If you had asked me 5 years ago what I thought about a syringe exchange—where drug users trade their used, dirty needles for unused, clean ones—I would have told you it was a crazy idea. I would have seen it as enabling, and I would have condemned not just using drugs but any assistance to an addict in his or her habit. I would have seen it all as the same immoral and destructive behavior.
Then, almost 4 years ago, I fell in love with a recovering addict. Colin has had (and continues to have) an incredible journey. I had not really known any addicts or alcoholics prior to meeting Colin; now, the recovery community is an indispensable part of my social and spiritual life.
But it wasn’t until a few years into knowing Colin that I was introduced to the idea of syringe exchanges, which became legal in North Carolina recently. I didn’t like the idea at first. It seemed like something that enabled and even encouraged the very behavior that could and almost did destroy the life of the man I love as well as my relationship with him.
But harm reduction is more than giving users clean needles. The group Colin and some friends have started here in Winston-Salem, Twin City Harm Reduction Collective (TCHRC), provides not only syringes but also naloxone—a truly lifesaving drug that reverses an overdose—along with education about how to use safely, how to prevent disease transmission, and where to get treatment.
The evidence is clear: harm reduction (including syringe exchange, naloxone, condoms, and more) cuts way down on HIV and Hepatitis C infections; crime has been shown to drop in neighborhoods where syringe exchanges are present; needle sticks to police officers (which happen far more often than I realized) go down; and addicts who use syringe exchanges are more likely to get treatment. It was after a conversation with an outreach worker at a harm reduction clinic in his hometown of Minneapolis that Colin first considered going to detox.
Harm reduction is also an opportunity for us to take off the blinders, to stop pretending that the current heroin epidemic isn’t happening and that if we just ignore it or condemn it, it’ll go away. That logic underlies why young evangelical Christians have higher rates of pregnancy and STDs than other groups (see Peggy Orenstein’s book Girls and Sex). Forbidding teens from having sex or blocking their access to protection or sex education, as many evangelical communities do in one way or another, doesn’t make them wait for marriage—it actually makes them more vulnerable to contracting a disease or having an unwanted pregnancy. Pretending that drug overdoses aren’t killing at the rate that AIDS did in the late 80s—or that opioid-related deaths haven’t surpassed gun homicides for the first time—and trying to keep addicts from using at all, especially not safely, will not save a single life and has already led to countless preventable deaths.
Let me be clear: “They’re gonna do it anyway” doesn’t do it for me as a blanket response to destructive behavior. When I was in high school, a mom following that logic bought liquor for her teenage son and his friends, and one of them died when he passed out drunk and drowned in his own vomit. As a Christian and a pastor, while I believe that sin is inescapable, I do not believe that means we should give up seeking holiness and wholeness.
But harm reduction humanizes addicts in a way our culture often does not, and it is that humanization that makes recovery possible. Society makes addicts out to be monsters, but harm reduction offers them choice and dignity, sometimes keeping them alive long enough to recover. It respects their right to choose whether or not to seek treatment, making those options available and accessible without making them mandatory.
Because that’s not how recovery works anyway. Too often, we think that if we force someone to get clean, they’ll recover—but that’s not the case. Meanwhile, we make it difficult for people to get clean even if they want to by limiting treatment options and timely accessibility to them. Groups like TCHRC are helping make treatment easily available to people if and when they are truly ready.
Sin and forgiveness work much the same way. (I think of sin in terms of wounds and brokenness in need of healing, not in terms of wickedness or badness to be punished, lest you think I’m moralizing addiction.) God does not force us to seek forgiveness. God allows us the freedom to choose whether or not to repent (turn around), because God is love, and love is non-coercive. God’s grace is always readily available and accessible to us—if we want it and seek it out. Sometimes the church becomes the gatekeeper of who can access God’s grace, when we should be constantly offering the gift of the good news as an open invitation to all people at all time in all places.
Harm reduction is about telling people whom society treats as disposable that somebody actually cares about them. Harm reduction tells an addicted person that he or she is worth something. The message an addict gets all day, every day, from all sides and from within his or her own heart, is that he or she is worthless, bad, dangerous, a piece of garbage, better off dead. For an addict to believe that he or she has even a shred of inherent value is itself a huge step out of the isolation and shame that come with—and often cause—the disease of addiction. This is about treating the desperate, the broken, the angry, and the traumatized as human beings worthy of love and respect. Harm reduction allows us to demonstrate the kind of unconditional love, care, and support that we all want and need.
In the Gospels, Jesus consistently identifies himself with the most vulnerable in society. He doesn’t just go to them—we find him in them. If we were to look for Jesus today, we would see him most clearly at the margins—in the LGBTQ community; in communities of color; among persecuted Muslims; among refugees and immigrants; in the prisons; in the homeless and the poor; among sex workers and addicts and everyone the dominant society treats as disposable or undesirable.
A few years ago, my friend the Rev. Tiffany Thomas preached at my church during a Lenten series we did at our Wednesday night worship service on Matthew 25. We broke down that passage (the familiar “I was hungry and you gave me something to eat” and so on) into 5 weeks of preaching and worship on the hungry and thirsty, the stranger, the naked, the sick, and the prisoner. Like a good colleague (ha!), I gave Tiffany “the naked.”
At the time, Tiffany was serving an urban church that was active in its neighborhood and with the community’s vulnerable populations. She offered beautiful insight on what it meant to be naked—oppressed, vulnerable, or shamed—sharing an example of an older woman who used to visit, talk with, and bring condoms and other needed items to prostitutes that frequented her neighborhood. It was the last line of Tiffany’s sermon I will never forget. She closed with a paraphrase of Jesus’ statement, “I was naked and you gave me clothing” like this:
“I was a prostitute and you gave me a condom.”
People will get hung up thinking she was saying that Jesus would sell his body for sex (that is sooooo theologically complicated to unpack…). That’s not the point. The point is that most prostitutes are desperate, vulnerable, and victimized. They are outcasts, shamed and despised by society even as their services are sought by people of all backgrounds. And many prostitutes are addicts supporting their habit the only way they can.
I imagine Jesus saying to us today:
“I was a drug user and you gave me a clean syringe.”
“I was an overdose victim and you gave me naloxone.”
“I was an addict and you gave me a chance at recovery.”
Meaning: I was broken and you offered me healing. I was ashamed and you told me I was worthy of love. I was isolated and you said I was not alone. I was desperate and you showed me how to get help. I was outcast and you welcomed me. I was demonized and you humanized me. I was at death’s door and you saw and valued and saved my life.
Don’t we all need to be able to say that?
North Carolina Harm Reduction Coalition’s website
North Carolina Syringe Exchange Fact Sheet (PDF)
Twin City Harm Reduction Collective’s Facebook page
The United Methodist Church’s Social Principles ¶162L, “Alcohol and Other Drugs”
“Hope for the Addict” by Colin Miller (The Winston-Salem Journal)
“A Pastor’s Journey from Dealing to Healing” by Tessie Castillo (The Fix)