"Joe Biden supports opium dens"

Or so says the epic crank Michael Shellenberger...

“Biden May Legalize “Modern Opium Dens” Michael Shellenberger claims.

What of America’s virtuous maidens!?

There was actually time when “opium dens” existed in America. Late at night, after a long day of hard work, people would unwind in plush dim rooms, layers of sweet billowing smoke hovering in the air. Places like that don’t really exist anymore. Instead, people sit in loud bars with a zillion TVs and stumble (or drive) home in the night. If only opium dens were a thing.

Everything’s a reboot though, so why not? Maybe Biden will open an old-timey Western brothel. Madame Malarkey’s. Biden family members get a discount!

Shellenberger ran for governor in California on a platform to mass arrest and institutionalize homeless and addicted people, “sweeping” them off the street and forcing them into “treatment.” As you might guess, he completely misrepresents overdose prevention centers, other wise known as supervised injection sites. He slaps together his ranting and raving like a kid mashing Play-Do.

Here’s Shellenberger:

“Advocates of such sites say that they have been used to successfully prevent overdose deaths in Amsterdam, Netherlands, which also gives addicts a safe supply of heroin. But the city of Amsterdam gives heroin to fewer than 150 people total, and only after every other treatment, including methadone and suboxone, has failed. And Dutch drug sites, like the nation’s overall approach to addiction, are aimed at helping addicts to overcome, not simply maintain, their addictions.”

OK, let me see if I’ve got this straight: Amsterdam (population 821,000) only gives 150 people a safe supply of heroin and only after other treatments haven’t worked. Shellenberger is conflating several things at once. Heroin-assisted treatment is different from a supervised injection site, which, in America will give precisely zero 0 people a safe supply of heroin. Rather, people procure their substances on the street and merely have a safe haven to use under medical supervision.

Shellenberger’s logic here is that Amsterdam sites are better than US ones, because they *only* give heroin to 150 people after Suboxone and methadone fail, while the US doesn’t give heroin to anybody at all, despite randomized clinical trials showing heroin-assisted treatment generates positive outcomes and improves the lives of entrenched heroin users who’d otherwise be trapped in illicit markets where they’re being sold god knows what.

Would Shellenberger feel better if the US government gave Americans heroin, but only after they’d tried methadone and Suboxone? Shellenberger assumes that people on the street suffering from drug addiction have never, ever tried treatment before. Maybe some haven’t, but if you actually talk to people, most have tried treatments that offer little else but a bed and interminable sessions of group therapy and scolding anti-drug lectures. What other serious medical disorder is treated in such a lackluster way?

“Dutch drug sites, like the nation’s overall approach to addiction, are aimed at helping addicts to overcome, not simply maintain, their addictions.”

Does he think that US supervised injection sites or even syringe-programs refuses to help people who inquire about treatment and recovery? Most of these places have a list of nearby Medicaid-approved treatment facilities and doctors at the ready. But most of those providers are at capacity so people languish on waitlists until it’s their turn. Shellenberger seems to think America is the land of treatment for free on demand for anybody who wants it. If only.

Here’s Shellenberger again, talking out of both sides of his mouth:

“The two of us have long publicly supported many so-called “harm reduction” strategies, including the use of Narcan to revive people from opioid overdose, needle exchanges to prevent the spread of HIV-AIDS, and even supervised drug consumption sites when they are in systems, like the ones in the Netherlands and Portugal, that encourage recovery. But neither the Biden Administration nor the Justice Department is proposing any such recovery-based system.”

How come European style harm reduction encourages recovery but in the US, according to him, harm reduction is actively against recovery? His argument is that American harm reduction encourages drug use because they simply let people who are going to use drugs use drugs. That’s what the Europeans do as well, only they have national public insurance systems where people can actually access effective and quality treatment. Elsewhere in the world, people can show up at a normal pharmacy to get their methadone but in America they’re forced into a cookie-cutter punitive clinic system that operates on the assumption their patients are not to be trusted.

