facilities” where people addicted to heroin and other opioids can consume the drugs under the supervision of medically trained staff without subjecting themselves to criminal penalties. While the idea of sanctioning illegal drug use still strikes many people as extreme, such programs in fact have proven effective elsewhere, and they’re also a logical consequence of a national trend toward treating addiction as an illness rather than as a crime. This isn’t something Maryland should rush into, but neither should it be dismissed out of hand.
When former Baltimore mayor Kurt Schmoke made national headlines a generation ago by suggesting that drug addiction be treated as a public health issue rather than as a crime, his proposal met with near universal condemnation. Critics charged Mr. Schmoke was “soft on crime” and that his ideas about treating users for their addiction rather than throwing them in jail could set a dangerous precedent that would lead even more people to consume drugs. But after three decades of the country’s failed “war on drugs,” the wisdom of Mr. Schmoke’s argument has become apparent. What sounded “radical” in 1987 sounds eminently reasonable today.
Maryland courts increasingly recognize that steering addicts into treatment programs often makes more sense than sentencing them to long prison terms. When addicts get out, they are likely to go right back to committing the same kinds of crimes to support their habit that got them locked up in the first place. It’s a vicious circle that police and prosecutors have contended with for years, but there still aren’t enough treatment beds available to break the cycle. And even if a slot is available, an addict may not yet be ready to embrace the chance for change that treatment offers.
Meanwhile, public health officials in Maryland — and Baltimore in particular — have been pioneers in “harm-reduction” strategies for drug users, from the establishment of clean needle exchange programs a generation ago to the current efforts to distribute the anti-overdose drug naloxone to addicts and their associates. The results have been encouraging in terms of reducing new AIDS infections and overdose deaths.
The cumulative result of the courts’ growing preference for giving addicts treatment options instead of prison time, coupled with the success of public health agencies’ harm-reduction programs, has been to put many more addicts on a pathway to treatment. Every time a judge sends an addict to detox and counseling, or a health worker in a needle-exchange program encounters addicts who say they want to kick the habit, it’s an opportunity to break another link in the chain of addiction, crime and incarceration. The aim of Maryland policy should be to create opportunities for as many such encounters as possible to occur between addicts and the institutions that can help them get their lives back on track.
That’s why legislation introduced by Del. Dan K. Morhaim, which would allow addicts to consume illegal drugs in a safe place with sterile equipment and under medical supervision, deserves serious consideration. Maryland is experiencing an epidemic of heroin overdose deaths, manyof which could have been prevented had the victims had prompt access to naloxone, also known as Narcan, which staffers at safe injection facilities can administer. A study of Insite, a safe injection facility in Vancouver, Canada, found that it prevented three overdose deaths and 35 newHIVinfections every year.
Theproposals put forward by Dr. Morhaim, a physician, include some provisions that clearly warrant further scrutiny, such as one that would allow some addicts not only to use safe injection facilities but to actually receive pharmaceutical-grade heroin in certain circumstances. Critics call the idea reckless and irresponsible and argue it would make the state an accomplice in murder in the case of a fatal overdose. Those concerns need to be thoroughly examined and debated before Maryland lawmakers approve such a law, and likely it will take more time than the remainder of this year’s General Assembly session affords. But there is a growing, bipartisan consensus that we cannot arrest our wayout of Maryland’s drug problem. Legislators need to be willing to have an open mind about where that conclusion might lead.