In 1971 President Richard Nixon declared a “war on drugs” and 52 years later the battle rages on – deadlier than ever.
The crack era got here and went within the Nineteen Eighties, followed by the agricultural opioid crisis, and now lots of our urban centers are being decimated by a fentanyl epidemic of plague-like proportions.
The truth is, over 70,000 people died on this country from fentanyl alone in 2021, in accordance with the Center for Disease Control – in comparison with just over 17,500 overdose deaths in 2000 from all drugs combined.
The war on drugs has gone from a battle to a bloodbath – and recent solutions are clearly required.
With the launch of the primary needle exchange program in Latest York City in 1988, the harm reduction movement emerged as such an answer.
At first controversial, needle exchanges were eventually accepted as standard practice across the nation and helped stem the spread of HIV in intravenous drug users.
As a former heroin addict, I utilized needle exchanges and sure avoided HIV due to it.
The truth is, I used to be accepted right into a detox center through a needle exchange program in Los Angeles.
This was years ago, nevertheless, when the harm reduction movement went hand-in-hand with treatment.
Needle exchanges were introduced to incentivize drug users to trade of their dirty needles for clean ones.
That is where the term “harm reduction” comes from, the literal reduction in harm – comparable to the prevention of recent HIV infections.
Such methods worked, but once the AIDS epidemic receded, harm reduction began to remodel into something entirely different – an all-encompassing support system for drug addicts.
It’s a method increasingly being touted by Washington, where Pres. Biden named harm reduction as a core element of his Administration’s drug policies.
Despite the initial outcry, needle exchange programs have actually change into one of the mundane components of contemporary harm reduction initiatives.
The movement has expanded into far more dangerous focuses, comparable to constructing supervised drug consumption sites – including a pair in Upper Manhattan – together with the promotion of protected drug supplies for addicts.
In cities like Boston and Latest York, this has even meant handing out free crack pipes and other drug paraphernalia.
It’s all a part of Pres. Biden’s billion-dollar push for harm reduction, implemented and overseen by his Drug Czar Rahul Gupta, a one-time harm reduction critic who has since fallen in line.
All of those measures clearly do more harm than good, but the best harm could also be yet to return.
Across the nation, a growing element of the harm reduction movement now rejects treatment or abstinence-based recovery strategies.
Which is why harm reduction has emerged as a key flashpoint within the “Treatment First” vs “Housing First” debate over whether addicts receiving housing and other social services must also enter rehab.
Add in recent calls to “defund the police” — and the sharp decline in prosecutions for many crimes — and cities like San Francisco are now contending with 1000’s of homeless addicts with no incentive to get clean.
Amid towering, unoccupied office buildings, San Francisco’s open air drug markets allow cartel-backed dealers to roam free, while a billion dollar industry of nonprofits comparable to Drug Policy Alliance vocally reject treatment as a viable solution.
It’s no surprise that residents on the front lines are fed up with the outcomes.
The truth is, nearly 1 / 4 million people have fled the Bay Area within the last three years. Governor Newsom finally took a stroll through the epicenter of San Francisco’s drug disaster late last month and was clearly distressed: just a couple of days later, he announced that the National Guard can be called in to assist clean up the crisis.
The problems facing San Francisco aren’t from a scarcity of funding. In 2021 alone, the town allocated $1.1 billion to its Department of Homelessness and its budget has risen 500% since 2016.
The outcomes: Homelessness actually increased 64% in the course of the same period.
Where does all this money go?
Much of it’s everlasting housing ($423 million in 2022). But everlasting housing will do little to mitigate addiction rates amongst the homeless without concurrent detox and treatment methods.
But such methods are simply not mandated: Of that just about half a billion spent last yr in San Francisco on everlasting housing, none of it got here with sobriety requirements.
And homelessness numbers and overdose deaths proceed.
Of the 515 residents the town tracked in everlasting housing since 2016, 25% died, while 21% returned to the streets.
Harm reduction is big business. How big?
San Francisco alone allocated $268 million to nonprofits within the name of “homelessness prevention” in 2022, all of which must follow a harm reduction approach in an effort to receive funding.
This number – the very best within the nation – is almost 50 percent more than in Latest York, a city eight times larger than San Francisco.
