In the Realm of Hungry Ghosts: Close Encounters with Addiction

by Gabor Maté

Why this hidebound resistance to a simple harm-reduction and disease-prevention method? “People often talk about American’s Puritan origins as the reason for opposition to needle exchange,” says Daniel Wolfe, the deputy director of the New York—based International Harm Reduction Development program at the Open Society Institute, “but it’s actually evangelism that underlies most of the politics against needle exchange. To give someone a needle or methadone is seen as giving up on the idea that they can be ‘saved,’ and as a moral failure for both drug user and care provider. The moral reality of leaving drug users to die of HIV because you refuse to adjust this vision of redemption to reality, or the moral implications of turning our anti-harm-reduction ideology into a global crusade go unexamined.… The ban on federal funds for needle exchange in the United States—the only such restriction in the world—finds further reinforcement in the American hostility to central government assistance to people in need.”7 Unless, one is tempted to add, the people in need—owing to their own poor choices—are shareholders of Freddie Mac or Fannie Mae.