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WHAT ARE AMERICA’S MOST HARM REDUCTION-FRIENDLY CITIES?

By Sarah Morris

Drug policy reform advocate Richard Branson once wrote that, “In business, if one of our companies is failing, we take steps to identify and solve the problem. What we don’t do is continue failing strategies that cost huge sums of money and exacerbate the problem.” Unfortunately, as debt and the death toll caused by drug abuse continues to climb, lawmakers have only just begun to identify and solve the problem caused by the War on Drugs.

However, one growing drug policy that has proven successful in countries like Portugal and the Netherlands may also soon find more prominence in the US. This method is called harm reduction.

“Harm reduction” refers to the political and public health movement aimed at reducing the harm caused by drug abuse. By promoting legal and political change, proponents of harm reduction wish to help addicts rather than stigmatize and criminalize them.

Less politically controversial harm reduction practices include increasing public awareness and providing education relating to the issues surrounding drug use and how to recognize and help someone who has had an overdose. However, harm reduction advocates also campaign to remove legal barriers and increase access to a variety of treatments and services. This includes:

-Safe needle exchange programs

-Testing and treatment facilities for diseases that are easily transmitted by certain practices related to drug taking, such as HIV and Hepatitis C

-Supervised injection facilities

-Treatment for addiction in a variety of forms, including medical and counseling and

-Alternative, legal drugs such as methadone or buprenorphine as a substitute for heroin use

So, which US cities are doing the most to promote these issues? In no particular order, here are TRE’s eight most harm reduction-friendly cities…

SAN FRANCISCO AND OAKLAND, CALIFORNIA

It’s unsurprising that the number one spot goes to California, well-known for its left-wing politics and liberal stance on a variety of issues. We realize it’s a bit of a cheat lumping these adjacent cities together, but since their approach is so similar it only made sense to do so.

With syringe exchange programs, legalized purchase of needles without a prescription, and of naloxone (an antidote for heroin overdoses) for people likely to be in the presence of an overdose, California has some of the most progressive harm reduction laws and policies within the US. Moreover, since 2012 the law has been amended so that life sentences are no longer mandatory and automatically imposed for those convicted of three or more non-violent drug offenses, and those incarcerated for life under the old law can apply for a new sentence.

There are in excess of 25 independent harm reduction centers across the two cities, providing a variety of services from counseling and homeless services to HIV and hepatitis C testing and treatment.

LOS ANGELES, CALIFORNIA

In addition to the state-wide points above, the District Attorney from LA, along with DAs from three other counties, advocated for the recently approved California Fair Sentencing Act, which brought sentencing for crack cocaine offenses in line with those for relating to powdered cocaine.

In addition to various other harm reduction centers, LA is home to the Los Angeles Regional Reentry Partnership (LAARP), which describes itself as “a network of public, community and faith-based agencies and individuals across Los Angeles County, focusing on the successful reintegration of previously incarcerated men and women back into their communities.”

Since statistics show that approximately 53% of the USA’s federal prison population in 2007 had been remanded for drug offenses, services such as LAARP could have an extremely positive impact on these people once released by providing support with housing and employment issues.

CHICAGO, ILLINOIS

With state permitted needle exchanges, public access to and training on naloxone, methadone programs, and legalized cannabis for medical use, Chicago has implemented a number of key harm reduction policies. It has also enacted a 911 Good Samaritan law, providing limited immunity to anyone who reports a drug overdose to a healthcare provider for the purposes of helping the person having taken the overdose. Although a number of states have caveats on these laws, for example limiting the amount of illegal drugs the person reporting the overdose can be carrying in order to benefit from this immunity, removing the disincentive to report overdoses can have life-saving results.

Additionally, the Chicago Recovery Alliance offers a mobile service to drug users, taking resources such as clean needles, ‘boilers’ (used to prepare heroin), naloxone, and educational materials directly to local areas commonly frequented by drug users.

NEW ORLEANS, LOUISIANA

In addition to legal methadone access, a 911 Good Samaritan law, and availability of naloxone and clean syringes throughout Louisiana, the New Orleans-based partnership program Voices of Formerly Incarcerated Persons (VOTE) provides a variety of services to prisoners upon release, to assist with reentry into society outside of prison. Amongst other things, these can include specialist training programs in leadership and legal services, as well as providing access to a healthcare clinic run by local medical students.

NEW YORK CITY, NEW YORK

In the last few years, New York has taken key steps to move away from harsh sentencing for drug offenders towards what is generally considered the more modern approach of providing harm reduction services. For example, since 2015 the possession of residual amounts of drugs in syringes has been decriminalized, thus encouraging the use of needle exchange programs. Even since the turn of the New Year, the city has effected legal changes to permit the dispensing of medical marijuana for the first time, and the state has extended a cost cap on naloxone to widen access by alleviating the potentially prohibitive costs for drug users and those trying to help them.

The city’s SKOOP program provides training to needle exchange program workers on recognizing overdoses and how to administer naloxone, as well as the major no-nos when dealing with someone who has taken an overdose.

GLOUCESTER, MASSACHUSETTS

Police Chief Leonard Campanello’s recent declaration that “the war on drugs is over” was deemed somewhat controversial by some, but the rationale behind this statement closely mirrors harm reduction theory principles. Having seen drug problems worsen over his years in the force, Campanello created the Police Assisted Addiction and Recovery Initiative (PAARI) with the aim of encouraging drug addicts to reach out to their local police force for help without fear of prosecution. PAARI puts addicts in contact with medical help, issues opioid-blocking drugs to reduce chance of overdose, and provides training to other police forces to put similar programs in place.

SEATTLE, WASHINGTON

Seattle also boasts a police-lead harm reduction initiative: the Law Enforcement Assisted Division, or LEAD for short. Participants are offered a range of support from clean clothes and employment advice to tuition fees and school books, with the aim of enabling them to turn things around and create a better, drug-free life for themselves; they must also commit to meeting with a counselor. LEAD has provided training and advice to police departments from across the US.

Washington also permits access to clean needles, methadone programs, and naloxone training sessions, as well as having a 911 Good Samaritan law and recently implementing the vote in favor of legalizing marijuana for adults over 21.

DENVER, COLORADO

In the last couple of years, Colorado has introduced progressive law reforms which are ahead of many other states. Amongst other things, the state introduced a tax on legalized marijuana, which is being used in part to develop and deliver drug education programs to youths. In addition, Colorado recently legalized safe needle exchange, widened access to overdose antidotes, and introduced its own 911 Good Samaritan law.

More specifically, Denver has a number of harm reduction centers offering services ranging from homeless services and advocacy to HCV screening and treatment.

So there you have it! If you think we’ve missed something, please feel free to post your comments so that other readers can benefit from your local knowledge.

For details of harm reduction services in a city near you, visit: http://harmreduction.org/connect-locally/