Supervised Injection Comes One Step Closer in Philadelphia

Rev. Alexander E. Sharp Decriminalization

Advocates stand in support of Safehouse. (Photograph: Christopher Moraff via filtermag.org)

We have moved one step closer to the opening of the first supervised injection facility (SIF) in the United States. A federal judge has ruled against a suit by the U.S. Attorney in the Eastern District of Pennsylvania blocking the launch of “Safehouse,” a SIF that is ready to go in Philadelphia.  

SIFs save lives by providing space for individuals to use drugs under medical supervision. Treatment is available but not required. Over 120 such facilities exist in cities around the world, including Europe, Australia, and Canada. The United States has none.  

Three years ago Clergy for a New Drug Policy organized a delegation of clergy to visit Insite, at that time the only SIF in North America. Since then, 44 have been authorized in Canada. In June, we joined the Chicago Recovery Alliance in visiting five sites operating in Toronto.

Advocates in Boston, New York, Philadelphia, Seattle, and San Francisco have been pressing for SIF’s.  Early this year, it appeared the breakthrough would come in Philadelphia, where political and community leaders, including the mayor, city council president, and states attorney, all support “Safehouse.” 

But last February, William McSwain, U.S. Attorney for the Eastern District of Pennsylvania, sued to stop Safehouse. He argued that it would be in violation of the so-called “crackhouse” provision of the Controlled Substances Act, which was designed to curtail drug racketeering.  

Clergy for a New Drug Policy joined other religious voices in an amicus brief challenging the U.S. Attorney’s action. The brief invokes the Religious Freedom Restoration Act of 1993 (RFRA).  It asserts that all humans are created in the image of God and that “all have value and significance and are worthy of others’ time, understanding, and advocacy.”  

In his ruling on behalf of Safehouse, U.S. District Judge Gerald McHugh determined that the federal Controlled Substance Act did not apply: “The ultimate goal of Safehouse’s proposed operation is to reduce drug use, not facilitate it.”  

It is widely anticipated that U.S. Attorney McSwain will appeal to the 3rd Circuit Court of Appeals, which covers not only a portion of Pennsylvania, but New Jersey, Delaware, and the Virgin Islands. 

The appeal process could take at least a year.  Nevertheless, Safehouse attorneys were pleased. “This is a huge decision in our favor,” according to Rhonda Goldfein.  “It is the first in a federal court that says ‘This is not an illegal purpose.’’ 

Given its broad applicability, the case could end up in the Supreme Court.

Initiative to Decriminalize All Drugs Being Considered in Oregon

Rev. Alexander E. Sharp Decriminalization

Last month the Drug Policy Alliance, joined by two other organizations, filed a petition for a ballot initiative in Oregon that, if approved by the voters in November 2020, would decriminalize drug possession. It would mandate treatment rather than arrests as the first response to drug use.  

Those possessing any drug—including heroin and cocaine – would be charged with a civil rather than a criminal offense. They would be subject to a citation, much like a traffic ticket. Drug trafficking would remain illegal.

The ballot measure would require the state to provide $57 million in the first year for the treatment of drug addiction. It would establish addiction recovery centers across the state with funds obtained from revenue from marijuana sales and from reduced prosecution and incarceration costs.  

Whether the proposed measure—called the Drug Addiction Treatment and Recovery Act—will actually be on the ballot is far from certain. It would require 112,000 signatures and will face strong opposition from law enforcement and community groups. The sponsors will decide in the next few weeks whether to move forward.  

Yet even the filing of this petition is hugely significant. It is difficult to imagine any single step that, if broadly imitated in other states, could do more to end our failed War on Drugs.

Clergy for a New Drug Policy has long advocated for drug decriminalization of the kind now being proposed in Oregon.  We have pointed out that Portugal adopted this model almost 20 years ago. Drug arrests have declined, drug use has not increased significantly, and hundreds of thousands of individuals have received treatment.  

We Are Witnesses: Chicago

Rev. Alexander E. Sharp Drug Education, Harm Reduction

My purpose today is to urge you to watch a powerful and haunting short film called “We Are Witnesses: Chicago.” Through the testimony of 15 individuals, the series captures the tragedy and anguish of violence in Chicago. We hear the voices of victims, police, and court officials. 

