When I first learned what Allison Downing did for a living, I thought it was criminal: She helped dudes shoot up.
I couldn’t believe it. Allison, whom I met online and instantly liked, was a health care worker in the United Kingdom and her job was literally to teach drug addicts how to do drugs better.
This was an idea that the middle school DARE curriculum never prepared me for. I’d been brought up with First Lady Nancy Reagan’s “just say no” rhetoric and it left no room for a world in which Allison could sit down professionally with drug addicts and teach them to properly inject themselves with needles.
And get paid for it. By her government. And be highly-regarded in her field.
But Allison can argue very well. Soon she was lobbing statistics my way and shooting down every objection I could raise. It didn’t help that I only had one bullet in my arsenal.
My entire argument against her job was this: It’s wrong to do drugs, and enabling addicts just teaches them it’s OK to do drugs, right?
It turns out I was very wrong. Addiction isn’t something willpower can overcome, any more than willpower can overcome cancer, Allison insisted. As a disease, addiction is going to get its victims eventually. And it’s up to medical professionals to help them through recovery. But addicts don’t just go cold turkey — and that’s where harm-reduction comes in.
The UK’s National Health Service used to believe the best way to fight its own opioid crisis is to first teach addicts how to do the least amount of harm possible to themselves and others. That means using clean needles, preventing fatal overdoses, and stopping the spread of infectious diseases.
But the NHS backed off the harm-reduction model several years ago and its problems exploded again. England had 2,383 drug misuse deaths in 2016, up 3.6 percent over the prior year and the highest figures on record. Drug misuse is now the third most common cause of death for ages 15 to 49 in England, according to the Office for National Statistics.
A majority of those deaths are linked to heroin.
If the human appeal of harm-reduction services isn’t enough, consider the economic appeal. The NHS says that for every $1.35 invested in public-subsidized drug treatment, the benefit to society is $3.39 (figures converted from British pounds). There were 203,808 people in treatment in 2015 and 2016, and without that treatment their health problems would have cost taxpayers $1.35 billion.
The UK saved another $1.35 billion in crimes prevented through treatment, the NHS estimates.
I recently sat down with Don Sheldon, retired physician and former president of University Hospitals Elyria Medical Center. He said a needle exchange is one of the best ideas Lorain County can implement right now.
Like Allison, he said the whole goal is to reduce harm — for the addicts, for their family members, and for the rest of us who see the problem from the outside looking in.
“You’re a drug addict,” Sheldon told me. “Let’s pretend. Let’s say I give you four clean needles. How many needles are you going to bring back if you know I’ll give you clean ones every time?”
The answer is all four. Drug addicts know the value of every needle they have. With the promise of an exchange, they’re not going to leave those needles lying on beaches, on streets, or in bathroom stalls. They’re not going to let their friends do it, either.
The chances those old, dirty needles will spread hepatitis C or AIDS around plummet.
And best of all in this scenario: Drug users are going somewhere safe and building trust with the person who provides the needles. When they’re ready, they are going to feel far more comfortable asking for help giving up drugs altogether.
What I’ve learned over the last several years, talking to experts like Allison and Sheldon, is that you can’t let your “just say no” prejudices get in the way. The drug problem already exists and now it’s time to treat it.
Sheldon said needle exchanges already work elsewhere. Pointing east, he said there’s lots of evidence to show Lorain County drug users are already heading to Cleveland, where an exchange is available, but it’s time to make it work here.
And that’s why the Wellington police get my loud applause on their intent to start an exchange. I can only hope other police departments follow suit.