This past November, Spare Change News participated in a collaborative article with the Street News Service on harm reduction. For part of the article, which was written by Katie Hyslop, Spare Change interviewed Allan Clear, Executive Director of the Harm Reduction Coalition. The Hrc is a national organization that provides education and training in harm reduction counseling techniques, safer injection techniques hepatitis C, mental health, or even how to prevent a drug overdose. While several of his quotes were used in Hyslop’s article, the interview is featured below.
Spare Change News: What does harm reduction mean?
Clear: Harm reduction for me is a philosophy. It’s a way of thinking about how one uses drugs. What we do in this country is we make drugs as unsafe as they possibly can be, and we do that through laws, which means that if you get busted with drugs you go to prison for a long time. And that’s designed as a deterrent to make people stop using drugs, which obviously it isn’t. We do things like take syringes out of circulation, which has caused epidemics of hepatitis and HIV. So harm reduction is a way of trying to make drug use safer for people who use drugs, without demanding that they stop using drugs. So it’s philosophical like that, but then there is also harm reduction services, such as syringe exchange, overdose prevention, dug testing, pill testing. If someone is going to use drugs on a Friday night, you’d like to know what your going to put into your system, safe injection facilities, a place where people can go and inject drugs under the supervision of medical staff. Prescription heroin is also classed as a harm reduction intervention.
It’s also something that drug users do for themselves, it’s not something you can make someone do. You give someone a set of options and then they apply them themselves. You can’t make someone use drugs in a certain way.
SCN: So this isn’t something a court could order someone to attend?
Clear: No, it would be good if it was a diversion program, because if someone could go and volunteer at a harm reduction agency or a needle exchange program or something like that, that would be a good thing.
SCN: What legislation has been passed in terms of harm reduction, and what positive and negative effects have they had?
Clear: Well, one of the things that has been really good, well this year really, since last December is that the federal ban on funding on syringe exchange was finally removed, which means, theoretically, that state departments of health can now allow people they fund to use federal money for syringe exchange. Unfortunately it hasn’t really happened yet. No state is actually doing it because they are still waiting for guidelines from the federal government. So that’s been a really good one. I think that state laws that change access to sterile injection equipment have been very good because that’s changed the face of the HIV epidemic and hopefully will have an impact on hepatitis C, meaning that it’s easier to obtain a syringe from a pharmacy now then it used to be for a few years.
SCN: Could you elaborate on that?
Clear: It used to be, like in New York City or in New York State for example, you could not purchase a syringe at a pharmacy, and you couldn’t posses it if you did have one. Changes in laws means you can go to a pharmacy and buy a syringe.
SCN: Have any other laws changed that you think have had a positive or negative impact?
Clear: Overdose laws have been changed so that users can a prescription of a drug called Naloxone, which is a heroin antidote. So if someone is overdosing on heroin then they can be injected with this drug Naloxone, and it will revive them.
SCN: That couldn’t happen before?
Clear: No, the problem is that most drugs are prescribed to be used on yourself, so with a drug like Naloxone you will be unconscious when it happens and someone else has to use the drug on you. So there has been special exemptions made so that prescription laws can be changed so that you can be prescribed Naloxone and use it on someone else.
SCN: With the changes in legislation, have you noticed more needle exchanges forming?
Clear:I wouldn’t say a lot more have popped up recently, and actually the economic times we’re in, we’ve seen a few of them go away. In most ways it’s been stable for the last few years. There’s around just over 200 programs in the country, but I think that the older ones, and the bigger ones are very solid in the sense that they are full fledged social service organizations. And I think that the changing in the legislation around the federal ban on the funding on needle exchange means that some of those programs that have been around for a while, but have not strictly been legal , will be tolerated a lot more by their local health departments. Hopefully we can build upon that, and then they can get funding and be legal and everything.
SCN: Over the past five to ten years have you noticed a change in public perception towards needle exchange programs?
Clear: The funny thing is that topic opinion polls, the few that exist, have always been pretty consistent that the general public actually supports them. It’s not overwhelming, but they are pretty consistent. It’s something like 55 to 45, or 42 to 48 in favor of syringe exchange programs. The general public has always been fairly supportive, especially is it’s explained what they are for. Mostly, the controversy comes from the level of our elected officials who oppose needle exchange, and also of course they drug free America type organizations who either don’t understand the science or are unwilling to accept the science, basically on moral grounds, grounds of morality. So that’s where we often get the opposition from. The opposition is usually not based in science, they are usually based on personal opinion, and that’s the battle, because when people say it encourages drug use, there is no actually scientific evidence that it does do that. But people hear that, and they say well, there is something here, and there is nothing there that backs that up.