Barred from mandating abstinence or treatment plans when housing the homeless, it’s hardly surprising that San Francisco also leads the nation highest in overdose deaths — nearly 80 per 100,000 residents, almost thrice the number in Latest York, in accordance with the CDC.
True, those figures can be far higher without the distribution of Narcan from city harm reduction advocates.
However the rejection of recovery-based harm-reduction strategies is doing far more damage than Narcan could ever do good.
Initially of 2022, San Francisco opened its first supervised drug consumption site within the Tenderloin district, which operated for 11 months.
During this era, overdose deaths dropped about 4% citywide in comparison with 2021.
But after the location’s closure last December, overdose deaths skyrocketed by 40% during the primary three months of this yr. Many harm-reduction activists, in fact, blame the rise on the location’s closure.
But overdoses also increased in the course of the site’s final three months, mostly resulting from the introduction of xylazine, the deadly “zombie drug” now getting used to chop fentanyl.
Since xylazine isn’t an opioid, life saving overdose-reversal treatments like Narcan are powerless against it.
Local experts broadly agree that the consumption site prevented over 300 deaths, which is a miracle.
But essentially the most staggering figure is definitely the number of individuals the power knowingly didn’t get into treatment.
In any case, the location was officially classified as a “linkage center” – with the goal of “linking” addicts to detox and treatment. As a former homeless addict now in recovery, this is a vital objective.
Nevertheless, out of the estimated 50,000+ those who utilized the middle, only 38 were “connected” to substance use treatment. Hardly surprising that the location dropped “linkage” from its name just months after opening.
The truth is, the one linkage that appeared to be occurring was between the drug users, drug dealers, and stolen merchandise rings that completely enveloped the compound.
San Francisco Mayor London Breed shut down this system after the resulting mayhem – together with pressure from Treatment First advocacy groups like North America Recovers and native business owners – proved unattainable to disregard.
Supervised consumption sites just like the Linkage center make sense so long as detox and treatment is the tip goal for patients. And harm reduction can play a job on this process.
There may be MAT (medication assisted treatment), which utilizes opioid substitute drugs comparable to Suboxone – or anti-craving medications like buprenorphine – to combat the trauma of detox.
And, in fact, there’s Methadone, which for a long time has served as a long-term substitute for heroin – in addition to more recently for fentanyl addiction.
Without these interventions, harm-reduction sites are merely facilitating addiction while concurrently destigmatizing antisocial behavior.
Which is why winning that also unwon “war on drugs” requires a multi-pronged approach that features harm reduction together with an increased shelter system, and highly incentivizing detox and treatment options.
Why then do radical harm reductionists and housing first advocates oppose such a path.
Partly due to ideology, however the more vital factor is that it’s the one strategy to keep the cash train going.
The passing of California’s SB1380 in 2016 outlawed any sobriety or treatment requirements for homeless drug addicts receiving state-funded housing.
In consequence, nonprofits looking for access to the money cow of public funding must push a Housing First ideology that rejects any type of abstinence-based treatment for homeless drug addicts.
These zealots imagine that addiction is usually a symptom of homelessness, whereas most formerly homeless addicts like myself say the alternative.
Who do the politicians in San Francisco typically side with (and solely fund)? When you guessed the side with actual lived experience in each homelessness and addiction, you’d be fallacious.
Folks advocating for treatment first approaches haven’t merely been sidelined, but incorrectly labeled as “far-right” and “quasi-fascist” by influential progressive activist groups comparable to DSASF.
San Francisco politicians, virtue-signaling behind a facade of false progressivism, almost inevitably echo such sentiments.
Gov. Newson is emerging as a rare outlier now that he’s stepped in to assist his hometown.
However the National Guard is barely being deployed to curb fentanyl distribution. Yes, this can be a step in the appropriate direction, and addresses the provision side of the difficulty.
But what in regards to the demand?
Even when fentanyl was fully eradicated, 1000’s of homeless drug addicts would still need detox and treatment. Providing them with shelter and other social services may appear merciful, but merely staves off continued decay and inevitable death.
Which is why harm reduction without the intent to finish addiction is unlikely to deliver any everlasting reduction in any respect.
Jared Klickstein’s writing could be found at jaredklickstein.substack.com; he’s currently working on the memoir, Crooked Smile, which might be published next yr.