Clergy Join Suit to Keep Drug Users Safe

Rev. Alexander E. Sharp Harm Reduction

“Dead People Can’t Recover: Support Overdose Prevention Sites”- Advocates stand in support of Safehouse. (Heather Khalifa/The Philadelphia Inquirer via Courthouse News Service)

In Philadelphia, the city of Brotherly Love, community leaders, service providers, and key public officials have joined together to bring safe injection to their city. At the proposed facility, aptly named “Safehouse,” individuals struggling with addiction could use drugs under medical supervision.  This would be the first such program in the United States.

But on February 6, the U.S. District Attorney in the Eastern District of Pennsylvania sued to keep Safehouse from opening its doors. William McSwain argued that it would violate the Controlled Substance Act, which is intended to ban the operation of “crack houses.”

When Clergy for a New Drug Policy was asked recently to join an amicus brief rejecting efforts to block Safehouse, we couldn’t say “yes” fast enough.  Here is why.

The United States is woefully and shamefully lacking when it comes to supervised injection facilities (SIFs).  Worldwide, there are over 120 in 12 countries, including Australia. As we reported last month, the score in North America is:  Canada 44, U.S. 0.

The arguments on behalf of Safehouse are strong.  Evaluations of SIFs have demonstrated that they: reduce both overdose deaths and infections due to unclean needles; increase access to health care; and provide opportunity for treatment without requiring it.  Nor have there been negative consequences such as an increase in crime or public disorder where facilities are located.

The amicus brief invokes the Religious Freedom Restoration Act of 1993 (RFRA).  It argues that in moving against Safehouse, the U.S. attorney is “substantially impair(ing) the ability of its Christian and Jewish Board Members to practice at least two tenets that they sincerely hold.”  

It raises an interesting and important question:  if you were asked to draft a brief that supported an SIF based on your faith, how would you make the case?  What would you consider to be the religious values at stake? The amicus brief offers two fundamental concepts.

First, all humans are created in the image of God.  We have “a unique and unrivaled status in creation.” (All quotes are from the brief.) This special status lies at the heart of the commandment to love others as ourselves: “all therefore have value and significance and are worthy of others’ time, understanding, and advocacy.” 

Guided by this concept, the brief argues that “In attempting to prevent adherents from providing care to those affected by the opioid crisis, the U.S. Attorney has dehumanized those in need and thus tainted God’s image… (and ) has also put the affected outside the reach of the community…thereby distancing neighbors from each other and God’s love.  The end result demeans the affected and strips them of their dignity, leaving God’s image in tatters.”

Second, the brief asserts the inherent dignity and immeasurable worth of each human being. It argues that “in recognizing the dignity and humanity in all, Jesus announced that everyone, including the poor, the sick, and the sinners, are worthy of salvation and protection.”  It follows that “all humans, even opioid addicts, possess an intrinsic, sacred worth that adherents must honor with respect.”

The drafters of the amicus brief make clear that it draws upon the core tenets of the Judeo-Christian, Islamic, and other traditions.  But in the final analysis, perhaps it does not entirely matter what its supporters call themselves and which faiths are represented.

When Safehouse is finally up and running, it will embody the fundamental injunction that we love our neighbor. To love our neighbor is to know God. In this sense, Safehouse is a religious organization.  This is why it is worthy of our support.

Rev. Alexander E. Sharp, Executive Director

Reckoning with the People Who Sell Illicit Drugs

Tom Houseman Decriminalization

In her superb new book Until We Reckon: Violence, Mass Incarceration, and A Road To Repair, Danielle Sered makes the case that lengthy sentences for violent criminals are misguided. Sered is a pioneer in applying concepts of restorative justice to violent, not just non-violent offenders.

In order to truly end mass incarceration, she argues, we have to focus not just on drastically reducing the sentences of people charged with violent crime, but on creating “a justice system that is not just smaller, but is truly transformed into the vehicle for accountability, safety, and justice that everybody deserves.”

Sered’s arguments are equally applicable to people who sell drugs. In recent years there has been a change in how politicians discuss people with substance use disorders. The narrative has shifted from a criminal justice to a public health issue. If people have an illness, they should not be punished, but instead offered a chance to heal.

Yet this shift has heightened a dichotomy that mirrors the distinction between “non-violent” and “violent” criminals: people who use drugs and people who sell drugs. With one hand legislators and law enforcement offer help to those who use drugs, while with the other they punish those who sell them.

