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Monday, January 29, 2018

Safe injection sites and the 'War on Drugs'

Heroin operation taken down in Delaware, May 2016
There has been a great deal of controversy in recent weeks here in my hometown of Philadelphia regarding a proposal by some local politicians to open so-called safe injection sites.

The position of Mayor Jim Kenney and others is that such sites would help combat the exploding opioid crisis.

This would be accomplished by providing a safe place for drug abusers, but also by providing them with counseling.

Kenney was quoted by Aubrey Whelan for Philly.com just last week:
“We don’t want dying on the street and we want to have a place to administer Narcan if necessary. We also want an opportunity to speak to people about their future and getting their lives straight. They can’t do that under a train bridge or on a train track.”
Almost immediately, various members of Philadelphia City Council tried to apply the brakes. Per a piece by Claudia Vargas and Holly Otterbein for Philly.com, those concerns were summed up by Councilwoman Maria Quiñones-Sánchez: “There’s no plan,” Sánchez said, adding that the city’s official presentation on the proposal looked “like an intern gave it to them.”

I have a number of problems with the idea. Concerns over exactly where any facilities would be located, issues involving liability for the city involving death and injuries at the facilities, and many others.

However, perhaps my biggest problem with the idea is even more basic and controversial. This is especially so coming from me, as I spent most of the last three decades as a Philadelphia Police Officer, Detective, and Sergeant. That included a decade in the Training Bureau teaching officers, supervisors, and commanders.

My biggest problem is that the city would be basically endorsing and supporting folks who are breaking the law. Possession and use of illicit drugs such as heroin is a crime. Addiction is not a valid defense.

Now that statement is factual, so my problem may not seem immediately apparent. Until I reveal why I feel that it is a problem. It's a problem because the city is supporting an illegal activity. But it is an activity that I do not believe should be illegal in the first place.

That's right - I do not support laws against the sale, possession, or consumption of narcotics. And if you do, I want to hear the reasons. The real reasons.

Those reasons cannot have to do with health concerns for the individuals involved in that usage, or their families, or for the community. Not unless you also support criminalizing the use of tobacco products and alcohol.

The cost of alcohol addiction to the U.S. economy has been estimated at nearly $250 billion annually. This includes lost productivity, health care expenses, law and other justice costs, and motor vehicle crashes.

More than 40% of that cost, over $100 billion, is drained from government. In other words, you and I pay for it with our taxes. Another $3.5 billion in costs is incurred by individual states, who of course also get their money from we the taxpayers.

Even with all of the education regarding tobacco abuse and the decline in its use over recent decades, its use remains the single largest preventable cause of disease and premature death in America today.





More than 55 million Americans continue to smoke cigarettes. Another 12.4 million smoke cigars regularly, 8.8 million use smokeless tobacco, and there are 2.3 million pipe smokers. These were the figures presented by the American Cancer Society as of just five years ago.

A 2014 study at Georgia State University revealed that cigarette smoking alone generates as much as $170 billion in health care spending annually here in the United States.

This doesn't include the simple economic cost of smoking to the user. An average pack of generic cigarettes costs more than $5, with many brands costing even more. Most smokers go through at least a pack per day, so that's at least $150 per month in basic costs.

Use a pack and half per day, you're up to $225 per month. Smoke an $8 per pack brand or product? That same pack and a half is now $360 per month. What could consumers and their families do with $360 per month if they were not addicted?

President Richard Nixon first formally declared a "War on Drugs" in June of 1971. The basic cost to the U.S. government to fight that "war" had risen to $1 trillion per a piece by Richard Branson for CNN back in 2012.

And the fact is, we are losing the war. How many times have you seen a local news story in which federal, state, or local law enforcement displays some vast amount of narcotics, cash, and weapons recovered from a drug operation? Was that the last one you would ever see? No. These stories continue to come, year after year. You'll likely see another on your local news any day now.

