Don't Forget About Drug Users

This letter to the editor was originally published in the Winter 2010 issue of Conscience Magazine

I want to congratulate you on your recent articles on HIV/AIDS. The issues you highlight - related to stigma and sexuality - are important in understanding the global AIDS epidemic. However, the link between HIV and illicit drug use must be examined as well.

Outside of sub-Saharan Africa, nearly one in three new HIV infections occurs among injection drug users. According to UNAIDS, the use of contaminated injection equipment during drug use accounts for more than 80% of all HIV infections in Eastern Europe and Central Asia and is a major entry point for HIV epidemics elsewhere.

Yet we know that clean needles and syringes, education, and substitution therapy, can prevent HIV infection. The use of these approaches, commonly called "harm reduction", has in some countries virtually eliminated new HIV transmission due to drug use. The reason they are not more widely adopted? Politics, including by the Catholic Church.

In March 2009 the Holy See issued a statement opposing harm reduction during meetings of the United Nations Commission on Narcotic Drugs. The Church's opposition was based on its belief that harm reduction is "anti-life" and leads to "liberalization of the use of drugs". As with sex education, the Holy See is substituting its moral position for evidenced-based measures proven to save lives. While the Holy See warns that it is not possible to "combat drugs with drugs", they ignore the fact that methadone is medicine, recognized by the World Health Organization and demonstrated to be effective in treating drug dependency and preventing HIV infection.

As early as 1989, the Catholic Bishops of the United States argued against harm reduction in a pastoral letter on AIDS, opposing needle exchange because it "would send the message that intravenous drug use can be made safe" and encourage drug use. Overwhelming evidence has shown that needle exchange programs do not lead to increased drug use, and some Church leaders have since spoken out in their favor. Support from the Church for methadone is needed too.

Drug users around the world often face desperate and destructive cycles of drug use and abstinence, ill health and abuse - sometimes as a result of the drugs they consume, sometimes at the hands of authorities who deny them their rights and their dignity. In opposing harm reduction, the Holy See is impeding global HIV prevention efforts, ignoring scientific evidence, and contributing to that abuse.