'Safe injection site' denounced as false solution to Philadelphia drug problem

Lethal injection Death row Credit Oleksandr Lysenko Shutterstock CNA Oleksandr Lysenko/Shutterstock.

A proposal to create a supervised injection site in Philadelphia has drawn criticism from the local archbishop and others who say resources to fight addiction should focus on full and authentic healing.

Archbishop Charles Chaput of Philadelphia called the supervised injection site proposal "saddening – but not surprising."

"The proposed facility is simply the latest dose of despair offered by a confused and suffering culture; a culture that refuses to understand the true nature of both addiction and those who are enslaved by it," the archbishop wrote in his weekly column for Catholic Philly Oct. 25.

He argued that the premise of such injection sites is built on "misguided compassion" and "an erroneous concept of human nature."

Chaput's column responded to a plan to open a supervised drug injection site in Philadelphia. The site would be run by a non-profit and would provide syringes and other tools for drug use, although users would have to bring the illicit drugs themselves.

Staff members would monitor users and be available to respond to potential overdoses with medical attention and naloxone, the antidote to fentanyl and heroine, two drugs driving the opioid epidemic. Recovery counseling would also be available, as well as referrals for housing and public benefits.

The plan has the support of city officials. Proponents of the site say it aims to respond to the opioid crisis in one of America's hardest hit cities. Philadelphia sees more than 1,000 overdose deaths per year.

The U.S. Justice Department maintains that such a facility would violate federal drugs laws and has sued the City of Philadelphia to block the injection site from moving forward.

Early in October, however, a federal judge ruled in favor of the city, saying its purpose in creating the injection site does not violate the law's intent.

The Philadelphia injection site would be the first of its kind in the U.S., although other cities have voiced interest in the possibility.

From a moral perspective, Archbishop Chaput said, it is clear that the use of illicit drugs, and the provision of them, are violations of divine law.

But there are also serious practical problems with the injection site proposal, the archbishop said. "The science itself doesn't support the sites."

Modern neurological science indicates that the environmental stimuli accompanying substance abuse can trigger cravings, he noted.

"That's why 12-step recovery groups urge members to avoid the people, places and things that led to their substance abuse, not unlike Christ's command in Matthew 5:29-30 to tear out one's right eye and cut off one's right hand to avoid sin. By enhancing these environmental stimuli, safe injection sites keep individuals locked in addiction."

'Doing harm, not good'

Supporters of the injection site point to a similar facility in downtown Vancouver. Known as Insite, the facility opened in 2003. Since then, staff members have supervised more than 3.5 million injections and responded to more than 6,000 overdoses. No one has died at the facility, a statistic which proponents tout as evidence that it has been successful as a harm reduction strategy.

However, Chaput argued that the data from Insite "can hardly be called convincing."

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"Since its opening in 2003, some 3.6 million clients have self-injected at the Vancouver-based site, yet only 48,798 (or 1.35 percent) have received any kind of addiction treatment," he said, adding that of those who have sought treatment, the type and duration of treatment are not clear.

He cited researchers who argue that politicization of evidence and flaws in data collection raise serious questions about the purported success of safe injection sites.

Steven Bozza, director of the Archdiocese of Philadelphia's Office for Life and Family and a bioethics professor at Catholic Distance University, argued in an Oct. 17 article for Catholic Philly that the proposed injection site violates fundamental principles of medical ethics.

"Making it easier to engage in life-threatening behavior and codifying it into law - while sending the bill to taxpayers - is doing harm, not good," he said.

Bozza warned that injection sites encourage individuals to feed their addictions, moving them down a path of increasingly diminished autonomy.

He also argued that "safe injection sites divert badly needed funds away from resources that have already proven effective in offering real hope of recovery from addiction for thousands."

"The money and resources sought to fund safe injection sites can and should be invested in what has already been proven to work: rehab centers, healthcare benefits that cover relapse treatment, counseling and social support services, vocational and life skills training."

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Pointing the harm that illicit drugs do not only to those who use them, but also to the millions exploited globally by drug cartels, Chaput stressed that while drug addiction is a serious wound for individuals, families, and communities, supervised injection sites are not the solution.

Instead, he pointed to proven recovery options including "medical treatment, abstinence, counseling, support groups and above all the love of Christ."

"Ultimately, healing from addiction is found not in a clean needle or Narcan, but in a heart renewed by its creator," the archbishop said.

A holistic approach

Renee Hudson-Small is the assistant director of Housing and Homeless Services for Catholic Social Services of Philadelphia. She said the agency has found that a broad approach focused on the whole person offers the greatest likelihood of successfully helping people recover from addiction.

"Definitely the holistic approach is, from where we sit, very effective in helping those individuals try to cope with something that is very difficult to overcome, but can be overcome," Hudson-Small told CNA in an interview earlier this year.

This holistic approach includes connecting individuals struggling with addiction – and their families – with resources offered by Catholic Social Services and throughout the City of Philadelphia and surrounding counties.

One way in which Catholic Social Services does this is through a recovery facility that it runs for single women and women with children. Shelter and support services are combined with case managers to help the women get back on their feet.

"They reside in our facility while they're in recovery, and we assist them with case management services, as well as support services," Hudson-Small said. This support includes "making sure they obtain the necessary life skills and a plan for housing, getting basic needs met – identification, maybe birth certificate, things that they may have lost while they were in their addiction."

Counseling and mental health care are included in case management support services. Catholic Social Services helps connect patients with mental health professionals if they need resources. They also help ensure that they are following through with appointments, working to resolve transportation issues or other obstacles.

"Every individual is different and is going to receive things differently, at different points or stages in their life," Hudson-Small said. "So one of the things that we pride ourselves on is that we know that at times, there may be individuals that fall back into addiction. We're there to be a support for them, at whatever stage, when they can get back to the point where they're ready to take on services. We're there to be available to them."

Providing support for families is also an important factor in helping individuals overcome addiction, she stressed.

"When someone is in an addiction, it's not just that person that is affected, but the entire family that is affected," she explained. "It touches everyone's lives - family and friends - because they are part of that person's network. So you want to provide services to that individual, but you also want to be a support to that family, so they can be prepared to address some of the concerns that they have about their loved one."

Part of this support for families is teaching them how to best help their loved ones with addictions, and how to be patient, especially "when the family is just so tired, which sometimes is the case, and understandably so."

"It may take several times for people to get to the point where they're able to maintain their sobriety," Hudson-Small said. It can be very difficult, she acknowledged, "for a family member who may have watched that person fall more than two, three, four, five times, and just get really frustrated and not know what to do next."

In these cases, she said, it is crucial for family members to "just be really patient and not to give up hope on them, because if you just stay in there, get them connected to those services that can continue to bring hope to them, eventually it will stick and they will reach that sobriety and hopefully maintain it."

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