On a bitter cold afternoon in front of the central bus stop in Bangor, Maine, about a half-dozen people recently surrounded a folding table covered with handmade signs offering free clean syringes, coffee and naloxone, the drug also known as Narcan that can reverse an opioid overdose.
They're with a group called the Church of Safe Injection that is handing out clean drug-using supplies in cities around the U.S.
Even though they could be arrested for doing so, volunteers say they have to step up because of the staggering number of opioid overdose deaths and because the public health system has failed.
"There are all these barriers to people getting well — like insurance and treatment rules," said one of the Bangor volunteers who goes by the name Dave Carvagio, though it's not his real name. "It's to the point where, for some people, the only treatment options are in institutions like prison."
Carvagio doesn't want to be identified because it's illegal in Maine to have more than 10 hypodermic syringes unless you're a certified needle exchange. Police cars sometimes circle the park, but no one has been arrested — yet.
"I believe that there is not just like a moral duty to violate unjust laws, but in this circumstance a spiritual duty," Carvagio said. On this day, they gave out 100 syringes, 10 naloxone kits and made one referral to treatment.
Bangor police Sgt. Wade Betters knows about the group. He says he'd like to sit down and meet with the volunteers, but he believes their focus should be on getting people into treatment.
"You know, if you're committing a crime in the state of Maine, you could be subject to arrest or ticketed," Betters said. "But in these cases, we use a lot of discretion because the goal is the same — to save lives."
In Lewiston, Maine, police have taken a different position. They've warned the group not to give out clean syringes in a local park because it's against state law. So the group members have arranged to meet with people and bring the supplies to different meeting spots.
Driving through Lewiston one night, in a car packed full of boxes of syringes and other drug-using equipment, Kandice Child met up with two young men standing near a convenience store.
"I'm going to give you 100 [syringes]," Child told one of the men. "What about alcohol wipes, you need any of those?"
Child gave them naloxone and test strips for the powerful opioid fentanyl. She says she only gives clean needles when someone returns their used ones so as to help keep syringes off the streets. Child says she does this because she has a family member who is struggling. She also says there are only six certified needle exchange programs in Maine, none in Lewiston.
"Why wait?" Child asked. "Should we all sit around and talk and point fingers or should we get off our a-- and do something about it? This helps, it works, it saves lives, it reduces HIV, it reduces hepatitis, and it keeps syringes off the streets."
Next stop was an apartment where three people were waiting to trade containers filled with used syringes for clean ones. Another volunteer demonstrated how to use naloxone as Child filled out paperwork keeping track of what she's handed out.
A 36-year-old man — who didn't want his name used because he's using drugs — was uneasy. He says he's glad to get the clean equipment but that he's conflicted about whether getting these supplies makes it easier for him to use drugs.
"The only reason I struggle is the inner conflict, you know? It's preventative maintenance yet at the same time it's enabling, you know?" he said.
A woman in the apartment, who also didn't want to be identified, chimed in: "I understand, but what are you supposed to do? If someone isn't able or ready to go to treatment — should they die?"
Even the founder of the Church of Safe Injection, Jesse Harvey, 26, acknowledges that he's struggled with the same questions. But he says working in addiction recovery has made him frustrated by the deaths and barriers to treatment. He says there are criteria to becoming a legitimate syringe exchange program that he's not likely to meet, so he started this church.
Harvey says there are now 18 chapters of the Church of Safe Injection in eight states — all of them funded by private, anonymous donations. Each one is independent but must abide by three rules: to welcome all people of all faiths, to serve all marginalized people and to support harm reduction.
But he says the group is not supporting legalizing drugs.
"We're not saying it's our religious belief to use heroin. No, not at all," Harvey said. "We're saying that it's our sincerely held religious belief that people who use drugs don't deserve to die when there are decades of solutions."
Harvey plans to register the church as a nonprofit and then argue for a religious exemption from drug laws. He says the U.S. Supreme Court has already ruled that a religious group is allowed to use the illegal psychedelic ayahuasca in its rituals.
"I don't think it's illegal, and if it is, I think we have a religious exemption here," Harvey said. "With the high rate of fatal opioid poisoning in Maine, why criminalize a group of people with lived experience who are trying to save lives? If the state is not going to do something about this, well guess what? We're going to."
Harvey says eventually he hopes to have a location for the church that will include a site where people could inject drugs under supervision. Such supervised injection sites are legal in some other countries, but Justice Department officials have warned that they will prosecute anyone operating one in the U.S. Nevertheless, at least a dozen U.S. cities are considering whether to open a site.
