will improve the efficacy of both SSE and SEP work. Acknowledging SSE and incorporating the work of SEPs into SSE work is practicing true harm reduction – meeting folks where they are at, respecting the rights and abilities of drug users to make decisions and take action, and creating and sustaining an environment in which folks can use drugs safely, without justification or explanation to anyone. Political, bureaucratic or ideological pressures can sometimes make it easy to gloss over the fact that the goal of more IDU contact with the SEP often equates to more control for the SEP and more chances for the SEP to get IDUs to adopt the SEP agenda. The unfortunate truth is that the more IDUs that SEPs can get into medical care or drug treatment programs, the more political support and money programs will get and, in turn, there will be less opposition to SEPs in general. These are not “bad” or inappropriate goals per se. However, when these goals are not made explicit, then the related power and control issues aren’t out in the open and therefore rarely get discussed, let alone negotiated and/or accounted for. So as harm reduction service providers (researchers, policy makers, and activists), how do we hold each other accountable to the “uncomfortable” issues? How do we call organizations or individuals out on issues without being threatening or disrespectful? How do we operationalize the tenets of harm reduction while still satisfying the bureaucratic, political, and funding, etc., needs? I believe the creativity of harm reduction “solutions” is formidable and amazing. SEPs are one example of this creativity. Overdose prevention and response programs are another
example of harm reduction “solutions” that not only have saved thousands of lives, but have contributed to renewed self-confidence and sense of community for many IDUs. Let’s use harm reduction’s creativity to address the problems of reporting requirements, evaluations, and paperwork in all its manifestations. Let’s also use that creativity to acknowledge and address the power differences and various frames of reference of those involved in harm reduction programs – whether it be participants and providers, women and men, younger and older, management and line staff. I do believe in harm reduction practitioners’ creativity and our ability to implement inspiration. I do believe we can and will challenge the many ways we get trapped by oppressive or stigmatizing barriers. And I do believe we can and will help this movement grow so we can finally rid ourselves of the current draconian drug policy and welcome an approach that enhances quality of life for drug users and their communities.
Rachel Anderson is a long-time advocate for the human rights of drug users. She has worked as a drug treatment counselor, an epidemiologist at the University of California, Davis, and Executive Director of Safer Alternatives thru Networking and Education (SANE) [cleanneedles.org] since 1993. She also has provided technical and political assistance to emergent syringe exchange programs in several Eastern European countries and currently is working on a multi year project to improve services for women at Ukrainian syringe exchange programs.
References 1. Anderson R, Anderson F, Clancy L. A thriving support network: the how and why of one community’s experience. Paper presentation, 8th National Harm Reduction Conference, Austin, Texas, November 2010. 2. Winkelstein E. User-to-User: PeerDelivered Syringe Exchange in New York City. Harm Reduction Coalition. 2011. issuu.com/harmreduction/docs/ user2user/1 3. Anderson RL, Clancy L, Flynn NM, Kral A, Bluthenthal RN. Delivering syringe exchange services through “satellite exchangers”: the Sacramento Area Needle Exchange, USA. International Journal of Drug Policy. 2003;14(5/6):461-463. 4. Whitteker, B. Personal communication with Mr. Brent Whitteker, Executive Director, San Diego Clean Needle Exchange. February 4, 2002. 5. Anderson R, Flynn NM. The Methamphetamine-HIV Connection in Northern California. In Amphetamine Misuse: International Perspectives on Current Trends. Klee, H ed. 1997 Harding Press, Reading, England 6. The Australian Injecting & Illicit Drug Users’ League (AIVL) [aivl.org.au]. 7. Costa K, Campbell J, Chapman K, Coats W, Gaughran C, Hoffman K, Nall D, Rautiainen R, Taylor D, Wally G, Clancy L, Anderson F, Anderson R. Harm reduction, satellite syringe exchange, and advocacy: my journey in the trenches to empowerment. Paper presentation, 6th National Harm Reduction Conference, Oakland, California, November 2006. 8. Lorvick J, Bluthenthal RN, Scott A, Riehman K, Anderson RL, Flynn NM, Kral AH. Secondary syringe exchange among users of 23 California syringe exchange programs. Substance Use and Misuse. 2006;41(6/7):865-82. 9. Small D, Glickman A, Rigter G, Walter T. The Washington Needle Depot: fitting healthcare to injection drug users rather than injection drug users to healthcare: moving from a syringe exchange to syringe distribution model. Harm Reduction Journal. 2010 Jan 4;7:1.harmreductionjournal.com/ content/7/1/1
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