Yes, the Biden adminstration and the Justice Department ought to support overdose prevention centers and heroin-assisted therapy and create a system where people can access treatment on-demand. If the Democrats aren’t going to do this does Shellenberger think Republicans will? His politics are a mess! What is this guy talking about?!

To back up his anti-harm reduction dance, Shellenberger details complaints from people in neighborhoods with supervised drug use sites. Only two of these sites that are actually sanctiond exist in America, and they’re in New York City:

“The same thing happened around a drug site in Harlem. “The clinics and injection sites have had the unintentional side effect of bringing dealers around,” a Harlem resident told The City last month. “I have witnessed things I’ve never seen before, including brazenly open dealing, people defecating (in broad daylight), users with needles openly using injection drugs … and even a man receiving oral sex between parked cars,” said another resident. “It looked like something out of a zombie movie,” said another.

The same chaos has plagued drug sites across Canada. Two representatives of the provincial government of Alberta told us earlier this week that they plan to shut down a supervised drug consumption site due to its record of failure and its disruption of the neighborhood around it.”

This is literally what people say anytime a service for addicted people appears in the neighborhood, including methadone clinics and syringe programs. In each case, the harm reduction interventions tasked with trying to prevent syringe litter, public drug use, and “disorder” are blamed for everything bad that happens in the neighborhood. Is a barely funded harm reduction operation really responsible for the degradation of communities in America? Could, I don’t know, a decades long system of redlining and racist divestment be the cause of anomie?

“The record is clear. Around the world, when supervised drug-use sites operate within systems that promote addiction maintenance instead of addiction recovery, open-air drug dealing, drug use, and overdose deaths all increase. Why, then, is President Biden seriously considering legalizing them?”

Again, he does not specify how other countries promote recovery while Big Bad Libertine America promotes “addiction maintenance.” The evidence is also certainly not clear that overdose deaths, drug use, dealing, etc. increase when harm reduction is pursued. NPR recently covered New York’s consumption sites and found:

“In their first three months, the sites in upper Manhattan’s East Harlem and Washington Heights neighborhoods halted more than 150 overdoses during about 9,500 visits — many of them repeat visits from some 800 people in all. The sites are planning to expand to round-the-clock service later this year.

“It’s a loving environment where people can use safely and stay alive,” says Sam Rivera, the executive director of OnPoint NYC, a nonprofit that runs the centers. “We’re showing up for people who too many people view as disposable.”

Those opposed to overdose prevention centers fail to understand this critical point that Rivera made: People with addiction have long been shunned from everyday health care institutions. They do not have loving environments available to them. For decades doctors have been taught to run for the hills when they see an addicted patient. Until very recently, people with addiction were told there was little medicine could do for them, and that they should probably go attend some 12-Step meetings.

These patients present an irreconcilable tension for health care providers. They have the tools to help people, but doing so, they think, would put their own status, license, and livelihood in danger. On ethical or moral grounds, they think their tools would enable or encourage addiction—which is the very same idea that Shellenberger wields to argue against American harm reduction. In our world not only is addiction criminalized, but our laws have been interpreted to mean that treating addiction is both a crime and a moral transgression. In many states, the very act of harm reduction is itself a crime. One of the reasons harm reduction exists, the reason why overdose prevention centers are necessary, is because other institutions in American life decided that addiction isn’t their problem.

Shellenberger doesn’t want to see people use drugs in public. That’s fair. It’s jarring and uncomfortable to witness a panorma of suffering from behind the wheel of your Tesla. But Shellenberger is also against the interventions that would bring public drug use indoors and out of public view: consumption sites, where people are not only using in safe and sanitary conditions, but also in friendly and caring conditions. Maybe a clinician or frontline worker, who is among the few people a person on the street actually trusts, says the right thing at the right time, showing the right amount of encouragement and care, and that might just be what someone on the street needs to want to change and get help.

To be against that is to be against humanity.