The Church of Safe Injection Saves Lives

Rev. Alexander E. Sharp Drug Education, Faith Perspectives, Harm Reduction

There is a new church on the horizon.  It usually operates out of the back ends of cars, often after dark and late into the night.  So far it exists in six locations in Maine as well as in six other states. It is called the Church of Safe Injection.  

Its founder is a 26-year old drug recovery coach named Jesse Harvey.  He preaches the Gospel of Harm Reduction: we should use all possible measures to protect drug users from the harm of their drug use. Measures include clean needle exchanges, and, in the case of potential overdose deaths, a life-saving substance called naloxone.  

“All too often, people who use drugs are offered only two choices, ‘Get sober or die.’” Harvey wrote recently in the Portland Herald.  “Jesus would have rejected this shameful and lethal binary….’Let all that you do be done in love,’ states 1 Corinthians 16:14. Too often when ‘religious’ people attack us on Facebook, their hate shines through and they betray this passage.  They betray Jesus.”

Last October Harvey started loading up the trunk of his 2017 Honda with sterile needles, naloxone, rubber tourniquets, alcohol swabs, and other materials to avoid infection.  Every week, usually in the evening, he drives to a site in Lewiston where drug users congregate. He makes these supplies available to all who need them.

For many, these gatherings seem almost like a mass.  Harvey himself has no doubt he is doing what Jesus would have done: “If syringes had been around in Jesus’ day, He would have supported safe injection, and he would have made sure the people he hung out with had access to sterile supplies.”

While many states have now authorized needle exchanges, 15 do not, and services that do exist are often sparse.  Maine, which spans over 35,385 square miles, offers only six, mostly in the southern part of the state. Only four make naloxone available.

Harvey is certified as a minister by the Universal Life church, which ordains individuals to perform weddings, baptisms, funerals, and start congregations. He carries a card that identifies him as a “disciple & acolyte.”

The Church of Safe Injection has only three rules for members:  they must welcome people of all faiths, including atheists; serve all marginalized people; and, of course, commit to supporting harm reduction. For the most part, the individuals have gathered outdoors. But there have been some house meetings along readings, including scripture.

The location within a physical structure will bring Harvey closer to what has been his goal from the beginning:  a safe injection site where individuals can administer their own drugs under supervised care to insure safe and clear conditions.

Such sites exist in at least 60 cities spread across Western Europe, Canada, and Australia. They are illegal in the United States, but strong support exists in Boston, New York, Philadelphia, San Francisco, and Seattle.  

Harvey’s strategy at this point is: first, to incorporate the church as a not-for-profit; and, then, to apply for a religious exemption from federal law.  He is looking to a 2006 Supreme Court decision that permitted a small sect to continue import a mind-altering drug – ayahuasca – for use in religious services.

At the end of the day, what Jesse Harvey is doing is an act of civil disobedience. He is breaking the law.  He distributes more than the limit of 10 needles at a time permitted in Maine. He also has never obtained certification to operate a needle exchange facility.   

He sees no alternative. “Overwhelmingly, the churches I’ve reached out to are not interested in helping people who use drugs…Politicians, law enforcement, and health care haven’t taken the lead here, so our church is,” he writes. “Join the Church of Safe Injection and save lives.”  

“We do not encourage drug use. However, it is our sincere religious belief that people who use drugs do not deserve to die, not when there is a proven, cost-efficient, feasible, compassionate solution that can be so easily implemented.”

Who among us can disagree?

Rev. Alexander E. Sharp, Executive Director

Jesse Harvey: My Faith and Work

Rev. Alexander E. Sharp Harm Reduction

(We had the opportunity to speak with Jesse Harvey, founder of the Church of Safe Injection, by phone last week. We were especially interested in whether he has been able to engage mainline churches in responding to the opioid crisis –ed.)

AL:  Tell us more about yourself and your religious faith.

JESSE: I’m in recovery and I’ve been to a bunch of AA meetings and I believe in a higher power. I’ve tried going to many churches here in Portland.  I’ve considered myself a believer in some higher power for maybe five years. But it’s really only been since I started this work that I’ve really come to think of myself as a religious person. I’m interfaith. I don’t necessarily subscribe to any one belief over another.  We have seen so many people disenfranchised by traditional religion and churches.

AL: What do you feel you are accomplishing right now with the Church of Safe Injection?

