The Case For Harm Reduction

Philip Seymour Hoffman and Drug War Sanity

It was to be expected. A famous person’s death by heroin overdose becomes a catalyst for today’s equivalent of the lynch mob. Leading the pack, Bill O’Reilly immediately and aggressively called for heads to roll. Soon, four people were arrested in Manhattan for allegedly selling the drugs to the Academy Award winning actor.

“Selling narcotics is a violent crime,” O’Reilly declared. He cited CNN’s Ashleigh Banville who that day said, “…the guy who gave an addict the drug that killed him deserves to go away for life.”

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[The haunting portrait of Philip Seymour Hoffman, at left, affects a daguerreotype plate circa the late 1800s. It was taken by photographer Victoria Will at the Sundance Film Festival two weeks prior to Hoffman’s death on February 2nd.]

Hoffman’s tragic death immediately mobilized drug warmongers to beat their drums for the usual reaction of police, courts and prisons. Outcries like O’Reilly’s were predictably vengeful and directed at demonizing drug dealers as disgusting pariahs who must be purged from the company of good, law-abiding citizens.

Fox News house liberal Alan Colmes stood up to O’Reilly’s vigorous bluster and responded rationally. He compared the selling of heroin that leads to an overdose like Hoffman’s to the person selling a gun to a suicide.

“That’s crazy!” hollered O’Reilly.

But is it any more crazy than this: The New York Times just ran an editorial about a study on prescription testosterone drugs like Androgel, made by the huge pharmaceutical Abbvie. Use of Androgel doubles the odds of a heart attack for men over 65, and it triples the risk of an attack in middle-aged men with a history of heart disease. If instead of the problems he self-medicated for Hoffman had suffered from “low T” and had been obsessed enough with jacking up his masculinity to rub Androgel into his armpit, given his lifestyle, he could well have fallen prey to a fatal heart attack. Would these lynch-mob talking heads, then, be calling for the marketing chief of Abbvie to get life in prison?

No need to answer that. Everybody already knows the answer:

If your drug connection has an MD and your dealer is a legitimate pharmacy, you’re OK, since the source of the drug is on the New York Stock Exchange and makes an outrageous profit. If your free private enterprise entrepreneur is a self-made small businessperson providing substances that aren’t tested by the FDA “nanny state” and that don’t come with a yard-long sheet of cautions, then we’re gonna call down some well-armed, high-testosterone nannies on that small businessperson. Presuming, as in this case, your corpse was once a celebrity beloved for providing insight into troubled souls. If you were a nobody, then it’s a Darwinian plus. That’s how it works.

Meanwhile, over on MSNBC, Chris Hayes featured Dr. Carl Hart, a neuroscientist who, in the brief time he had, tried valiantly to address what he saw as a plague of ignorance when it came to getting the heroin story right. Dr. Hart has written a book on drug realities called High Price: A Neuroscientist’s Journey of Self-Discovery That Challenges Everything You Know About Drugs and Society. Hart is a black man with dreadlocks, which could have some bearing on his message. The key, he said over and over, was education. For instance, he said, 75 percent of overdose deaths were due to the mixture of heroin with alcohol, something many heroin users may not be aware of — since useful, non-judgemental information on heroin use tends to be embargoed from morally upstanding venues. Hart cited a female friend of his who had died this way. You got the sense Hart was a man swimming upstream against a powerful current of cultural ignorance, erroneous assumptions and lynch mob minds.

“People are conflating a number of things,” he told Hayes. “This is part of the problem. This is part of the ignorance that the public has.”

It seemed to me he desperately wanted to get beyond the stereotype of heroin users as filthy pariahs. The fact Hoffman was so public and so successful made him a very potent exception to that stereotype, which turned him into the spark that set off the lynch mob talking heads. The demons have brought down a prince among us! They must be stopped.

Dr. Hart’s approach is in line with classic harm reduction thinking, harm reduction being the much-researched counter-approach to attacking the problem of drugs with police, courts and prisons. Harm reduction, instead, advocates the employment of medical and social forces. Humanization versus demonization is the thrust, and education is one of its major tools. The trouble is, whether one feels we live in a police state or not, it’s a call for vengeance at the hands of police, courts and prisons that the most sensationalist and loudest zealots direct their rants toward when something like the Hoffman death occurs.

It seems obvious from all reports that Hoffman, a father of three young kids, was pretty screwed up. It also seems safe to say that all the experiences and suffering he must have gone through in his life amounted to fodder for this extremely talented man’s art. No one could better play lowlife cruds and make you care for them than this man. He also seemed to intimately understand the intricacies of human power and weakness, something he put on display when he played a charlatan in The Master, a film the circumstances of his death make me want to see again.

Some years back, I spent time shooting intimate portraits of heroin addicts on the streets of Philadelphia. I did it in conjunction with a controversial needle exchange group that sent good-hearted people to pre-announced places where addicts could exchange old needles for fresh, sterile needles. The point was to prevent health problems from unclean needles.

As with the lynch mob talking heads, some people found this enterprise to be abominable. How dare you go out and encourage drug use by providing paraphernalia. Providing needles to addicts was the work of the devil.

During that episode I’ll never forget the woman I met in her fifties who worked for the needle exchange group. She had been, and I suspected may still have been, a heroin addict. She said addicts get to the point there is no pleasure in the drug. Your physiology has been changed, and the heroin becomes like insulin to a diabetic: Something you just need to maintain life. She may have been one of the dirty little secrets the media does not talk about, a maintaining heroin addict. Someone with a hard-earned maturity who has figured out how to take the heroin he or she needs and how to do it while maintaining a responsible, working life.

No mainstream media enterprise can profile such a person for two reasons: One, it goes against the culturally mandated image of heroin addicts as filthy pariahs, and two, what heroin user in his or her right mind would agree to be so profiled in the police-saturated climate we live in. The only alternative we have is for fictional scripts and great actors to portray such a person. As perverse as it may seem, we have to believe Hoffman would have been powerful portraying himself in his last days.

Like all the classic tragic roles of the acting trade, he made his own decisions in his life. Did he have accomplices in his downfall? As in all theatrical tragedies, life is pregnant with human interaction. But if those who sold him the drug that killed him were, like most drug dealers, following the rules of free-private-enterprise, they certainly did not wish to kill him. People in business don’t kill those who buy their product. In fact, they tend to do the opposite. Like the Addvie Pharmaceutical Group, they tend to encourage the buyers of their product to stay healthy so they can buy more. The worst you can say about dealers is, like pharmaceutical corporations, they’re enablers, not educators looking out for the best interests of their consumers.

I would not attempt to speak for Philip Seymour Hoffman. But I will say this about the notable rise of heroin use these days in America. This is an incredibly demoralizing time in America, and sometimes it’s natural to want to just make it all go away for a while. Again, this story is about a human tragedy and, from the point of view of film lovers, a great waste. From Hoffman’s point of view it was about something else only he could explain. It seems to me we owe him the respect to just leave it at that. Unfortunately, we don’t have the benefit of his great acting to provide us a window into his inner life and motives.

To emphasize Dr. Hart’s point about education, Hoffman may simply have been ignorant about the physiological realities of what he was doing to his body and how he was risking the life of his children’s father. I cannot but believe he would want his death to be a catalyst for greater understanding. It’s clear from his work that’s the kind of man he was.