NEEDLING THE HABIT

Want to Reduce Harm From Drug Use?

I'll Go Out on a Limb Here

Reduce Drug Use

They're not junkies -- they're clients! Still addicted to your pathetic cigarettes? Shame on you. You, my friend, are a pariah, to say nothing of a public-health menace, and we are slowly driving you to the margins. Stay at least six feet away from the office door, please, so you don't contaminate the rest of us, and enjoy your filthy habit while you can, because some cities are about to ban smoking in any public space. Have kids? Double shame. Don't you know secondhand smoke is a form of child abuse? Watch out, or you're gonna lose custody.

On the other hand, if you're a crackhead, our city's public-health workers are here to help you. Here, have a free crack kit. It has a nice clean mouthpiece and a pipestem. Or maybe you'd like a needle and some alcohol swabs for your heroin habit? If you don't like shooting up in the back alley, how about a safe consumption site, where a registered nurse will give you some useful tips about vein maintenance and injection techniques?

I'm not making this up. This is the innovative new drug strategy that has been unveiled by Toronto's leading public-health officials. It is very similar to the drug strategy adopted by Vancouver, which operates "safe" injection sites in the notoriously drug-ridden Downtown Eastside. And it's merely an extension of what Toronto is already doing. Residents of Cabbagetown recently discovered a pile of used needles, alcohol pads, matches and "safe crack kit gear" scattered near a children's playground. Some of these items bore the Toronto public-health logo.

In the world of progressive drug policy, the word "addict" has been outlawed. Even the word "abuser" is avoided, because it's too judgmental. Such persons are now known as "users," or sometimes "clients." As one safe-injection nurse in Vancouver put it, her job is to "educate participants and to support them in making their own informed choices."

British Columbia's public-health officers have weighed in with their ideas, too, in a document called A Public Health Approach to Drug Control in Canada. In their view, it's no good fighting drug use, so we might as well make illegal drugs legal, cut the criminals out of the action, and have the government run the whole drug business. They propose a giant state monopoly that would control supply, production and access, regulate drugs for quality, purity and potency, and decide who would get what drugs under what circumstances. Presumably, this monopoly would cover everything from heroin, crack and crystal meth to cooking sherry and solvents sniffed from paper bags. Naturally, money from the proceeds would be set aside for safe-shooting campaigns and even rehab. Crack Control Board of Ontario, anyone?

The common notion behind these various schemes is "harm reduction," which argues that, if you can't get people to kick the habit, you might as well give them clean needles so they don't spread diseases or kill themselves with an overdose. So far, however, there's no solid evidence that harm reduction reduces either diseases or overdoses. What it does do is create a magnet for drug dealers, who know they can operate around safe-injection sites with impunity.

Now don't get me wrong. I have a lot of sympathy for addicts, and I think it's useless to criminalize them and throw them into jail. But a bit of stigmatization is no bad thing. Social stigma is the reason why hardly anyone you know smokes any more. When I started smoking at 16, it was thought to be sociable and sophisticated. Then it become filthy, unhealthy and disgusting, so I quit. Take it from me and the many other former addicts I know -- shame and self-respect are the most powerful motives to kick your habit, whatever your habit may be.

Heroin users say tobacco is more addictive than heroin. And yet, we don't hesitate to treat smokers with scare stories and tough love. We don't give them tobacco kits and matches to win their trust and show them we are non-judgmental about their informed choice. We expect them to keep quitting and quitting till it sticks.

The harm-reduction crowd argues that prohibition is futile because it doesn't work. But it does work, although imperfectly. Make cigarettes expensive and prohibit their sale to kids, and fewer kids are going to smoke. Our restrictive strategy for tobacco has been reasonably successful in cutting down on teenage smoking. So has our zero-tolerance crusade against drunk drivers. Nobody is more stigmatized than they are. We set up roadblocks, randomly test them, and throw the book at anyone who flunks the blow test. Because of our intolerance, far fewer drivers are failing the test, and drunk-driving fatalities are dropping.

All these public-health manifestos strenuously argue that the distinctions we make between different types of users and their choice of drugs are arbitrary. Drug use is hard-wired into the human species, and you, Mr. Merlot-swilling elitist from suburbia, are essentially no different from that cokehead on Dundas Street. You're both users. In fact, the Toronto Drug Strategy paper spends far more time dwelling on the social horrors of the demon alcohol than on all the city's hard drugs put together. It wants more restrictions on alcohol, except for winos in shelters, who ought to get more.

But the differences between legal and most illegal drugs are not exactly trivial. It's pretty hard to argue (although these people try) that alcohol and crack are basically the same. There's also the matter of criminality. Illegal drugs wreck communities, enrich international narco-terrorists and turn their victims into social outcasts. Not all of this is an artifact of prohibition. Some drugs really do deserve to be banned.

Personally, I don't think that turning governments into drug enablers is such a great idea. Maybe the real way to reduce harm from drug use -- I know I'm going out on a limb here -- is to reduce drug use.

Can this actually be done? Well, maybe. Miami cut drug use among kids in half with a vigorous campaign that combined the efforts of courts, police, business, schools and parents. Sweden (a liberal welfare state that's also strongly Lutheran) has a tough zero-tolerance policy. Although drug use there has soared in the past decade, it's still the lowest in Europe. Most Swedes would think that giving addicts safe crack kits or a steady supply of heroin (Vancouver's latest hot idea) is nuts. So do the people who stumbled on Toronto's official crack kits. The dealers like it, though. As one Cabbagetown resident told a Toronto newspaper, the drug dealers are "absolutely laughing at the fools at City Hall."