Updated: Jul 21, 2022
Two decades ago, a brilliant young nurse who was studying with us at Regent College asked me about the morality of offering harm reduction to addicts. In particular, she talked to me about where she worked: InSite, Vancouver’s innovative safe-injection house in the city’s notorious downtown east side (DTES).
I have a great deal of respect for nurses. And this was no ordinary nurse. Meera Bai had earned three degrees in relevant fields: a BA in development studies (international and community development), a BSc in biology, and a BN in nursing. She was now working on her master’s degree in theological studies. And she has since completed her MD and is heading for residency. (UPDATE: Dr. Bai is now certified in addiction medicine.)
My initial reaction to her question was dumb shock: How could such a serious Christian person, and a highly trained health care professional at that, possibly conspire in helping addicts shoot up? But as we talked, and as Meera cleverly used some of my own ethical principles against me (which would become my books Making the Best of It and Why You’re Here), I became persuaded.
Harm reduction in itself is a good idea. How could a Christian not want to help people avoid loneliness, fear, illness, and death…on top of the miserable life of the hard-core addict?
I was all the more persuaded when I found out that other staff members were connected with Regent or with other Christian schools in Canada. InSite, in fact, looked more and more like an outpost of the Kingdom in one of the darkest mission fields in our country.
This impression is bolstered by science and a vast range of relevant professional experience. InSite has been shown to be a successful public health initiative in over 30 scientific research reports published in peer-reviewed medical journals. Such reports demonstrate that InSite users are significantly more likely to seek long-term addiction treatment and to stay off the street than users who choose to inject outside.
Moreover, the HIV rates in the DTES are on par with many African nations. Such blood-borne diseases are spread by sharing needles—something that is banned at InSite. And instead of using puddle water from urine-soaked alleys, participants are provided with sterile water, which reduces various kinds of horrific infection.
Clean supplies, safe rooms, friendly staff supervision during injection, and compassionate nursing care help injection drug users to learn how to value their bodies, and thus themselves, even as our society generally tells them they are worse than useless. And InSite doesn’t operate alone, but as part of a comprehensive program to help addicts make better choices. The detox and counseling centre, Onsite, is literally on the same site.
The point of harm reduction is not, of course, to enable addicts to keep on in their self-destructive ways. The point is to help them recover—which they can’t do if they’re dead.
Christians should be glad to participate in a multi-pronged approach to the compassionate treatment of our neighbours. Do we wish all addicts were off drugs and healthily contributing to society? Of course we do. But wishing don’t make it so.
And in the real world—the only world there is and the world Christ calls us to love—sometimes the best we can do, at least immediately, is to make things less bad. InSite makes some awful things much less bad. We need more such places.