When handing out heroin improved a city’s opioid crisis
Opioids are this generation's plague.
A soccer stadium's worth of people died of opioid overdoses last year. Many more live in shadows. The stigma is bad.
There's talk of opening a "safe injection center" in places all over the country — a room where folks who use heroin or opioids could have clean needles, medical professionals, and drug testing kits.
This is a radical idea.
But there was a time when it wasn't so radical. In fact, it was banal.
A hundred years ago, clinics didn't just give out needles. They gave out the drugs themselves.
The most famous was in Shreveport, Louisiana, a town in cotton country on a winding river. In the 1910s it was home to blues singers, saloons, brothels and dance halls. Dudes drank and smoked and caught STDs and used opiates. It wasn't a huge deal. Morphine was sold at the pharmacy. It treated the STDs. You could have it delivered to your house.
In 1919 the government outlawed opioids. The addicts panicked. When they withdrawed, they doubled up in pain. Some broke into doctors offices and stole the drugs.
The county doctor, named Willis P. Butler, took a rare step and set up a clinic to, as addicts half-jokingly say, "get well." Partly in defiance of the law, he sold doses of opioids, mostly morphine but also heroin, for a few cents a dose — a few dollars in today's money. He watched the patients shoot up.
He called it a "dispensary."
According to the doctor, the clinic succeeded.
No one came close to overdosing.
It was legal, regulated, safe and clean.
Shreveport's opioid problem got better.
You can be cynical about what Dr. Butler did; say that he was just trying to profit off opioids; by ignoring the law and calling his opioid-dispensing service a "dispensary" or "clinic," he was little more than a drug dealer. He was profiting off addictions.
But Shreveport's experience inspires folks who think we should look for new solutions to the Drug War and the opioid crisis.
Bill Masters is one of them. He's the sheriff of San Miguel County in Southwest Colorado. He's the longest-serving sheriff in Colorado's history. And he knows drugs. He wrote a book called "Drug War Addiction: Notes from the Front Lines of America's #1 Policy Disaster."
Masters studied the case of Shreveport.
"They found that most people could go back into society and they could function in society, and they didn't have to be thieves and prostitutes and burglars, and they could actually hold down a reasonable job," Masters said.
The addicts stopped burglarizing doctor's offices for drugs. The local sheriff, chief of police and local judges said it reduced crime. There was less street dealing of opioids. The newspapers wrote glowing reviews.
And then all that got wiped out in the War on Drugs.
In the 1970s, a group of researchers opened the clinic's old files and combed through the dispensary's medical records. In those files, they found that it was highly possible to do opiates and function. Despite the common conception of drug users as "morally inferior, and so beneath human consideration," the users were actually "relatively productive citizens who held steady jobs." There were four doctors, two ministers and two retired judges getting fixes.
"The addicts were found to respond well to morphine treatment when regarded as responsible human beings, rather than irresponsible, disturbed criminals as they often are today," the report said.
There were bums, sure. Not everyone operated well with an opioid addiction; many died young.
But, the researchers wrote, one thing is clear: "The narcotics policies of the United States … have grossly exaggerated the effects of opiates." As a result, we are "irrational and emotional about opiates."
The paper on the Shreveport clinic was funded by the Drug Abuse Council, a nonprofit. In the 1970s, as the Drug War was heating up, the Drug Abuse Council tried to add a calm voice to the growing hysteria about "non-medical" drug use. It was powerful; its board included a current congress member and one of the founders of Hewlett-Packard, But it couldn't slow down the coming train wreck of the Drug War.
As the Drug War enters its final phases, it's worth asking: Could a dispensary for opioids operate today?
Yes. Some already exist, underground. Opioid injection dens already operate in most major cities.
In other countries, in happens above ground, like it did in Shreveport. In Switzerland, heroin addicts take their prescribed fix in supervised rooms. This "manages one of the most risky and problematic forms of drug use," a reports says. "If this form of treatment were rolled out widely – particularly in major consumer countries – it could have major benefits for many people dependent on heroin."
Could this be a solution in America?
"We really need to open the box and think outside of it," said Masters, a Colorado Sheriff and Drug War opponent. "There's probably a solution out there, we just don't know what that solution is. We need to have that experimentation, because nothing we've done so far in regard to alcohol or drugs is working."