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Opinions on Harm Reduction Initiatives

There is an article in my newspaper today regarding the battle brewing over harm reduction intiatives - programs that provide clean needle kits, crack pipes, etc. to addicts to prevent the spread of disease.  There is one site in B.C. that provides public health nurses to assist with injecting safely and is admittedly very controversial.  The funding for these come largely from the province (this is Canada, so the equivalent of a state government in the U.S.)  

This approach is very controversial of course.  It's seen by some as perpetuating the problem rather than addressing it.  By others, it's seen as limiting the damage that would be done otherwise.

Tough thing to ask here perhaps.  Wondering if anyone has opinions on whether this is a regrettable necessity or if it is a misguided effort to do the right thing but in the wrong way.  

Since I'm asking .. I'll state that for myself, I'm perplexed by the whole thing and it seems as if in preventing one problem, the spread of communicable disease, we're prolonging the other problem, substance addiction.  However, there's still much I don't grasp on this and wondering if others have thoughts they want to share on this.

Hoping we can keep this respectful to each other.

Trish
26 Responses
220090 tn?1379170787
I think the vast majority of people will never become drug addicts no matter how easy it is to get needles.  I don't think access to needles is the gating factor to using drugs for anyone.  So the question becomes will a small group of people that would not normally use drugs start using drugs if needles become readily available?  I doubt anyone could come up with hard facts to answer that question - at least I couldn't.

My own belief is that not a singe person will start using drugs because the needles are legally available and many lives will be spared.

Eric
148588 tn?1465782409
Please clarify how you see this is "prolonging the other problem, substance addiction."
96938 tn?1189803458
A very long time ago there was a different person inhabiting my body, he's long gone but he left a few reminders of his occupation, one being hcv.  Back then, that guy would survey the landscape for what he needed.  Once found, whatever the place and whatever the conditions, he'd take matters into his own hands and arms. Burned out shooting galleries, little light except for those bunched matches under the bowl of a spoon and cellulose from a cigarette filter.
That guy would never turn to his cronies and say, 'hey, let's go over to 125th St, they've got a neat place with flouresscent lights, new works and some help'.  No, never would.  At that point the guys were invincible and even if they weren't they didn't care.
I think this world needs a little less enabling.
I read the BC article you mentioned and remember thinking at the time that the program was designed to give the those who thought of it a warm and fuzzy feeling for reaching down to the poor miserables of the world.  The miserable have greater needs than a clean set of works from the government.  What they need cannot be provided by a government at all.
Avatar universal
I agree completely with Eric.
I will also point out that this subject doesn't seem to fit the description found at the top of the page which clearly sets forth the subject matter that is appropriate for this side of the board. I hope I am not being disrespectful by pointing this out to you. Mike
Avatar universal
Eric:  I'm not suggesting nor do I think that providing clean needle/crack kits is a "gateway" activity.  I really don't think someone will decide to shoot up (is that an older term?) because they can get a free needle kit to use.  These things are going to people who are already well into using.  If they were going to "newbie" drug users, frankly, I'd be really p.o.'d by that.  Yes, it will save lives.  I guess .. what about the life of that drug user?  Sacrifice his life to save others?  Perhaps it's saving his/her life also to at least provide clean paraphernalia.  Some things are lesser shades of evil rather than being good.  I don't know.

dsrt:  "Please clarify how you see this is "prolonging the other problem, substance addiction."

I said "seems as if "and that really is more of a question on my mind, IF this prolongs substance abuse.  Seems to me .. that if you can make substance abuse more of a comfortable experience where you get friendly chat, a sandwich and a coffee and a clean needle kit for dessert, you make it almost a social event OR you get people who .. sure, they'll take your paraphernalia and not have to rustle it up themselves and whatever else you've got to give and carry on.  Whether it actually contributes to helping anyone get OFF the drugs .. I don't see it.  Perhaps though that's why they call it harm reduction.  Maybe that's all they're trying to do.  Reduce harm.  If they can't get people off the drugs and keep them from killing themselves that way, then perhaps they can reduce the spread of communicable disease at the least.  I don't know.  I don't know how I feel about this and I only have my limited perspective to go on....and felt others opinions would broaden my insight on this.  

FlGuy:  I appreciate your bravery and honesty.  In another life, the person who used to inhabit this body, stole the needle sharps from the doctor's cabinet at each visit while waiting for him, until he got wise and locked his cabinet.  This was, however, only for comparatively benign shooting up but enough to perhaps get that person her HCV.  Even with that comparatively benign sort of use, I don't think any of us would have gone to a government program for our supplies. I appreciate your perspective.  Perhaps that's why they're now going to mobile programs, they'll now bring the kits TO the user.  Seems to back up your assertion that the miserable have greater needs than a clean set of works from the government or they'd go and get them rather than the government resorting to delivery.  I want harm reduction .. but am having a hard time with this being the right approach.  However.  Now they have mobile needle exchange programs that are almost downright homey .. at the recent HCV workshop I attended for service providers, they were joking about how pleasant and approachable the one program's van was and they wanted one like that.  I dunno.  

That's where I'm at. I know I lack enough insight on this and I'd like to understand the implications of it better, both pros and cons.  My mind is open and that's why I asked the question. I'd really like to have a better grasp on it.