It is a story of suffering and pain, systemic cruelty and corruption.  It offers moments of compassion, courage, and forgiveness. It speaks to our hearts, and helps to open them. It makes us cry out for change, especially in our criminal justice system. 

Violence tears our cities apart.  Chicago is synonymous with gun shootings, even though some other cities have numbers worse than Chicago’s.  In CNDP’s advocacy to end the War on Drugs, I have long wanted to argue that this failed War is a primary cause of urban violence.

My problem in making this case is that the topic of violence is hideously complex.  It is what academics call “a wicked problem.” As such, it hard to generalize about. It has so many causes.  “We Are Witnesses: Chicago” helps us to identify and begin to connect them. 

The War on Drugs is certainly key.  It calls for prohibition. As a result, gangs rather than sanctioned outlets become the economic vehicle for distributing drugs.  There are no legal means to settle disputes, so violence, usually with guns, becomes the vehicle for doing so.

Huge amounts of easy cash from drug sales lure kids to the streets rather than school.  This same cash finances the guns that are so plentiful on city streets.

This misguided and unjust war undermines the relationship between police and communities.  How could it be otherwise when officers are trained to track people down in pursuit of often low-level economic transactions that, in poor communities, may be their only way to feed their families?

The War on Drugs feeds upon itself.  When parents are incarcerated for low-level drug possession, their future is obliterated, their families are destroyed, and their children suffer. All of this, in turn, feeds the poverty and despair than can often lead the next generation to escape into drugs. The cycle continues.  

In “We are Witness” Chicago we meet Dr. Nneka Jones Tapia, until recently the Executive Director Of The Cook County Department Of Corrections.  At age eight, growing up in North Carolina, she witnessed the arrest and incarceration of her father for possession of marijuana: “I can only imagine being the man in the house and watching your young daughters seeing you arrested,” she recalls. “It’s humiliating.”

After her responsibilities for Cook County Jail, she writes, “When you walk into those doors and you see hundreds of young black men chained together you see the hopelessness in their eyes and it does something to you.  I saw them as my brother. I saw my father in them…We are more than our charge. We are the whole person who can still have the ability to offer good in the world.”

The War on Drugs does not fully explain the tragedy of urban violence in our cities.  There are many causes. But is time that we started to realize what is also true. The violence in our cities will not end until, at long last, we decriminalize low-level drug possession, thereby effectively ending the 47-year-old War on Drugs.  I am grateful that “We Are Witnesses: Chicago” is so effective in helping to make this case.

Rev. Alexander E. Sharp, Executive Director

Inside Out Network: Connecting Churches to Returning Citizens

Rev. Alexander E. Sharp Harm Reduction

Our nation continues to incarcerate over two million individuals annually. They will return to their communities, with limited prospects for housing, education, and jobs.  Many need mental health and substance abuse treatment. How can clergy and congregations help?

Most just do not have the information to connect service providers and returning citizens.  

That’s why I am delighted to present to you the Inside Out Network.  This interactive online system connects service providers, including clergy and congregations, with those coming out of prison. And vice versa. 

It has been developed by Rev. Fred Nelson, a Lutheran parish pastor in Park Ridge, Chicago, who 13 years ago felt drawn to prison ministry.  He wrote the book Spiritual Guide for Prison and Beyond, which now has a national circulation of about 65,000. 

He surveyed inmates and those who on the outside about their first year after release.  He reports, “They were talking about the dream they had of what would happen when they got out, how they would be a force for good, and even what role they wanted to play in the church.  Not every inmate, of course, but a surprisingly large number of them.”

“It just wasn’t happening,” he continues. “What was going wrong? I landed on the twin evils of isolation and invisibility.  They are isolated from their support networks and families and friends while they’re locked up, but also the service providers, people working on the outside.”

Rev. Nelson’s first step was to create RED Chicago, a hardcopy, 50-page Re-Entry Directory for the Chicago area:  “Our church produced that because we didn’t find anyone that had done something that was really geared for people getting out of prison. 

