Harm reduction for whom?
EDITORIAL OPINION
Harm reduction for whom?
One cannot comprehend the political divide in Portland today without unpacking an approach known as harm reduction. The term gained attention last year when Multnomah County announced it would give tin foil and straws to fentanyl users so they could pursue their addictions more cleanly and conveniently.
Blowback was so swift that the idea had to be shelved. Still, other forms of harm reduction are carried out in the shadows with the help of our public agencies.
With hidden help from above, the Portland People’s Outreach Project distributes syringes, pipes and other supplies to drug users at seven sites around the city, including the notorious corner of Northwest 19th and Burnside that has drawn considerable media attention lately.
Needle exchange programs are a long-established practice around the country, and many—including PPOP—have dropped the exchange element. Syringe services programs, as they are now called, provide limitless clean needles, on the belief it is the surest way to discourage the reuse of dirty needles.
Harm reduction programs assume that drug users are best able to decide what they should put into their own bodies. Guilt and social disapproval are worse than useless, in this logic, and do not persuade users to change their ways. That will only happen when a user is ready. Meanwhile, clean paraphernalia and positive social support help keep people alive another day in which they may find a way out.
I call this militant libertarianism, a contradiction in terms suitable to the situation. If someone asks for a razor blade to slit their wrists, supposedly one should give them a clean blade and wish them well.
Extending to infinity anyone’s rights and prerogatives inevitably bumps up against the rights of others to live their lives in peace and of society as a whole to function. Defenders of harm reduction identify with those in the most pitiable state, taking license to belittle the concerns of housed and healthy people as trivial by comparison. Tents and trash on the sidewalk are downplayed as merely matters of aesthetics at which some choose to take offense.
Harm reductionists may seem the most extreme vanguard of a fringe culture. In Portland today, that would be a false assumption. The people behind the masks at PPOP handouts include health care professionals from the Oregon Health Sciences University. An OHSU newsletter touted the work of a nurse practitioner who volunteers at PPOP events.
The Multnomah County Health Department, though chastened by the reaction to tin foil giveaways, supports harm reduction programs while denying a specific connection to PPOP.
Before there was harm reduction, America tried Prohibition, a war on drugs, public education, interdiction, employer drug screening and countless other strategies. None “solved” the problem.
Harm reduction surmounts that test by declaring that illegal drugs are not a problem at all, purely an individual choice. A pandemic of early death, damaged brains and social breakdown is not a solution either, but if one calls it freedom and declares victory, that is success of a sort.
Complex problems rarely have once-and-for-all solutions. They may have to be managed, perhaps perpetually. Many fatal human diseases can be kept at bay through treatment and scientific advance. That could also be called success.
As the moderator of a District 4 City Council candidates’ debate in September, I posed questions in order to distinguish the candidates’ positions. Almost all candidates can name the major problems facing the city and explain how we got here. They tend to offer similar strategies to deal with them. How is a voter to make a meaningful choice?
It’s like scanning a display of 50 varieties of laundry detergent, each touting fresher, brighter clothes.
The question I should have included in the debate (and which all candidates should be asked) is: What do you think of harm reduction?
I believe there were some adherents on stage in September, and their answers would have given voters insight into their approach to life and public policy. If the harm reduction camp remains a secret society, it avoids democratic scrutiny and the salutary effect of compromise. Public-funded agencies that condone this approach without engaging in the necessary public debate must realize that they skate on the thinnest ice.