Almost a year ago we wrote about Kristen’s Law, a Rhode Island law (named after a woman who died of a fentanyl overdose) that allows prosecutors to charge dealers who sell heroin laced with fentanyl with first degree murder. Similar laws have recently been passed in Florida, North Carolina, and Connecticut. There has even been talk at the national level of ceding control over fentanyl sentencing to the DEA.

The arguments for long prison sentences generally include punishing the guilty, protecting the public, deterring crime, and helping victims heal from the harm done to them. Yet as Sered explains, our current systems of law enforcement and incarceration are woefully ineffective at producing any of those outcomes.

Long mandatory minimum sentences for both violent and drug selling crimes are shockingly ineffective deterrents. Sered points to studies showing that a swift and consistent punishment is far more effective than a longer punishment handed out inconsistently. This applies particularly to people who sell drugs at the “street level,” usually in small quantities to regular customers. Because they have no hand in the production of these drugs, they usually don’t even know if their drugs contain fentanyl. It is impossible for them to know the likelihood that the person they are selling to will overdose.

Another argument in favor of long punishments is that locking up wrongdoers will reduce drug selling. However, targeting low-level dealers does nothing to reduce supply because they are so easily replaced. Police officers refer to the task of locking up low-level dealers as “playing whack-a-mole” because of how quickly a new dealer will pop up.

Increasing punishments for “causing” a drug overdose death makes drug use less safe. If somebody overdoses, their survival is dependent on how quickly they receive medical care. One tool most states use to increase emergency medical care for people overdosing is “Good Samaritan Laws.” These laws ensure that somebody who calls for medical help in the event of an overdose will not be prosecuted for a drug violation. The hope is that knowing they will be protected by the law will make people more likely to call emergency medical services.

Laws targeting drug sellers will have the opposite effect. Often drug users will share drugs, which could categorize somebody as a “dealer.” Aggressively prosecuting people who sell or provide drugs makes those people less likely to seek medical help in the event of a drug overdose.

If the goals are fewer people selling drugs and fewer drug overdose deaths, there are solutions that we know will be successful. Safe consumption facilities around the world, including several in Canada, help people use drugs safely. In the United States such facilities are illegal, but there are other harm reduction tools that can be provided to drug users. When people have access to Naloxone, an opioid antagonist that reverses the effects of an overdose, they are able to save not just their own lives, but the lives of people around them.

To stop people from selling drugs, Sered believes that “the solution lies in developing more tools, not in eliminating the person we fear.” If people sell drugs to survive, providing economic resources, whether it is education and job training or assisted housing, will create opportunities to financial stability.

Putting people in prison only takes those opportunities away, labeling people as criminals for the rest of their lives. Sered notes one study  found that “those who received a formal label [such as convict or felon] were more likely to recidivate than those who did not.” Locking a person up for as long as possible will accomplish nothing besides destroying that one life as punishment for accidentally being party to another person’s death.

Sadly, there is no way to heal the damage done to somebody who dies of a drug overdose. But the wounds caused by violence go beyond the victim themselves. When somebody dies it impacts their family and their communities. A prison sentence makes it impossible to heal the damage done to a community, by taking away “the very power people should be obligated to use to make things right, thus rendering the possibility of repair nearly impossible.” Instead, it often doubles the harm initially caused. People who sell drugs also have families who rely on them, and children who will grow up with a parent in prison.

We cannot think of prison or the War on Drugs as tools for, in Sered’s words, “managing monsters.” The goal must be, above all, safety, and creating communities and spaces where people can make safe choices. While it may be politically popular to demonize people who sell drugs, or even to argue that they receive the death penalty, these policies destroy lives, including the lives of people they are designed to protect.

Until We Reckon lays bare the contradictions and hypocrisies of these policy and provides a roadmap to undoing their damage. Hopefully, that reckoning will begin soon, and we can find a better, safer path forward.

Tom Houseman, Policy Director

Supervised Consumption Facilities: Canada 44 U.S. 0

Rev. Alexander E. Sharp Uncategorized

A Memorial to Drug Overdose Victims in Toronto 

Both the U.S. and Canada are in the throes of a deadly opioid epidemic. But there is a major difference.  Canada has life-saving sites where individuals are able to consume drugs under medical supervision. The U.S. has none.

Last week, under the auspices of the Chicago Recovery Alliance, I traveled to Toronto as part of a group of service providers, state and county legislators, and law enforcement officials.  It was an extraordinary opportunity to view Canada’s supervised consumption facilities (SCFs) first hand and learn from them.

The sheer number of Canadian facilities is striking. When I visited Insite in Vancouver three years ago, it was still the first and only SCF in North America.  Now 44 have been authorized in Canada. There are nine in Toronto alone.

