Harm Reduction: A Unifying Movement

Harm ReductionWe'd been sitting in this room-the kind where the pale blue carpet matches the stackable chairs and the sound-proofing fabric on the walls-for over an hour. I had flown to Miami, FL for the 3rd Annual National Harm Reduction Conference and had spent the last few days wandering into this or one of the identical rooms lining the conference hall of the hotel. My schedule had been controlled not only by the conference workshops, but also by my hunt for coffee. At this point in the day (mid-afternoon), I was tweeky on too much caffeine and recycled hotel air.

One of the women in the workshop asked Rev. Sanders if he would lead us in prayer. He agreed and we made a circle, hand in hand, in the front of the room. It was the end of the Faith Community workshop, at a conference that joins people from a variety of communities and background to talk about drugs and drug use from a radical or "harm reduction" perspective. These conferences are some of only places you'll find punk kids, drug policy experts, Baptist ministers, active users, folks in recovery, and those who were interested in applying the theory of harm reduction to other health and social service workers all in one place. Once in the prayer circle, all of this hit me and overwhelmed me with joy. I was in awe that, despite the many divergent approaches to health, life and drugs there are, so many of us could come together, not only with a religious and spiritual openness, but with a dedication to harm reduction.

Harm Reduction is an approach to drugs and the people who use them that meets drug users "where they're at," addressing all the things that go along with the use itself. (Read the Harm Reduction Coalition's definition.) Harm reduction says that while drugs individually have some harms, they are often outweighed by the harm caused by mis-education, the criminal justice system, and the underground nature of drug use. The harm reduction movement aims to address all of these harms and, as its title suggests, to reduce them. The Conference is a way for people from around the country to come together and share information and experiences around incorporating harm reduction into their lives and work.

Harm reduction is a philosophy but it is also a growing movement, a way of connecting those who have often had very different opinions and approaches to social change. When the Harm Reduction Coalition (HRC), a non profit organization out of Oakland, California and New York City, put the conference together each year, they are joined by organizations like the American Foundation of AIDS Research, Dancesafe, and the Center on Crime, Community and Culture. People like Rev. Sanders are helping Harm Reduction become one of the fastest growing and strongest threads in the Progressive Movement, and are taking it beyond reducing the harm of drug use itself, to being a source of inspiration and action to increase health and justice for people from a variety of lifestyles. This year the conference drew 1500 people from all over the country, and a number of those were youth and youth allies. The HRC works to ensure that those who are most affected by the issues can be there, including drug users, people of color, people with HIV and/or Hepatitis, and front line workers from small community-based agencies.

What brought me here? I have became familiar with the term "harm reduction" through my work as a youth health educator, and intimately connected with what it means in my work doing needle exchange. I liked the way harm reduction steers away from the hypocrisy of other attitudes toward drug users by acknowledging that drug use has always been a part of being human and that people shouldn't be punished for it. I was here because I believe it is the best approach, the only real approach for most young people to take control of their relationships with drugs-whether its about their own use, or the way they look at it in the context of the culture in which they are growing up.

"I was here because I believe [Harm Reduction] is the best approach, the only real approach for most young people to take control of their relationships with drugs-whether its about their own use, or the way they look at it in the context of the culture in which they are growing up."
Needle Exchange: a Practical Example

Needle exchange is probably the most well known and most controversial example of harm reduction. In San Francisco, I volunteer for one of the country's only government supported (locally) needle exchange sites. The basic idea behind needle exchange is that allowing injection drug users to exchange their used needles for new ones stops the spread of HIV and Hepatitis. It is also a way to make sure that used needles end up in sealed containers where they can't endanger others. Every Wednesday night, I leave work and head to a social service agency, which has rented us a little space, once a week, as an exchange site. At about 10 minutes to 6pm, I walk up a deserted street and help pull boxes of needles and supplies and red biohazard waste buckets out of the van. People are usually already waiting outside and come inside with us to wait while we set up. They first drop in their used needles into the bio-bucket while we count them. We mark the number of needles they exchange and the number of people they are exchanging for. Some people exchange 5 a week for themselves. Some people exchange 120 for themselves and their partner. Some people exchange for over 5 people, bringing in over 600 needles at a time. We then give them needles in exchange as well as new supplies associated with injecting: cotton to draw up cooked dope, bottle-cap-like cookers, latex tourniquets, and sterile water, all of which could transmit something if they were shared.

We get some people walking off the street as if by chance, and for others, this is part of their regular routine, like grocery shopping. Some people walk in high; others are just in a hurry to make it to the night shift. We have several people who are on methadone treatment and no longer shoot heroin themselves, but who exchange needles for their friends or family to keep them from getting HIV. Some people take an HIV test-there is a counselor there every other week. Some people ask for information on treatment programs but many do not. All of these parts of our needle exchange site help improve or maintain the health of injection drug users and their families and communities.

Questioning the Messages

Like many people in my generation, my relationship with drugs and harm reduction really goes back to high school. When my friends and I started making decisions about using drugs, I knew that we weren't getting all the right information. We were smart enough to see that the lines between legal and illegal drugs, prescription and "street" drugs, were often arbitrary if not hypocritical, but we had no way of finding out the real risks of the ones we were told to avoid.