Trish

Avatar universal
MS:  I will also point out that this subject doesn't seem to fit the description found at the top of the page which clearly sets forth the subject matter that is appropriate for this side of the board. I hope I am not being disrespectful by pointing this out to you.
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Hey Mike, Thanks for the comment.  I actually never comprehensively read those descriptions at the top of each forum until reading this comment from you.  I guess I don't find it clearly setting for the subject matter that is appropriate for each side of the forum as you do.  In each case, the wording is identical except for the following:

On the Social side:  If you have a medical question, comment or research study pertaining to Hepatitis, please post it in our Hepatitis Forum

On the Hepatitis C side:  If you would like to communicate with other people who have been touched by Hepatitis, please visit our new Hepatitis Social/Living with Hepatitis forum.

In light of that, I'd have to say that my post is a "comment" AND a "study" pertaining to prevention of Hepatitis C .. seems entirely relevant on this side and that's why I posted it here.  Seems a rather heavy topic for socializing over.

I find it a bit ambiguous really, which side to post on and it gets a bit blurry knowing whether something is considered social or less so .. just as it's blurry knowing whether a comment someone makes is sincere or facetious.

And no, it's not disrespectful of you to point that out to me.  Thanks for your thought, Mike.  Considerate of you.

Trish
408795 tn?1324939275
Wow!  Hot topic, very interesting, I have frequented Harm Reduction Services in my area as they have very good and caring doctors/interns.  With that said, I even used to get syringes from their underground needle exchange before that program got the blessing to do it above board.  Of course I don't need their services any longer but I am glad they exists.  With that said, free crack pipes!!  I don't think they do that in my area and I hope not.  Guess I'll have to Google away cause I'd like to read that story.  In closing there was one lady in my area who someone would contact when they needed syringes and she would stop by your house and give you some.  It was set-up on a two-for one idea but if you didn't have any to give her she would gladly supply you with them.  I didn't see anything wrong with that, the sad thing is that "angel", of a lady got arrested for doing that.  Of course that was prior to the (above board), blessing and implementation.  Anyways, like I was saying I need to get off of here and go read the article.  Free crack pipes!!  Yikes!!  Good post Trish and God Bless.
Avatar universal
IF the question I've posted is too personal for some to discuss out in "public" so to speak but you wouldn't mind discussing it with me in private, please, do email me here.  

Regards,

Trish
Avatar universal
I should have checked if the article was in the online edition of the newspaper and it is:

http://www.nationalpost.com/todays_paper/story.html?id=411240

Avatar universal
Fret, if it's not too intrusive to ask this ... after reading your comment, I'm wondering if the contact with "warm and caring doctors/interns" eventually contributed to you or others you knew eventually getting off the drugs in some way?

You were glad these programs existed.  Because it was at least less harm?

Can I ask you .. do you think this kept people ON the drugs longer because it made it easier to keep using them (that is what I think opponents of this think and I admit, I wonder or am concerned about that myself) or do you think they would have stayed on just as long only used drugs in more unsafe ways?

I very much appreciate your contribution to this thread, Fret.  Thank you.

Trish

408795 tn?1324939275
I don't think their services affected my using one way or the other as I went there very seldom.  Also I usually bought my own syringes and I got them from HRS very seldom,  but there was a small window of time, when I did utilize their services and was glad they were there.  They don't just provide medical care for drug addicts, they provide health care for all people who are in need.  Do I think it prolongs others' addiction, that's a good question, I believe the answer is no, at least it was "no", in my case.  About the free crack pipes, I just looked at my local area site and that would be very counter-productive as the HRS in my area is located in a "ghetto", part of town.  In fact one of the sleaziest parts in Northern CA, and it's well known that there's loads of crack and crack heads around that area.  Another thing is I have never used crack cocaine in my life, ever.  Also, I couldn't be around them even years ago in my active addiction and I surely wouldn't be around them now.  I can't say it's better to be this kind of addict rather than that kind of addict but I have a brother who uses that krap (crack), and it has reduced him to a total sleaze, and unfortunately a mindless person.  He wasn't that bad on other drugs, I hope this helps as once again I have spoken tooooo much.  Only for you, Trish.  
God Bless  
372366 tn?1284407473
Eric hit it right on Trish.
  Ten users sittin round an ounce of coke, pulled from someones "A" hole and only two fits among them selves, no one will leave for clean fits, they're freaks. Maybe they'll due without smokes even untill a cab is called to deliver some.
  Get this,hours later a knock on the door, ten paranoid jacked up freaks try to find a way out of the appartment,some are clawing at the exhuast vents till their fingers bleed, others hidin in closets, some are climbin over the balcony and jumpin to the one below, while one guy is wrappin the rest of the bag up in tape to hide in his hooper, another mixes up whats left layin round quick like, for one last one before the bust, and picks up a fit from the floor still red from the last user. One brave sole looks out the peep hole with his glock ready, it's the friendly neighborhood needle exchange lady come to save their soles.LOL
  That needle exchange lady can not reach the users that are'nt on the "street"!!! Most hide because it's illegal. If most or even a few don't always get clean kits then it's a bust, the virus's wins again.
  Just had to put this in perspective, they're junkies, they have a deeper than life it's self need to get the rush again, clean, used, dull or found.
  In Canada the liberal thinking "FUZZY" types are tryin to ban hand guns, because of gang warfare. Hand guns are banned now!!! The black market that brings in everything from fake CDs to sex slaves, continues on because the Fuzzy types want to feel good and tell the neighbor they did good by ignoring the root causes.
  Even after 911 and the tightening of the borders, the black market continues, in fact heroin is flooding the streets, and as a result it's cheaper than ever and most comes from  Iraq!!! Hows that possible????????
  It's the illegal importation of drugs that is the issue, no drugs, no gangs, no gang killings, no junkie freaks robin and stealin and wasting the cops time, no junk to spread the virus's.
That is the root problem!


Just my perspective.

Harry

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