Jesse Harvey describes himself as “in recovery.” He has been involuntarily committed five times for substance-abuse disorders—principally addictions to methamphetamine, alcohol, and tranquilizers. He has also used opioids, though he is not addicted to them. He tried to commit suicide before his third involuntary commitment. The treatment facility in Pennsylvania summarily discharged him onto the street with no follow-up plan. Just recently, Harvey relapsed again, was arrested, and checked himself into another treatment program.
The road to recovery is rocky and long. Harvey, who is twenty-seven and lives in Portland, Maine, claims the reason he’s not dead is that he’s had access to sterile syringes and needles and fentanyl testing strips. In 2016, after his fifth involuntary commitment, Harvey founded the nonprofit Journey House, which now oversees four recovery houses in Maine. He became a state-certified recovery coach. He also began distributing, out of the back of his car, sterile syringes and needles, tourniquets, alcohol swabs, fentanyl testing strips, biohazard disposal bins, and the opioid “antagonist” naloxone. It is illegal to distribute syringes in Maine unless one does it under the auspices of a needle-exchange program certified by the state’s Centers for Disease Control. There are only six such programs. According to the National Institute on Drug Abuse, Maine had 360 overdose deaths in 2017, which came to a rate of 29.9 deaths per 100,000 people—well above the national average. Harvey operated his uncertified needle exchange as part of another nonprofit he founded in 2018, the Church of Safe Injection (CoSI), which has a board comprised of clergy, physicians, nurses, counselors, people in recovery, and people who use drugs. The police in Portland decided to turn a blind eye when Harvey made his distributions there, but the police in Lewiston threatened him, albeit politely, with arrest.
CoSI is dedicated to what Harvey calls “the harm-reduction gospel” and has as its foundational belief that, as he put it in an interview with me, “people who use drugs don’t deserve to die, especially when we have decades of evidence-based solutions.” As its name suggests, CoSI advocates for safe-injection sites, also known as supervised injection facilities, as one of those solutions, along with needle exchanges. Fundamentally, safe-injection sites, of which there are around a hundred worldwide, aim to keep people who use drugs alive in the hope that they might eventually seek treatment. CoSI, which currently has twenty chapters across nine states, does not itself operate a safe-injection site—they are illegal under U.S. federal law—but one of Harvey’s aims for the organization is “to leverage our collective First Amendment right to gain protection against counterproductive drug laws.” He has sought legal advice and has a letter to the Drug Enforcement Administration ready to go. According to Harvey, the U.S. government’s “war on drugs” is “oriented toward killing drug users.” Stigmatized as addicts or junkies, they are cast aside as human trash whose lives are not worth saving. Harvey knows this from experience.
Harvey is a provocateur. Though soft-spoken, he’s not averse to publicity—he and CoSI have been the subject of stories by NBC, NPR, and Huffpost—and he acknowledges that he is drawn to guerilla-theater tactics. He likes to cite Matthew 5:10, “Blessed are they who are persecuted for the sake of righteousness, for theirs is the kingdom of heaven,” and he calls naloxone CoSI’s sacrament. Harvey is also, however, morally serious. Commenting on Matthew 5:10 (with an eye to Luke 10), he wrote me that he is “sure we will be judged not by how many politicians and bureaucrats we mollycoddled or placated, but by how many times we did the right thing when we had the opportunity to, when we acted as the Good Samaritan when nobody else would.” He cites, among his inspirations, Dorothy Day. He hadn’t known of the Berrigan brothers when we first spoke, but later wrote me to express amazement and admiration that Daniel Berrigan had been arrested for civil disobedience at least 250 times. (I should add here that Harvey is a 2014 summa cum laude graduate of King’s College, where I teach, though he was never my student and I did not meet him until 2019. It also should be noted that, after his recent relapse, Harvey is trying to focus more on his own recovery program.)
A branch of Catholic Charities in the diocese of Albany, New York, has been operating a needle-exchange program called Project Safe Point since 2010, so harm reduction is not unknown in Catholic health care. Nevertheless, such programs remain both rare and controversial—there are fewer than two hundred of them in the whole country. This is partly because they may not be supported with federal funds. One of Project Safe Point’s directors told me that their program was launched in anticipation of the second wave of opioid addiction, when deaths from abuse of prescription drugs were compounded by deaths from abuse of heroin. Predictably, Project Safe Point generated a blizzard of commentary when it was announced a decade ago, as did the 1999 announcement of a safe-injection site that the Sisters of Charity planned to run at St. Vincent’s Hospital in Sydney, Australia. That plan had to be abandoned after the Vatican’s Congregation for the Doctrine of the Faith warned the Sisters of Charity that operating a safe-injection site was “extremely proximate material cooperation in the grave evil of drug abuse.”
And there lies the heart of the controversy over both needle-exchange programs and safe-injection sites. Do such harm-reduction strategies enable and even encourage drug abuse? When I asked Jesse Harvey whether he has any qualms about his work, he told me that he did find it hard to read the NPR story about CoSI. There a man is characterized as “conflicted about whether getting these supplies makes it easier for him to use drugs.” Harvey quickly added that “the science demonstrates” that people don’t use drugs, or use more drugs, because of needle-exchange programs. Still, he acknowledged that it’s difficult to keep the science in mind “when you’re handing someone a needle.”
Pope Francis has famously likened the Roman Catholic Church to “a field hospital after battle.” He added, “It is useless to ask a seriously injured person if he has high cholesterol and about the level of his blood sugars! You have to heal his wounds. Then we can talk about everything else.” Over the past year, the church in the United States has itself become one of the walking wounded, especially here in Pennsylvania. In the wake of this latest annus horribilis, it hardly needs repeating that the church’s moral authority has been deeply compromised. But the church would not be the body of Christ in history if it turned in on itself and gave up on its healing mission. How, then, should Catholics think about needle-exchange programs and safe-injection sites? Should Catholics join CoSI, and others, in advocating for and seeking to implement such harm-reduction strategies? Meeting Jesse Harvey raised those questions for me.