By our senior year, my friend Marilyn, who had been the vice-president of the Just Say No club in the 8th grade, was dropping acid every few weeks. I had heard that this would seriously damage her brain, but she seemed fine. I had also heard that people, while tripping, would have great spiritual revelations that would turn out to be meaningless or incoherent when they came down from the trip. But Marilyn's were actually very valuable to her, and continued to be so when she was sober. My friends and I thought it wasn't smart to use alone. But Marilyn said that was part of the beauty of it. I was sure that if I could just find the right information my fears would be calmed, but no one I knew seemed have it.

When I became a peer counselor on a hotline for teen-agers and young adults, I thought even more about drugs and hypocrisy. We got some calls about drug use, but our biggest concern was that people would call to talk to us while they were high. When I started there was a policy that we weren't supposed to talk to people if we knew they were using drugs. A group of us decided to re-visit that policy. We knew that some people would be too scared to even pick up the phone unless they were on something. Even though we'd rather that people could talk about the hard stuff in their lives without using, we also knew this wasn't always realistic. We agreed that having a safe place for people to talk about their families, school harassment, suicide, and sadness was more important than policing their drug use. If they wanted to talk about drug use, we could do that. It was clear to us, though, that most of our callers had a long list of worries and questions, and hat drugs were usually toward the bottom of the list.

"When my friends and I started making decisions about using drugs, I knew that we weren't getting all the right information."
These experiences made me increasingly critical of our country's official stance on drug use. Drug education as it existed when I was in most high schools is not very effective. "Just say no" isn't education at all; it is propaganda. Education would give the best information possible, encourage critical discussion of the topic (from drug company advertising to the ways we dull pain or increase pleasure to the War on Drugs) and help people form their own opinions. Abstinence-only drug education does none of this. It rarely engages young people into really thinking about and knowing about drugs and their effects. As it stands now, the goals of most drug education programs are wrong. "Just say no," or the abstinence approach, may scare some young people away from experimentation, but it's been proven that youth who have freedom to experiment safely are not usually the ones who deal with addiction later in life.

The "just say no" line is impossible to draw. What about a glass of wine with dinner? What about ibuprofen for menstrual cramps? What about St. John's Wort for depression and anxiety? What about a double espresso? How do we realistically just say no when we can't even clearly define a "drug"?

Just as the schools and institutions fail students so often, the criminal justice system fails the residents of this country. As the system disproportionately targets poor people and people of color, so too does the War on Drugs. (To learn more about the War on Drugs, read How the Drug War Harms, Not Helps, Kids and A Strange Time in the Drug War -- Youth Feel the Heat.) Harm reduction is an alternative to this abstinence-only-or-if-you-get-caught-incarceration-only approach. What does this mean, practically speaking? One example is real drug education that gives accurate information and allows people to make their own decisions. Individuals can use harm reduction in their own lives too, for example, reducing the number of alcoholic drinks that one consumes each Saturday because three inevitably leads to a hangover but two doesn't, without stopping drinking entirely.

What draws me most to the movement is its broad understanding of health. Health is not just about being disease free nor having access to the best treatments for disease; harm reduction acknowledges that health is having control over one's own life.

That's why I was sitting in that blue-carpeted room, saying a prayer for healing the people who have been harmed by the Drug War, by HIV/AIDS and Hepatitis, by the criminal justice system, and by mis-education. Finally, I was at a health conference where all the injustices I see in the world were discussed and their connection to health made clear. We freely talked about US imperialism and militarism, the prison-industrial complex and its racism as well as the economics that fuels it. We looked at ways to apply harm reduction to sexuality and sex education, which is also taught from a primarily abstinence-only standpoint, and the way our culture's inability to discuss sex and safer sex openly leads too many people to make decisions that put them at risk for HIV.

Reverand Sanders connected harm reduction (needle exchange) and spirituality in a non-judgmental way. He talked about how to introduce the concept of harm reduction into other faith communities. This was refreshing because so many people associate religion with extremely judgmental, right wing views on drugs and the people who use them. "Read the pamphlet that defines harm reduction," the reverand boomed in his black church pastor rhythm, "and you will find that it fits right in with their religious teachings in their church."

I had already experienced many amazing and inspiring moments at the Harm Reduction Conference, but Rev. Sanders was the one who pulled it all together for me. He gave the closing speech calling us to continued action in our harm reduction work and to recognizing the power of this movement. He pointed out that harm reduction ties together issues that progressive people have been trying to connect for a long time. It's tiring to see the way progressive people are divided and can't get a unified political movement together. As part of the next generation of voters and activists who believe that harm reduction poses a realistic, human solution to so many of our personal and societal crises, I was inspired to hear Rev Sanders say "this is THE MOVEMENT." He articulated the feeling that had been growing in me from long before the conference. The things that bring people to the Harm Reduction movement, like my own search for ways to connect spirituality, health and justice, have the potential to bridge other gaps, and to unify us in other ways.

Jes Meyer is currently a health educator, writer and editor for Health Initiatives for Youth (HIFY). She also has a spotted cat named Sugar.
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