“The Department of Corrections loved it and asked ‘Can you do something for the whole state,’” Nelson recalls. This is prompted him to take the basic concept to a “whole other level and make it available online.”

Here’s how he describes the Inside Out Network: “It’s not an app.  It’s a website. Don’t think of it as an online database. Think of it as a dating site. It’s for people who want to connect, who want to find relevant matches that are proximate enough, near where they can actually connect with each other, filtered for the things they are looking for so that we can make that connection. 

“You want to be known and seen and connected with the relevant people.  It’s the same for service providers. There are a lot of under-subscribed programs, unfilled beds.”  The services listed include housing and shelter, substance abuse treatment, food pantries, legal services, and multi-agency programs.  

The Inside Out Network operates in Chicago, with a database of over 200 providers and several hundred returning citizens.  It is also active in cities in South Carolina, Pennsylvania, and Wisconsin.

At the end of September, Rev. Nelson will be moving to Tucson, AZ to devote himself full time to the Network.  

How will he bring it to scale? Basically, he sees the process as building a “network of networks.” He notes that existing coalitions have come together: “They reach out and say, ‘Hey, we’re in.  You want to be in? Then we can go to a Department of Corrections saying, ‘We’ve got a network going. Work with us.’”

When I asked how anyone reading this piece could get involved, he said, “They can register their organization today.”  In addition to the web link, Rev. Nelson is eager to speak with anyone wishing to participate in or support the Inside Out Network. He can be reached at: Fred@insideoutnetwork.net and at 847-323-3744. 

Rev. Alexander E. Sharp, Executive Director

Interview with Author Timothy McMahan King

Rev. Alexander E. Sharp Drug Education

Timothy McMahan King’s book Addiction Nation is both a personal memoir and an exploration of addiction. He brings an understanding of public policy, knowledge of advances in neuroscience, and his own religious faith to bear on this complicated and urgent topic. We were pleased to discuss the book with King last week.  

How would you describe your own faith history and current affiliation? 

I started off in an evangelical home. I was even homeschooled for a while. That culture certainly shaped my early life, and also introduced me to Jesus and taking Jesus seriously. And the more I learned about Jesus, the more I became concerned about people and issues that are on the margins. Over time, that shaped and formed me to the place where I am today of still loving parts of the tradition I grew up in, but also being drawn into contemplative spirituality and now the Episcopal church.

How did you become addicted to opioids?

My addiction started with an extended hospital stay. I had a minor case of pancreatitis at the age of 25. My doctors weren’t sure why so they kept doing some procedures and tests. One of those went wrong and that was when I developed acute necrotizing pancreatitis. I was put into the ICU, given a 50/50 shot about whether I would live or die, and pulled through after about two months in the hospital. I was sent home on heavy doses of opioid pain medication.

Being on those drugs for that long, I moved from a simple physical dependence to a compulsive usage and addiction. I didn’t know how to process that experience for a long time, because so many of the models and the stories and the narratives I had in my head about addiction were wrong ones. They were stories about how only immoral people get addicted. If you get addicted, you must have done something wrong. It was through this journey and the blessing of having medical staff who understood the scientific and medical parts of addiction that I was able to find recovery.

Why did you decide to call your book Addiction Nation? 

Typically, people approach addiction as if there is an aberrant group of individuals who have done or participated in something wrong. The more I understood about addiction, the more it was clear that addiction isn’t an issue of certain people, it is something that we have facilitated with our entire culture and our public policy. Our nation itself has its own addictions. That might be to our criminal punishment system, a rampant capitalism without restraint, our culture of constant consumption.

All of these things contribute to a culture that facilitates addiction. We have to work against those streams that so often draw people in.  I wanted this book to be an exploration, not so much of the individual issues at stake, but of these broader cultural implications for the levels of addiction and overdose we see today.  What does that say about all of us, not just the people who are caught up in the midst of it?

Is drug use a sin?