We are getting naloxone out there and exchanging syringes.  We are distributing other harm reduction supplies. There are other organizations that serve far more people than we do. With us it’s sort of catch-as-catch-can.  We try to be as regular as possible with the people that we know, but we can only serve about one in every thousand people in Lewiston and Auburn that need it.

Our real output, our real product, if you will, is changing the narrative, inspiring the macro sort of conversation.  It’s like guerrilla theater if some other advocates and I get arrested, which we are thinking about doing in the coming month.

AL: Did you come up with the concept of church because of the theater messaging part, or would you like to move toward a more formal church structure?

JESSE:  Absolutely, yes. That’s what actually our Bangor branch does.  It has weekly meetings. It uses scripture. When I did my Narcan training in Auburn last week, I read a scripture. It is a real church. It’s non-traditional but certainly we would love to move into more conventional spaces as well — whether a physical building and whether tradition X,Y or Z. Just so we can capture that audience as well.

AL: Have you established any program connections with “mainline” churches?

Jesse:  I’ve done two Narcan trainings, one in Biddeford, Maine and one in Auburn, Maine, both Unitarian Universalist.  I have reached out to so many churches. I’ve let them know about the urgency of what we are doing. I’ve quoted Matthew: 31-46. I never hear back.

AL: I know Chicago pretty well. I’ve worked in Illinois and lived in Chicago for 35 years. I can’t find a mainline church where one might even detect a hint that we are faced with national opioid crisis.

JESSE: Its really disillusioning, to tell you the truth.

AL:   Recently I called a friend at Chicago Recovery Alliance, which is licensed to do the kind of work you do.  They operate out of a large van. I asked whether any churches, especially in neighborhoods where the risk of overdose and drug infections is greatest, had ever reached out to them. So far that hasn’t happened.

JESSE: I actually have been thinking a lot about purchasing a van.  As soon as the church is built up enough in terms of people and media coverage and legal assistance and partnerships, I’m going to start operating safer drug consumption spaces. Probably in the back of this van I’m talking about. It would be foolish to do it now because I would just get thrown in jail or prison for no good reason.  But in a few months, if things continue at the pace they’re continuing at right now, we will do this. When we do, I think religious intervention to save lives and to keep people safe is a real possibility.

The Dangerous War on Syringe Exchange Programs

Tom Houseman Drug Education, Harm Reduction, Uncategorized

In a 1996 episode of the tv show Spin City, Deputy Mayor Mike Flaherty (Michael J. Fox) is discussing a proposed syringe exchange program with city hall’s Head of Minority Affairs, Carter Heywood (Michael Boatman). Flaherty would rather the city stick with its old plan of handing out AIDS prevention pamphlets, because “it’s almost impossible to inject narcotics with a pamphlet.”

The scene is played for laughs, but there is an underlying truth.  The US government has historically avoided harm reduction policies in favor of strategies that are less controversial, but also woefully ineffective.

Syringe exchange programs have existed in the United States since the 1980s. They were created by community activists, without government support, as a response to the AIDS crisis. Since HIV is transmitted through blood, distributing clean needles reduced the risk that somebody could become infected with HIV after sharing a needle previously used by an HIV-positive person.

Indeed, countless studies have shown that access to clean needles drastically reduces infection rates of not just HIV, but infections such as Hepatitis as well. In addition, those who repeatedly reuse needles risk a variety of infections. By providing drug users with clean, sterilized needles, syringe exchange programs are one of the most effective forms of harm reduction. As the opioid epidemic leads to increased rates of heroin use, syringe exchange programs are more important than ever.

Unfortunately, draconian laws at the federal level and in many states make it extremely difficult for syringe exchange programs to help the people who need them most. U.S. Code Title 21 Section 863, also known as the “drug paraphernalia statute,” bans the distribution of drug paraphernalia. The Department of Justice defines drug paraphernalia as “any equipment that is used to produce, conceal, and consume illicit drugs,” a category broad enough that they mention “miniature spoons” as potential paraphernalia.

Many states have similar laws, also vague enough that syringes are not always necessarily included. Even when syringe exchange programs are exempt, funding them publicly is an additional hurdle. Until 2016, it was illegal to use any federal funds to support syringe exchange programs. Even now, while funding these programs with federal money is legal, the money cannot be specifically used to purchase needles, a piece of legal tightrope-walking meant to deflect criticism that the government is “soft on drugs.”

