Safe Supply: the Problem With Demonizing Drug-Users and the Drugs They Use   

Drug prohibitions villainize both those who use the drugs and the drugs themselves.

We’ve made remarkable progress on the first half of that equation; humanizing those with problematic or recreational drug use. This is a golden age of drug policy reform, and the dignity and respect given to victims has strengthened familiar tools—education; Medically Assisted Treatment, social services, and the gold standard, Overdose Prevention Sites, also known as Safe Consumption Sites.

But the life-saving potential of these proven approaches is thwarted, because while our reaction to drug users has evolved, our reaction to the drugs themselves remains clouded in hysteria. The chemicals are fetishized as irresistible, radioactive temptations.

At its best, drug hysteria plus time equals comedy (Reefer Madness). Until just five years ago, for another example, adult restaurant patrons in Utah were physically barred from seeing their drinks prepared. (To protect the children, of course). So while legalization provided a safe place to use a safe supply of that dangerous drug, hysteria yielded this silly artifact.

But this was quaint silliness only because the supply is safe—regulated, inspected, and labeled. If the drinks prepared behind those walls had no legal restrictions on potency or ingredients, the human impacts would be less purely humorous.

They would be deadly.

While people struggling with heroin are less demonized than before, the demonization of heroin itself remains unchanged. And at 50 times the potency of heroin, and appearing in virtually all fatal overdose post-mortems, Fentanyl is the newest poster child for tempting, radioactive evil. An object worthy of hysteria.

A single fatal overdose on my block some time ago jammed the street with fire trucks, police cars, and experts in full hazmat suits; all officiously refusing to answer any questions from anyone. Can’t talk. Too serious. Too dangerous.

Fentanyl, it was finally leaked, and people nodded, knowingly.

But one neighbor shook her head at the commotion and pointed out that Fentanyl was safely used routinely at her hospital. Dangerous, of course, but manageable. Not radioactive.

Fentanyl is a public health threat, not because it is hair-trigger fast or spreads like carbon monoxide, but because heroin, the drug typically sought, is unregulated and hence more likely to be contaminated with synthetics of unknown potency. And as likely as bathtub gin to spread permanent, avoidable pain.

The hard won sympathy and respect people who use drugs have won is squandered by hysteria regarding the chemicals themselves.

We cannot claim to care about people whose very blood the legal system can call “unclean” while forcing them to use chemicals that are truly unclean.

Of course any drug, from aspirin to heroin, can be fatal. Indeed, the BBC reported that a 29 year old personal trainer died last year because he profoundly miscalculated his caffeine powder mix; a perfect example of the exception proving the rule: it is the exception for a legal, regulated drug like caffeine to be fatal. And it is the rule that if a user doesn’t know dosage, any drug can be fatal.

The moment of consumption is fraught enough for anyone struggling with dependence, however much they crave change. Fentanyl and its inevitable successors will kill people whose use is haunted by deadly uncertainty until we confront our hysteria towards such chemicals and guarantee one very specific thing for those suffering from drug use disorder: a safe supply of whatever drug they are dependent on.

Even if it is every bit as dangerous as alcohol.

Especially if it is even more so.

Alcohol users in Utah may or may not have an addiction problem, but they damn well know the purity and potency of their drink.

Heroin users in Utah may or may not have an addiction problem, but they damn well have the same right.

Bill Fried is the co-Author of The Uses of the American Prison. He is retired from the staff of Law Enforcement Action Partnership and is on the Somerville Task Force regarding Supervised Consumption Sites. His op-eds have appeared in the Boston Globe, the Baltimore Sun and elsewhere.