No. And the Bible’s pretty clear. Jesus used (and even created) a drug, alcohol. There was a big debate in the early church, in particular the Council of Jerusalem.  Is it inherently sinful to eat particular foods? The answer was no. Then you have Augustine, who was in the midst of a battle of whether evil is a specific substance. He argued “no,” and the church agreed. Everything God created is good. Everything God created has a role and a purpose. The things that we call sinful or evil are not those things that God created. Sin comes with our relationship to those things.

In the hospital, I was on the chemical equivalent of heroin. It was called Dilaudid.  In fact, it’s often referred to as “hospital heroin.” It was not a sin for me to be on that. It was lifesaving. My doctors said that if they hadn’t been able to manage my pain, I might not have survived.  These chemicals were a blessing. 

But just because something is good in one situation doesn’t mean we shouldn’t also be cautious and that it doesn’t have dangers. This is where we need a better theology of understanding of our relationship to drugs, to be able to say simultaneously this can be a good in a person’s life under certain circumstances and also be a danger.

We know that water is essential for life and it also can be dangerous. We do this with other substances where we have a cultural and political historical bias against specific substances that too often means that our policy is not based on science or even a consistent ideological approach, but just cultural biases often rooted in racism and anti-immigrant sentiment.

You mentioned your evangelical upbringing. What would you say to evangelicals who oppose even the legalization of marijuana, which is obviously safer than the drugs that you were making good use of?

First, I would quote the Bible. Don’t call anything bad that God has created and called good.  Second, Jesus was clear when asked about Sabbath laws. Jesus said, “God did not make man for the Sabbath, but the Sabbath for man.” There is a role for laws in our society. But laws always have the purpose of human flourishing, and that is where we need to ask, “Are our laws around marijuana adding to human flourishing or detracting from it?” Based on the amount of people who have been locked up for this substance, I think the answer is clear.

Third, I’d ask if they know their history. Do they know why marijuana was singled out as a drug to be criminalized? It didn’t have anything to do with science and how marijuana affects our brains. It didn’t have to do with research around the substance. It had everything to do with a racist campaign focused on Mexican and Latinx people. It was about stirring up fear about people who didn’t look like the European immigrants who were in this country. It was based in our fear of the other, not in an understanding of the proper role for that substance.

But, again, so many people of faith consider drug use a sin. Where does that concept fit into this discussion?

This is where I think we need better language. I think it is imprudent and unwise for an individual to use, say, cocaine recreationally and it might lead to behaviors and broken relationships we would call sin. But if that same individual were to try the traditional usage of chewing some leaves from the coca plant while hiking in the Andes mountains, that certainly wouldn’t be a sin.

When we look at the origins of the last major usage of coca products in Coca-Cola, I don’t think it was a sin to use that. But I do think we have a very high responsibility to talk about prudence and wisdom.  I’m not a parent, but if I were, I would definitely warn my children about the potential dangers of addictive substances and want them to have the best knowledge on how to make those decisions. Any kind of drug use, whether nicotine and alcohol or cocaine and heroin, has even higher risks for those under the age of 25. 

What we have today is misinformation for young people.  That is what’s most dangerous. They get misinformation from people about a particular drug as an evil substance, and then the first time they’re exposed to it—they see their friends using it or they’re offered some and they don’t see the dangers that they heard about from the authorities—then they just don’t trust the authorities at all. They don’t trust their parents at all. And I think that has led to a higher problematic usage rate than if we simply had the honest conversations about the realities of drugs. It’s the lying to young people that makes them lose trust, and we need to be honest about it.

Is addiction a disease?

I think the disease model of understanding addiction has really helped us move forward in understanding the physical, the neurological, and the medical ways of dealing with and addressing addiction. This is hugely important in shaping the ways that we can address addiction as a public health crisis. At the same time, I think we need to understand that there are also limits to any model for understanding a complex phenomenon.  This is where I always try to be careful with my phrasing.

It’s important for people to always know that they are a part of their own recovery. There are some studies that have indicated if a person believes that their addiction is a disease that they can’t do anything about, they are less likely to enter into recovery than if they think they’re a full participant. The disease model is important, but it’s also not the only way, the only lens we should look at addiction through.

