Coke, Pepsi, or OxyContin.  Could that be coming to a vending machine near you?  Not yet, but the race is on in Philadelphia, San Francisco, and Seattle to see which American city will be first to radically advance the so-called "harm reduction" movement, which seeks to coddle drug addicts through programs such as safe injection sites.

Officials recently granted preliminary approvals of safe injection sites in all three cities – or, another way of putting it, safe spaces for shooting up heroin.  They are all inspired by Vancouver, Canada.  There, a person credited with establishing the first such facility in North America is now advocating for even more extreme measures to provide comfort and convenience for drug addicts.  Yes, the top health official in British Columbia is proposing vending machines to dispense opioid "painkillers."  Mark Tyndall, director of the province's Center for Disease Control, is suggesting not OxyContin, but another opioid painkiller he hopes will reduce abuse of heroin, fentanyl, and other more potent versions of the drug.

As the Canadian health official demonstrates, there is no limit to the lunacy of the harm reduction movement.  Encompassing needle exchange programs, which began in the 1980s, and fueled by the opioid epidemic today, harm reduction measures include various drug therapies and safe injection sites.  While Philadelphia, San Francisco, and Seattle are not yet proposing vending machines, they nevertheless hold up Vancouver as a case study in how to treat opioid addicts.

Official reports from all three cities essentially credit safe injection sites with saving lives because someone overdoses and keels over, and a nurse is on hand to intervene.  A report for Philadelphia cites the Vancouver facility, known as "Insite," where it is said the mortality rate is lower within 500 meters of the building.  One could make the same case for an emergency room or an ordinary drug rehabilitation center.  San Francisco's public health department credits Insite with adding over 1,000 "life years" to addicts, whatever that means.  Local officials in the Seattle area credit Vancouver with increasing awareness of the opioid epidemic because of its embrace of safe spaces.  

In Baltimore, the Johns Hopkins school of public health publishes "Harm Reduction Journal" to help professors keep up with the latest trends in excusing addiction.  The report also cites Vancouver, and its author asserts that "safe spaces help increase the touch point" with addicts, as if someone were caring for an infant.  A Maryland legislator who proposed a site in Baltimore, inspired by Hopkins's research, received a succinct rebuke from Gov. Larry Hogan, who correctly called the concept "insane."  Finally, here's a rare voice of reason, coming from someone who campaigned on the opioid epidemic in 2014, before it was in the headlines.

What all these studies have in common besides touting meaningless and contorted statistics, speculation, and groupthink, is that they repackage the same research.  It seems that merely labeling conclusions as peer-reviewed or evidence-based is all that is required to pass muster with some officials.

This research is driven by those with a vested interest in promoting themselves.  Philadelphia's "review of the evidence" report admits that the majority of the studies of the impact of safe inject sites are based on estimates from the Insite facility itself.

As for the so-called "touch points" that Hopkins envisions, this actually has potential to provide additional treatment and referral options for social services.  But it's nothing more than overpromising and underdelivering.  Nobody tracks data that show how many individuals achieved long-term recovery because they were able to shoot up in a supervised facility.  Vancouver's Insite started in 2003, yet we don't see any statistics on how many ended addictions.  Perhaps touch points really mean developing a feel-good narrative to advocate for more harm reduction.

If city leaders in Philadelphia, San Francisco, Seattle, and elsewhere are going to blindly follow Vancouver's lead in establishing safe injection sites, who is to say the same won't happen in establishing opioid-dispensing vending machines in the U.S.?  Surely there will be a study out about that, too.

By making too many promises and ignoring treatment options focused on abstinence and personal responsibility, we face the disturbing prospect of government making the opioid epidemic worse.  More politicians should question harm reduction before it harms the country.

Matt Mossburg, a former Maryland state legislator and recovering opioid addict, advises policymakers on treatment and recovery options.