There are 15 states in which it is illegal to run a syringe exchange program, a diagonal stripe across the country from Idaho to Florida. In these states, which make up the bulk of the Midwest and the Southeast, drug paraphernalia laws forbid individuals from selling or distributing syringes if they have reason to believe that they will be used for illegal drug use.

But even in states where syringe exchange programs are legal, hurdles created by state and local governments, as well as local law enforcement, make it unnecessarily difficult for harm reduction organizations to ensure that drug users have access to clean syringes.

Illinois is one of the few states in the Midwest that allows syringe exchanges, but the onerous restrictions placed on these programs make the work far more difficult than it should be. Organizations like The Chicago Recovery Alliance must obtain a “research exemption” in order to distribute syringes, a barrier that makes it harder for them to reach the people who need them most.  

And there is, in fact, no need for more research on the efficacy of syringe exchange programs. Mountains of evidence show that such programs are cost effective for cities and states and that access to clean syringes lowers rates of HIV infection without leading to increased rates of drug use. Effective syringe exchange programs save lives and make communities safer.

This has not stopped towns from shutting down needle exchange programs, or preventing them from opening, based on unfounded fears. Last year the mayor of Charleston, West Virginia forced a local syringe exchange program to shut down, claiming that too many used syringes were being found unreturned. This was a baseless claim; 9 out of every 10 needles distributed were returned to the program.

Earlier this month, Scientific American dug into why so few syringe exchange programs exist in Virginia, one of the states hit hardest by the opioid crisis. One of the issues, they found, is that “the law [requires] any local community to obtain formal written consent from local law enforcement officers for programs to operate,” and “continues to criminalize possession of even sterile syringes” for the program’s customers. As a result, only three of the seventy-five eligible counties in Virginia have a syringe exchange program.

The opioid epidemic is worsening by the year; more people are going to be using heroin, often without the resources they need to stay safe. Harm reduction is about helping people stay safe while offering them whatever support and assistance they need. No program does that more effectively than syringe exchange programs, yet too many states are stuck in a War on Drugs mindset that punishes and stigmatizes drug use. That approach has failed, and harm reduction is one of the new strategies that must be embraced.

In the fictional world of Spin City, Deputy Mayor Flaherty shoots down the idea of a needle exchange program. “We are in a war against drugs, in case you haven’t noticed,” he tells Haywood. “That’s the same war we’ve been fighting the last forty years?” Haywood asks sarcastically. “How we doing?” More than twenty years after this scene was first shown on television, it seems that too many politicians have the same answer to that question as Michael J. Fox’s character did at the time: “Any day now.”

Tom Houseman, Policy Director

Why Decriminalization is Not Enough

Tom Houseman Decriminalization, Marijuana Legalization

There have long been two sets of de facto marijuana laws: one that punishes people of color in poor communities; and another, far more lenient — when they are enforced at all — for whites, mostly in the suburbs. This is largely because of discriminatory law enforcement.  Blacks and Latinos have long been at least three times more likely to be arrested for low-level marijuana possession.

Those who oppose legalizing marijuana for recreational use would have us believe that a half-measure, called decriminalization, would end this social injustice of the past 80 years. They want us to treat low-level marijuana possession like a civil, not a criminal, offense. This, they say, will solve the problem.

They also argue that decriminalization is the best way to protect public safety.  They are wrong on both counts.

Historical perspective is helpful here.

Anti-marijuana advocates opposed medical marijuana, now legal in 33 states, every step of the way.  Many, including Alex Berenson in his new book Tell Our Children, still do: “Marijuana is not medicine.” he writes.  Most opponents were also against decriminalization when it was first brought forward. Decriminalization is now is their new line in the sand. They are united in supporting it.

Why does decriminalization not eliminate the harmful effects of law enforcement primarily on minority communities? Civil offenses generally include a fine – up to $200 in Illinois. Fines can have a debilitating effect on lives at the margin.

The New York Times and National Public Radio have both thoroughly documented the impact that accumulating fines can have on those living paycheck to paycheck. The Federal Reserve Board has estimated that 40 percent of Americans don’t have enough money to cover an emergency expense of $400.

Decriminalization continues to provide law enforcement with an excuse to target poor communities of color. “In certain communities, some police just throw the book at people,” an activist commented recently. Until marijuana is legal, it will potentially continue to be an instrument of harassment.

Some people sell marijuana to support a substance use disorder or because they have no other means to subsist and, in some cases, feed their families.  Decriminalization does not address this issue. A legal, regulated market with a focus on social equity could provide opportunities for these people to seek treatment or jobs.  

