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Wealth & Poverty Review The Harm in “Harm Reduction”

Vancouver’s experiment with safe-injection sites is a dead end for addicts—and a public-health risk. Originally published at City Journal

Every major city in the United States seems to have its designated opioid district, a tucked-away part of town where normal rules are suspended and the drug trade shapes the social order: Kensington in Philadelphia, the Tenderloin in San Francisco, Pioneer Square in Seattle. The scenes are sadly familiar: disheveled men and women living under blue tarpaulins, dealers doing hand-to-hand transactions between large trash receptacles, and dope fiends searching with their fingertips for the last good vein. Methadone clinics and rescue missions operate amid a steady rumble of ambulances and police cruisers, vehicles sent not to enforce public order but to manage the status quo.

Political leaders have long sought to transform these places. Among progressive policymakers, the prevailing trend is “harm reduction,” a public-health approach that accepts widespread drug use and directs resources toward mitigating its negative consequences. Harm reduction began with needle exchange and methadone clinics, which helped, respectively, to reduce the transmission of blood-borne diseases and to stabilize addicts with opioid replacements. Now, as Western nations confront the opioid crisis, cities in Canada, Australia, and Europe have adopted a new harm-reduction strategy: so-called safe-injection sites, where addicts can take drugs—predominantly heroin and methamphetamine—under the supervision of medical professionals, who intervene in case of emergency.

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Christopher Rufo

Former Director, Center on Wealth & Poverty
Christopher Rufo is former director of the Discovery Institute’s Center on Wealth & Poverty. He has directed four documentaries for PBS, Netflix, and international television, including his latest film, America Lost, that tells the story of three "forgotten American cities.” Christopher is currently a contributing editor of City Journal, where he covers poverty, homelessness, addiction, crime, and other afflictions. Christopher is a magna cum laude graduate of Georgetown University, Claremont Institute Lincoln Fellow, and has appeared on NPR, CNN, ABC, CBS, HLN, and FOX News.