The United States has been waging a war on drugs and the drugs are winning: in 2016 63,000 people died from drug overdoses. The path from prescription opioids to heroin has resulted in over 15,000 deaths from heroin overdoses. The addition of fentanyl made things even worse.
Because of slowly shifting attitudes and the fact that the opioid epidemic hit white Americans and cut across our economic classes there was increased interest in treating addiction as a medical issue. This change is long overdue and could help provide some solutions to drug abuse.
One approach to reducing deaths has been 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, reducing the risk of infection and disease. Looked at from a legal viewpoint, these sites are problematic: they enable illegal activity, although the intention is to mitigate rather than contribute to the harms of drug abuse. While the legality of such facilities is a matter for law makers and judges, they also raise an ethical issue.
As with most 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 value 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. For folks who profess to be pro-life, supporting such facilities should be an easy and obvious choice.
Because the facilities provide clean needles, they reduce the occurrence of infections, and this saves the community money as sick drug addicts often end up being treated at public expense. Clean needles are 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 just bailing out a sinking boat rather than plugging the holes. Fortunately, such facilities also refer their visitors to addiction treatment and some people 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 other things, 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. While this is mainly a matter of an assessment of worth, 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 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. So, those who care about other people should support these facilities. Those who favor human suffering should oppose them.
A third matter of moral concern is that, as noted above, injection facilities enable illegal activity. It could be argued that this might damage the rule of law and have negative consequences that arise when laws are ignored. The easy and obvious counter is that the laws should be changed as treating drug use as a crime rather than a health issue has proven to be a costly disaster. Even if the laws were not changed, it can be argued that 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. The cynical might also note that the rule of law has been openly shown to be a lie and to allow people to suffer for this delusion would be a grave moral mistake.
A final point is that the utilitarian approach could be rejected in favor of another moral theory. There are many other approaches to ethics. 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.
Considering the above arguments, while there are some concerns about the ethics of aiding people in using drugs, the strongest moral case favors injection facilities. As such, the laws should be changed to allow them to operate legally.