It's obviously not that law enforcement isn't doing anything about the problem. Brave police officers at all levels of government are working hard every single day and night trying to enforce the law. In this "war", some of those brave officers have even lost their lives.

But just as with the prohibition against alcohol a century ago, the prohibition against and war on drugs is a losing proposition.

Throughout the 1920's and into the early 1930's, a great deal of law enforcement manpower, time, and financial resources were expended enforcing prohibition against the evil and illegal scourge of alcohol. Officers died enforcing those laws as well.



And then, alcohol prohibition was repealed in 1933. It was all for nothing. Police did their jobs, as they are doing them today. It wasn't law enforcement that was the problem. It was the law itself. It is long past time to revamp and even repeal many drug laws.

In November 2016, Elevations Health published a piece on the financial costs to the U.S. taxpayer to continue fighting this war. The piece included this summation of those financial costs:
"In 2015 alone $36 billion was spent on the war on drugs, but that number was just for law enforcement and some social services, and does not take into account the cost of incarceration for nonviolent drug offenders once they are arrested and sentenced to jail. Roughly $80 billion is spent each year on incarcerating American prisoners and since 50% of our prison population is serving time for drug-related crimes that means that an additional $40 billion needs to be added to $36 billion price tag for the war on drugs, bringing the grand total to $76 billion."
The fact is that human beings have used and abused substances almost since the beginning of our existence as a species. Many of the substances now considered illegal were not so at a previous time. The same can be said for other vice crimes such as prostitution.

It is my position that not only would cost to taxpayers go down with decriminalization, but in some cases we might find revenue streams. This is already happening today with the widespread and growing trends involving marijuana.

Can you imagine the decrease in violence which is currently perpetuated in the trafficking of illicit narcotics by cartels and street gangs? What kind of impact would the loss of that violence have on our neighborhoods?

If we continue on, trying to fight this losing battle, we will never find out. We will simply continue with the status quo. And trust me, there are many who are just fine with that status quo. Their own livelihoods depend on it.



More importantly, if we can get to decriminalization we can begin to treat this as what it really is, a health problem. Focus dollars instead on education, prevention, and treatment.

So called "Safe injection sites" might then become some piece of a viable treatment opportunity for folks who were fighting this particular addiction.

Want to argue that the abuse of heroin and the current opioid crisis is killing people every day, while cigarettes and alcohol are not? Seriously? Now who is being naive?

The CDC estimates that cigarette smoking accounts for 480,000 deaths per year in the United States alone. Do the math. That's 1,315 people dying every single day.

Per the NHTSA, in the year 2016 in the United States there were 10,497 people killed in car crashes involving drunk driving. These were crashes where a driver had a BAC of .08 or greater. Again, do the math. That's roughly 29 folks every single day.

There are some who are going to question my conservative bona fides after this piece. There are many in law enforcement who are going to think that I have either lost my mind or gone over to some "other side" now that I am in retirement from the profession.

Nothing could be further from the truth. The truth is something that most people are unwilling to deal with. The truth is that this isn't a war that we are losing - it's a war that we lost a long time ago. It's one that we should have never begun fighting, in fact.

There will always be a criminal aspect to drug abuse. If drug users and abusers commit some crime while high, they will pay for that crime, just as drunk drivers and others who commit crimes while intoxicated on alcohol have to pay for their crimes.

In his CNN piece, Branson quoted H.L. Mencken, one of the most influential writers of the early 20th century. On the issue of prohibition, Menchen had this to say. The same sentiment can be applied to the war against drugs:
"Prohibition has not only failed in its promises but actually created additional serious and disturbing social problems throughout society. There is not less drunkenness in the Republic but more. There is not less crime, but more. ... The cost of government is not smaller, but vastly greater. Respect for law has not increased, but diminished."
Tell me why this is a criminal issue rather than strictly a health issue. I'll wait. Meanwhile, safe injection sites are not the answer as long as drugs remain illegal.

Dealing with that bigger issue is what has a chance to make a real, significant difference in the lives of individuals and communities in the long run.

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