Pubdate: Thu, 10 Mar 2016
Source: Baltimore Sun (MD)
Copyright: 2016 The Baltimore Sun Company
Contact:  http://www.baltimoresun.com/
Details: http://www.mapinc.org/media/37

A SAFE PLACE TO INJECT DRUGS

MD. Should Consider (but Not Rush Into) Legalizing 'Safe Injection Sites'

Lawmakers are considering a bill in the General Assembly that only a 
few years ago would have been thought a dangerously radical proposal: 
legalizing the creation of so-called "safe injection facilities" 
where people addicted to heroin and other opioids can consume the 
drugs under the supervision of medically trained staff without 
subjecting themselves to criminal penalties.

While the idea of sanctioning illegal drug use still strikes many 
people as extreme, such programs in fact have proven effective 
elsewhere, and they're also a logical consequence of a national trend 
toward treating addiction as an illness rather than as a crime.

This isn't something Maryland should rush into, but neither should it 
be dismissed out of hand.

When former Baltimore mayor Kurt Schmoke made national headlines a 
generation ago by suggesting that drug addiction be treated as a 
public health issue rather than as a crime, his proposal met with 
near universal condemnation. Critics charged Mr. Schmoke was "soft on 
crime" and that his ideas about treating users for their addiction 
rather than throwing them in jail could set a dangerous precedent 
that would lead even more people to consume drugs.

But after three decades of the country's failed "war on drugs," the 
wisdom of Mr. Schmoke's argument has become apparent.

What sounded "radical" in 1987 sounds eminently reasonable today.

Maryland courts increasingly recognize that steering addicts into 
treatment programs often makes more sense than sentencing them to 
long prison terms.

When addicts get out, they are likely to go right back to committing 
the same kinds of crimes to support their habit that got them locked 
up in the first place.

It's a vicious circle that police and prosecutors have contended with 
for years, but there still aren't enough treatment beds available to 
break the cycle.

And even if a slot is available, an addict may not yet be ready to 
embrace the chance for change that treatment offers.

Meanwhile, public health officials in Maryland - and Baltimore in 
particular - have been pioneers in "harm-reduction" strategies for 
drug users, from the establishment of clean needle exchange programs 
a generation ago to the current efforts to distribute the 
anti-overdose drug naloxone to addicts and their associates. The 
results have been encouraging in terms of reducing new AIDS 
infections and overdose deaths.

The cumulative result of the courts' growing preference for giving 
addicts treatment options instead of prison time, coupled with the 
success of public health agencies' harm-reduction programs, has been 
to put many more addicts on a pathway to treatment.

Every time a judge sends an addict to detox and counseling, or a 
health worker in a needle-exchange program encounters addicts who say 
they want to kick the habit, it's an opportunity to break another 
link in the chain of addiction, crime and incarceration. The aim of 
Maryland policy should be to create opportunities for as many such 
encounters as possible to occur between addicts and the institutions 
that can help them get their lives back on track.

That's why legislation introduced by Del. Dan K. Morhaim, which would 
allow addicts to consume illegal drugs in a safe place with sterile 
equipment and under medical supervision, deserves serious 
consideration. Maryland is experiencing an epidemic of heroin 
overdose deaths, many of which could have been prevented had the 
victims had prompt access to naloxone, also known as Narcan, which 
staffers at safe injection facilities can administer. A study of 
Insite, a safe injection facility in Vancouver, Canada, found that it 
prevented three overdose deaths and 35 new HIV infections every year.

The proposals put forward by Dr. Morhaim, a physician, include some 
provisions that clearly warrant further scrutiny, such as one that 
would allow some addicts not only to use safe injection facilities 
but to actually receive pharmaceutical-grade heroin in certain 
circumstances. Critics call the idea reckless and irresponsible and 
argue it would make the state an accomplice in murder in the case of 
a fatal overdose.

Those concerns need to be thoroughly examined and debated before 
Maryland lawmakers approve such a law, and likely it will take more 
time than the remainder of this year's General Assembly session affords.

But there is a growing, bipartisan consensus that we cannot arrest 
our wayout of Maryland's drug problem. Legislators need to be willing 
to have an open mind about where that conclusion might lead.
- ---
MAP posted-by: Jay Bergstrom