For now, Harvey says his congregants will continue to risk arrest to hand out supplies.
This story was produced in partnership with WBUR.
SCOTT HORSLEY, BYLINE: The staggering number of opioid overdose deaths in this country is prompting people to take action even when they could be arrested for what they choose to do. In cities across the country, a group called the Church of Safe Injection is handing out clean supplies such as needles for using drugs. They say they have to step up because the public health system failed. Deborah Becker from our member station WBUR visited some volunteers in Maine.
DEBORAH BECKER, BYLINE: On a bitter cold afternoon in a park in front of the central bus stop in Bangor, about a half dozen people surround a folding table covered with handmade signs. They're offering free clean syringes and naloxone, also known as Narcan, the drug that reverses an opioid overdose.
DAVE CARVAGIO: We have some safe-use supplies, which would be cookers, straps, cottons.
BECKER: This man goes by Dave Carvagio, even though that's not his real name. He doesn't want to be identified because it's illegal in Maine to have more than 10 hypodermic syringes unless you're a certified needle exchange. Police cars sometimes circle the park, but no one's been arrested yet.
Oh, there's a police car right there. Police ever stop and talk to you or anything like that?
CARVAGIO: There's one officer who's come and talked to us a couple times.
BECKER: But this time, the police car keeps driving. Carvagio's a member of the group called the Church of Safe Injection. He says its mission is to help prevent diseases and overdose deaths.
CARVAGIO: I believe that there's a - not just, like, a moral duty to violate unjust laws but in this circumstance a spiritual duty.
BECKER: Bangor Police Sergeant Wade Betters says the group's focus should be on getting people into treatment.
WADE BETTERS: You know, if you're committing a crime in the state of Maine, yeah, you could be subject to arrest or ticketed. But in these particular cases, we generally use a lot of discretion because, again, the goal is the same - to save lives.
BECKER: At the next stop in Lewiston, police have warned volunteers there not to hand out syringes in a local park, reminding them it's illegal. But that hasn't really stopped them.
KANDICE CHILD: There's one, two - there's three salines.
BECKER: Kandice Child is in a car packed full of boxes of syringes and other drug-using equipment. Child arranged meeting spots to give people their supplies. They stop at a street corner where two young men wait as she rummages through the boxes.
CHILD: I'm going to give you 100. OK. What about alcohol wipes? You need any of those?
UNIDENTIFIED PERSON #1: Yeah, actually.
BECKER: Child says she does this because she has a family member who's struggling. She also says there are only six certified needle exchange programs in Maine, none in Lewiston.
UNIDENTIFIED PERSON #1: Thank you.
CHILD: You're welcome. God bless you.
BECKER: Child says she's willing to risk arrest because she believes she's doing what government health officials should be.
CHILD: Why wait? Should we all sit around and talk and point fingers, or should we all get off our [expletive] and go do something about it? This helps. It works. It saves lives because it reduces HIV and reduces hepatitis.
BECKER: We head to a third-floor apartment where three people are waiting to trade containers filled with used syringes for clean ones.
CHILD: OK, so I've got 60. Do you want some fentanyl test strips?
UNIDENTIFIED PERSON #2: Please.
BECKER: A 36-year-old man who didn't want to be identified because he's using drugs is uneasy. He says he's glad to get the clean equipment. But he admits he's conflicted about whether these supplies make it easier for him to use drugs.
UNIDENTIFIED PERSON #2: The reason I struggle is this - the inner conflict, you know? This is preventative maintenance. Yet, at the same time, it's enabling, you know?
BECKER: Even the founder of the Church of Safe Injection, 26-year-old Jesse Harvey, admits that he's struggled with the same questions. But after working in addiction recovery, Harvey says he's become frustrated by the deaths and the barriers to treatment. Harvey plans to register the church as a nonprofit and then argue for a religious exemption from drug laws. He says the Supreme Court's already ruled that a religious group is allowed to use an illegal psychedelic in its rituals. And Harvey's quick to say he's not advocating legalizing drugs.
JESSE HARVEY: No, not at all. We're saying that it's our sincerely held religious belief that people who use drugs don't deserve to die when there are decades of solutions.
BECKER: Harvey hopes his church, which he says has 18 branches in eight states, eventually will have a location that will include a site where people could inject drugs under supervision. For now, though, his congregants will continue risking arrest to hand out supplies. For NPR News, I'm Deborah Becker.
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