Is there any sense in which personal drug use should be considered a crime?

Not the use itself. But, as with other drugs like nicotine and alcohol, that doesn’t mean there aren’t restrictions or responsibilities. If your usage endangers or puts others at risk, that could be considered illegal or criminal. But that is drug usage plus a behavior, not usage itself. 

Would you decriminalize all drugs?

Yes. I didn’t start at this place when I first started researching. Once I started seeing all the papers and the studies out there that made the case for decriminalization I was amazed at the level of evidence for its effectiveness at saving lives and reducing crime. It isn’t a “soft on crime” position, it is just smart policy.

Would you legalize all drugs?

I would be much more careful about legalization and what that looks like. A lot of people who think about legalization see this kind of Wild West with the availability of dangerous substances. It is important that we always communicate that that is not the approach. But should we look at programs like heroin-assisted treatment in Switzerland? Absolutely. It was creating a highly restricted and controlled program and environment for legal access to heroin. It destroyed the country’s black market for the drug, plummeted the crime rate, reduced overdoses, and the majority of the people on the program to begin with are now in recovery. We need to follow the science and the evidence, not our biases.

The reality is most people are dying from drug use because they don’t know what’s in their drugs. They don’t know the dosage. All these drugs are being sold on the black market. These crimes are happening because it’s black market. One of the ways to undercut the black market is to make sure that if someone is in the throes of addiction to a substance, they have safe and legal access to that substance in order for us to be able to reduce harm and give that person the opportunity, time and time again, to make that choice to enter into recovery when they’re ready.

What role then does punishment have when it comes to drug use, both in our criminal justice system and in the home? 

One of the things I believe as a Christian is that the most transformative power in the universe is not punishment but grace. And I don’t think that that’s just true, uniquely true, about someone in the Christian tradition.  I believe that what Christ revealed is a deep truth about how the world works and how people change. The primary mode of helping people change, the path to the most sustainable change, is not the outside imposition of a specific behavior, but the cultivation of a vision for what is a good and full life.

I think that is true about our criminal justice system. Addiction is a self-harming behavior by its very definition. Increasing the level of harm through punishment doesn’t change that behavior. It’s completely nonsensical to think that is going to work.

In the home, I think it’s important for parents to be able to talk with their kids about these issues, to set boundaries that are age appropriate for their children. But you also need to ask whether your parenting is going to be driven solely by fear for your child, or by the belief that you are trying to cultivate your children to make wise decisions on their own.

If you use fear and punishment to control your children in the home, are you setting them up to make decisions for themselves, for the rest of their life, in a way that makes sense? And are you as a parent going to be able to be a trusted person?  Will they know that even if they make a wrong decision, they can go to you for help not having to worry about whether they will get kicked out of the home or whether this will end your relationship?

I’m not saying that is easy for a parent to do. But I’m saying it’s a place that they need to lean into. 

What should churches and individual clergy be doing given the reality that we live in, as you say, an Addiction Nation?

One thing churches can do is give people a language to talk about a topic that we are often silent about. Addiction thrives in silence and shame. As soon as it’s brought out into the open, people begin to feel that they have the opportunity to admit the struggles they might have in their own life or in the lives of their families and friends.

Another huge piece, and it’s related, is to reduce the stigma. If we’re able to talk honestly about addiction, this facilitates recovery. When people feel the community they’re a part of requires them to be perfect, they are not going to be honest about their struggles.

Churches should be on the front lines of making sure that “justice rolls down like a mighty water, and righteousness like an ever-flowing stream.” They should mobilize to end a War on Drugs that is antithetical to everything that Christ taught and everything that Christ demonstrated on the cross.

When politicians hear people talking about ending the War on Drugs, or decriminalizing drugs, or legalizing certain drugs, they picture a libertine society devoid of all morals.  The truth is just the opposite. We’re advocating for it because we have a deep moral compass. We’re advocating to end the War on Drugs because we care about human flourishing. We care about the dignity of every human life. And that’s what motivates us.

Rev. Alexander E. Sharp, Executive Director

(This interview has been edited for length and clarity. -Ed)