This did not happen overnight. The election of a liberal federal government in 2015 helped to open the door. Although conservatives gained power in Ontario in 2017 and have raised regulatory barriers and threatened to reduce funding it seems likely that SCFs are in Canada to stay.

On the first day of our visit, we gathered at Moss Park OPS, an overdose prevention service much like a SCF.  Its staff have consulted closely with the surrounding business leaders and residents. They report that “Moss Park OPS has not received any direct complaints from neighbors or the stakeholders.” They add that “Toronto Police have been supportive of the establishment of overdose prevention facilities operating in the Moss Park Neighborhood.”  

According to the Moss Park OPS, there is “long-standing and strong support in Toronto for the establishment of permanent supervised injection/consumption services…In March 2016 more than 50 Toronto community leaders signed a statement calling for the city to establish supervised injection services within existing community health and social service sites.”  

Two of the three facilities the Chicago delegation visited were community health service centers, offering a broad array of services. The space for supervised consumption seemed one part of a continuum of health care responses.  

That said, there is no requirement that those consuming drugs under supervision at an SCF accept other services.  For staff this is perhaps the essence of the harm reduction approach. They treat overdoses and prevent the spreading of disease.  Their approach is consistent with Jesus’ warning, “Judge not lest ye be judged.”

What does this accomplish? During our visit, Thomas Kerr, Professor of Medicine at the University of Columbia, shared data showing that SISs save lives by preventing overdose deaths and they stem the spread of infectious diseases such as hepatitis. They have led neither to increased drug use nor to other crime. “The evidence is indisputable… in Canada there is no serious evidence against these facilities.”

Something else of profound significance is happening as supervised consumption facilities gain traction. Drug use is increasingly being framed as a health rather than a criminal issue.  A service provider we met posed this question: “If someone is in our facility with drugs, we try to help them. If they possess drugs and are sitting on a park bench, they get arrested. How does that make any sense?”

It does not, of course.  That is why the Canadian HIV/AIDS Legal Network has just issued a report in which its most prominent recommendation states, “The federal government should decriminalize activities related to drug use.”

What I learned in Toronto is that supervised consumption facilities save lives, prevent disease, and respect human dignity.  Even without requiring behavioral change, these facilities can be an avenue to treatment. They have broad public support.

When will this happen here?

Rev. Alexander E. Sharp, Executive Director

The Justice Department’s War on Supervised Drug Use

Tom Houseman Uncategorized

Supervised consumption facilities are one of the most important harm reduction tools available in fighting the opioid epidemic and saving the lives of people with substance use disorders. Unfortunately, the Department of Justice (DoJ) is doing everything in their power from stopping Philadelphia from opening the first legal such site in the United States.

There are around one hundred legal, regulated supervised consumption facilities (SCF’s) around the world. Facilities have existed in Switzerland since 1986, in Australia since 2001, and in Vancouver, Canada since 2003. Insite, one of several sites in Canada, which has supervised nearly 4 million injections since it opened. Nobody has ever died of a drug overdose at Insite or any other public, legal SCF.

In the United States, where more than 130 people die of drug overdoses every day, it is illegal to run any sort of supervised drug consumption facility. This illegality has done nothing to quell the opioid crisis or to stop people from injecting drugs. Some of the alternatives in the US include unlicensed, underground facilities, which inherently carry more risk. Otherwise, people are injecting drugs in public restrooms or in private, making it extremely difficult for them to receive assistance if they overdose.

After decades of a failed War on Drugs, we are finally seeing a pivot from treating substance use disorders as a criminal justice issue to treating them as a public health issue. Unfortunately, not all public officials are on board. In particular, while the Trump Administration has preached the importance of addressing the opioid epidemic, their actions have sent more mixed messages. In February, they made it unequivocally clear that they will stand against progress.

Over the last few years the possibility of opening SCF’s has been debated in San Francisco, Denver, and Pittsburgh. Earlier this month, the Rhode Island State Senate passed a bill authorizing a supervised consumption pilot program there. The bill is now being considered by the State House.

Last year, when the Philadelphia-based organization Safehouse announced its plans to open a site at which people could inject drugs safely and with supervision, the proposal received the approval of District Attorney Larry Krasner, who made it clear that his office would not interfere with Safehouse in any way. The Department of Justice, unfortunately, had other plans. In February, the DoJ filed a lawsuit to stop Safehouse from moving forward with their plans.