Finally, marijuana arrests continue to be higher under decriminalization. This is because the amount of marijuana one can possess with legalization is higher, usually 30 grams, rather than 10 grams under decriminalization.  In Washington, marijuana convictions decreased by 76% from 2011 to 2015 and by 96% in Oregon between 2013 and 2016.

When it comes to public safety, opponents fail to recognize that decriminalization is still a form of prohibition. In fact, it is the same kind of prohibition that was disastrously applied to alcohol in the 1920’s.

Decriminalizing marijuana without legalizing it does not solve any of the problems associated with prohibition. It does not address the issues of the illicit, street corner, school yard, back alley markets and their myriad negative effects on both communities and drug users. Without a regulated market, any time individuals buy drugs they are doing so through the black market from an unlicensed dealer. They have no way of verifying what they are actually buying, and no recourse if something goes wrong.

Legalizing marijuana, and creating a taxed and regulated market, will solve these problems. A regulated retail market will make it safer for people to use marijuana, create jobs, and provide opportunities to revitalize neighborhoods trampled by the War on Drugs. These opportunities are just not possible – even as current injustices continue – under decriminalization.

In short, despite what opponents say, stopping short of full legalization does not ensure social justice nor does it adequately service public safety. Decriminalization is not enough.

Tom Houseman, Policy Director
Rev. Alexander E. Sharp, Executive Director

Marijuana Reform: Framing the Debate

Rev. Alexander E. Sharp Decriminalization, Marijuana Legalization

In theological terms that go back to Augustine and Aquinas, the War on Drugs is not a Just War.  First, it has no reasonable chance of success. Second, it has disproportionately harmed others, especially people of color. Third, reasonable alternatives exist, especially drug treatment rather than jail or prison for those struggling with substance use disorder.

As we head into 2019, thirty-three states have now legalized medical marijuana, 13 have decriminalized it, and 10 have approved legalization for recreational use. Policy debates are intensifying as opponents fear a new national approach to drug policy is taking hold.

Witness the just published book Tell Our Children by journalist and novelist Alex Berenson warning that marijuana can cause psychosis and other mental illness.  This is not a new concern. But as similar incomplete and partisan tracts appear, it is more important than ever before to examine the basic assumptions underlying the national marijuana debate.

The struggle is really between “prohibition” and “regulation.”  Is this too simple? I don’t think so. Those opposing legalization now make their stand at decriminalization. This is really a soft word for prohibition.  All production and distribution would remain with the illicit market. Low level users are given a civil citation, a small fine, like a traffic ticket. The same was true during alcohol prohibition in the 1920s: drinking liquor was legal, but selling it was not.

The best way to think about drug use and most other vices (defined as any activity that provides pleasure but also the possibility of harm) is set forth in the book Regulating Vice by James Leitzel, who teaches public policy and economics at the University of Chicago.  

Leitzel argues for regulations that protect youth, those in the throes of addiction and therefore unable to make rational decisions, and drug use that will likely harm others, such as driving while intoxicated.  None of this requires prohibition, which creates more harm than good.

As for legalization, I tell my clergy colleagues that is a misnomer: what they are really supporting is “regulation and taxation.”  I have heard opponents assert that we are encouraging marijuana use. In fact, we are merely acknowledging the reality of drugs in our society, including marijuana, and seeking the most effective ways to prevent abuse.  

The clearest evidence of the prohibition mindset is the federal classification of marijuana as a Schedule 1 drug under the Controlled Substances Act of 1970. According to this Schedule, marijuana is as dangerous as heroin and ecstasy, and has “no currently accepted medical use.” Federal agencies use this classification to block scientific studies even as they oppose drug policy reform citing a lack of research.  Most opponents of marijuana legalization try to defend this nonsensical classification.

Where does all this leave us?  On November 20, 2018, U.S. Rep. Joseph Kennedy III laid out a critical next step: “our federal policy on marijuana is badly broken… [Congress must] remove marijuana from the Controlled Substances Act (CSA)” and legalize it at the federal level.

After 47 years of a tragic War on Drugs that has cost our nation over $1 trillion dollars and destroyed innumerable lives, federal legalization will make it possible to continue to test regulation, starting with marijuana, at the state level.  Perhaps, at long last, we can end drug prohibition and achieve a national policy concerning drug use that best meets the needs of all our citizens.

Rev. Alexander E. Sharp, Executive Director