While the United States has been waging a war on drugs, the drugs seem to be winning: in 2016 63,000 people died from drug overdoses. Opioids have received special attention in the media and the path from prescription opioids to heroin has resulted in over 15,000 deaths from heroin overdoses. The addition of fentanyl has made matters worse, so it would not be surprising to see the death toll increase.
Because of slowly shifting attitudes towards drugs and the fact that the opioid epidemic is heavily impacting whites and cuts across class lines, there has been greater interest in treating addiction as a medical rather than criminal issue. This change is long overdue and could go a long way in addressing the problem of drug abuse.
One approach to the problem is the creation of safe injection facilities. A safe injection facility, as the name states, is a place where people can safely inject drugs under the supervision of people trained and equipped to deal with overdoses. These sites also provide clean needles. From a legal standpoint, these facilities are problematic: they are places created to enable people to engage in illegal activity, although the intention is to solve rather than contribute to the ills of drug abuse. While the legality of such facilities is clear, there is also the matter of the ethics of such facilities.
As with many moral matters dealing with large-scale social ills, a good starting point in the moral discussion is utilitarianism. This is the view that the morality of an action is determined by weighing the positive values it generates against the negative value for the morally relevant beings. An action that creates more positive value than negative value would be good; one that did the opposite would be evil. Bentham and Mill are two famous examples of utilitarians.
There are numerous positive benefits to injection clinics. Because trained people are present to deal with overdoses, these facilities reduce overdose deaths. For example, there were 35% fewer fatal overdoses in the area around a Canadian injection facility after it opened. In contrast, other methods of addressing overdose saw only a 9.3% reduction in overdose deaths. While more statistical data is needed, this does point towards the effectiveness of the facilities.
Because such facilities also offer clean needles, they reduce the occurrence of blood infections. In addition to thus improving the health of users, this also saves the community money—drug addicts who become ill often end up being treated at the expense of the taxpayers. Clean needles are, after all, much cheaper than emergency room visits.
If all the facilities did was provide needles and try to keep addicts from dying, then it would be reasonable to argue that they are merely bailing the boat of the drug problem and not plugging any holes. Fortunately, such facilities also refer their visitors to addiction treatment and some of them manage to beat their addiction.
While significant statistical data is still needed, an analysis indicates that each dollar spent on injection facilities would save $2.33 in medical, law enforcement and other costs. From an economic and health standpoint, these are significant positive factors and help make a strong moral case for injection facilities. However, proper assessment of the matter requires considering the negative aspects as well.
One point of concern is that the money spent on injection facilities could be better spent in other ways directly aimed at reducing drug use. Or perhaps on things not related to drugs at all, such as education or community infrastructure. This is a reasonable point and a utilitarian must be open to the possibility that these alternatives would create more positive value than funding injection facilities. While this is mainly a matter of an assessment of worth (is saving addicts more valuable than improving the schools?), there are also empirical factors that can be objectively assessed, such as the financial return on the investment. Given the above, injection facilities do seem to be worth the cost; but this could be disproven.
Another point of concern is that although injection facilities due refer people to treatment programs, they enable people to use drugs. It could be argued that this helps perpetuate their addiction. The easy and obvious reply is that people would still use drugs without such facilities; they would just be more likely to die, more likely to get sick, and less likely to enroll in addiction treatment programs.
A third matter of moral worry is that, as noted above, injection facilities are enabling illegal activity. It could be argued that this could damage the rule of law and have various negative consequences that arise when laws are ignored. The easy and obvious counter is that the laws should be changed—treating drug use as a crime rather than a health issue has proven to be a costly disaster—something people are waking up to. Even if the laws were not changed, morality trumps the law. After all, if people should obey the law because it is the right thing to do, then unjust or immoral laws would be self-undercutting.
A final point to consider is the rejection of the utilitarian approach in favor of an alternative moral theory. There are, after all, other approaches to ethics that reject the consequentialist approach. For example, under some moral theories actions are inherently good or bad. On such a view, enabling drug use could be regarded as wrong, even if the consequences were positive. While this sort of view can provide the satisfaction of being among the righteous, it can impose a high cost on others, such as those dying from overdoses. But, to be fair to these moral theories, they also provide the foundation for moral arguments against views that terrible means can be justified by the ends.
In light of the above arguments, while there are some concerns about the ethics of aiding people use harmful drugs, the most solid moral case is in favor of injection facilities. As such, the laws should be changed to allow them to operate legally and with public (and private, of course) funding.