The suit, filed by U.S. Attorney William McSwain, points to a provision in the Controlled Substances Act, 21 U.S. Code Section 856, that was written in the 1980s to target “crack houses.” The provision makes it unlawful to “knowingly open, lease, rent, use, or maintain any place, whether permanently or temporarily, for the purpose of manufacturing, distributing, or using any controlled substance.”

Safehouse argues that this provision should not apply to a medical facility like an SCF. It is represented by AIDS Law Project of Pennsylvania and DLA Piper attorney Ilana Eisenstein. In their counterclaim to the lawsuit, Safehouse’s legal defense team wrote that “Providing lifesaving medical services to individuals who are suffering from substance use disorder does not and constitutionally cannot violate Section 856.”

In its opposition, the DoJ is sending a clear message. McSwain stated that the case “could be persuasive, or helpful authority to a judge in California, New York, Colorado, Washington State, or wherever this issue might come up.” Clearly, he wants every city around the country to know that an attempt to create a legal supervised consumption facility will result in a costly legal battle with the federal government.

The fact that there is precedence in Canada to support the legality of SCF’s is reassuring. In 2011, the Supreme Court of Canada ruled that locally-run SCF’s are exempt from federal prosecution.

Still, it is clear that McSwain believes that the Department of Justice has a strong case. He has argued that “Normalizing the use of deadly drugs like heroin and fentanyl is not the answer to solving the opioid epidemic.”

But among public health advocates and researchers, the evidence is clear. “These facilities save lives,” Philadelphia Health Commissioner Tom Farley said about Safehouse’s proposal, “while serving as an entryway to drug treatment.” Hopefully, as visibility of the effectiveness of SCF’s increase, the idea will become more popular, and creation of such facilities in the United States more politically feasible.

In the meantime, the Department of Justice’s lawsuit against Safehouse marks a serious turning point for harm reduction policies around the United States. Many cities and states have come around to increasing access to the overdose-reversing drug Naloxone, to syringe exchange programs, and to Good Samaritan laws that protect people who call emergency services in the event of an overdose.

The opioid epidemic is a serious problem with no simple solutions, but there is considerable evidence that SCF’s work, will work in the United States, and do not incentivize drug use or lead to increased rates of use.

How much longer will the Department of Justice ignore this evidence? How many lives will be needlessly lost in the meantime? Depending on how this lawsuit plays out, we may find out the answer soon.

Tom Houseman, Policy Director

Illinois Cannabis Bill Resets the War on Drugs 

Rev. Alexander E. Sharp Marijuana Legalization

On Friday, May 31st, 2019, the Illinois House reset the War on Drugs for an entire nation. It passed legislation approving adult-use cannabis and sent it to the Governor for his signature. 

Our nation’s drug laws were founded in racism. The major reason this bill passed was because it will begin to repair what such racism has wrought. 

When Congress passed the Marijuana Tax Act of 1937, few members knew what “marijuana” was. A virtually self-appointed federal drug czar named Harry Anslinger had brainwashed the members with claims  to the effect that “Negroes under the influence of that crazy drug will molest our women,” and “Lazy Mexicans smoking weed will take our jobs.” 

With the help of William Randolph Hearst’s “yellow journalism” chain, Anslinger created a stigma around marijuana use that has infected the national consciousness for over 80 years. This stigma has given police license to break into the homes of people of color and round them up on mere suspicion of possession.  Marijuana laws have always been at the forefront of our national War on Drugs.  

Finally, Illinois is effectively repealing these marijuana laws. Their legacy is written in the lives lost to racist and unjust prison sentences. It will take many years to undo even a portion of this damage. Fortunately, this bill is a start.

Prohibition is misguided. In trying, and failing, to stop people from using drugs, it turns them into criminals. Treating people as criminals simply because they use drugs is cruel and immoral.

So, thank you, Governor Pritzker. Thank you, Sen. Heather Steans, and Rep. Kelly Cassidy, the lead co-sponsors of SB 7 and HB 1438. Thank you, Marijuana Policy Project staff, who helped to craft a hideously complex piece of legislation under extreme time pressure.

Thank you to the 58 religious leaders who supported this legislation with a letter to the General Assembly. You have shown that clergy can speak out against the stigma that has blinded too many of their colleagues to racial injustice and misguided prohibition.  

With the Cannabis and Regulation Tax Act, Illinois has demonstrated that it is possible to regulate cannabis through legislative action, something no other state has yet been able to do. All of you have brought us to the point where a national reset on the War on Drugs is not just a dream. At long last we can see the way.  

Rev. Alexander E. Sharp, Executive Director