9th - Harm Reduction Coalition

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9th National Harm Reduction Conference FROM PUBLIC HEALTH TO SOCIAL JUSTICE abstinence-based aspects of project-based HF make it compatible with the broader set of harm-reduction approaches. In the first half of this workshop, we will define the project-based HF model and recount its historical development. Next, we will discuss the principles of project-based HF and insights into its day-to-day implementation in a population of chronically homeless individuals with alcohol problems. In the second half, we will present findings from the research partnership between the University of Washington (UW) and Seattle’s Downtown Emergency Service Center (DESC) that show significant associations between project-based HF and reduced harm for affected individuals and their community. Specifically, we examined the associations between project-based HF and two-year alcohol use, substance-use treatment attendance, motivational factors, and criminal justice outcomes. Although project-based HF was not associated with increased formalized treatment attendance, residents nonetheless showed significant decreases across alcohol and criminal justice outcomes as a function of time in housing and their own intrinsic motivation to change. Further efforts to decrease alcohol-related problems via harm reduction interventions will be discussed. Susan E. Collins, PhD, is a licensed clinical psychologist and Research Assistant Professor at the University of Washington – Harborview Medical Center. She specializes in substance use treatment and research and has published over two dozen journal articles and book chapters. Since 2007, she has been part of the UW team working with DESC to evaluate its project-based HF approach. Cooke, Mark, ACLU of Washington, Seattle, WA mcooke@aclu-wa.org Implementing Portugal’s Decriminalization Laws in the U.S. In 2001, Portugal decriminalized the possession of all drugs intended for personal use. This groundbreaking policy change has successfully kept individuals out of the criminal justice system and connected them with services. It has not led to increases in drug usage or drug tourism. But can this type of system ever be implemented in the United States Although adopting a system identical to Portugal’s in a state or local jurisdiction in the United States is unlikely in the immediate future, a variety of legislative and policy changes can be adopted, now, that are similar to Portugal’s law. As we’ve seen with the introduction of drug courts and diversion programs, drug de-penalization policies can survive politically in the War on Drugs. However, these policies still criminalize drug possession and rely on the discretion of courts and prosecutors to operate, which can lead to arbitrary enforcement. What are needed are broader policies that decriminalize drug possession and offer services for all offenders. To that end, policies and legislation can be introduced that more broadly apply decriminalization principles to drug use. This panel presentation will focus on legislative strategies that will put state and local jurisdictions on the path to full decriminalization. Data Visualization – Marijuana Enforcement in WA Statistics are a valuable tool when advocating for changes to drug policy and highlighting the effectiveness of harm reduction practices. They allow people to tell complicated stories in an efficient manner. Unfortunately, statistics are frequently used in a dry and unclear manner which limits their impact. One way to avoid this is to use visually appealing representations of data, such as graphs, tables, and maps. These visualizations are pleasant to look at and make complicated statistics easy to understand. Luckily, a variety of new software tools now exist which make it easy to turn boring data into more user friendly visualizations. This panel presentation will provide examples of data visualizations that specifically focus on drug policy and harm reduction. It will also provide strategies for obtaining good data and compiling it in a manner suitable for public use. A recent data visualization project focusing on the enforcement of marijuana laws in Washington State will serve as the primary illustrative example for this presentation. Mark Cooke is a Policy Advocate with the ACLU of Washington working on drug policy issues. He graduated from Washington University in St. Louis in 2007 with a law degree and a master’s in social work. While in St. Louis, he worked at the Missouri Institute of Mental Health researching drug policy issues, including methamphetamine laws and needle exchange programs. Prior to joining the ACLU, Mark practiced family law in Seattle. Before going to graduate school, he worked in the foster care system 22
9th National Harm Reduction Conference FROM PUBLIC HEALTH TO SOCIAL JUSTICE Corcoran, Eileen, Evergreen Treatment Services - LEAD Project, Seattle, WA eileenc@etsreach.org Harm Reduction and Law Enforcement Working as a Collaborative. Law Enforcement Assisted Diversion Program (LEAD): Challenges-Successes of Collaborative Efforts for Social Workers and Law Enforcement Entities practicing the Harm Reduction Philosophy. Is it possible for law enforcement and social workers to “work together” and practice harm reduction when working with low-level drug users, and street based sex workers Yes. One approach is through pre-booking diversion. Evergreen Treatment Services, The Defenders Association, and Seattle Police Department (SPD) have implemented a program called Law Enforcement Assisted Diversion. Although there have been some challenges with social service providers and law enforcement we are making great progress. Operating from a harm reduction philosophy social service providers are working with law enforcement to keep low-level drug dealers, and street based sex workers out of jail and provide them services. Despite occasional differences of opinions on what the individual consequences should be we have attempted to reduce both addiction and crime in one of the more prevalent open-air drug markets in the downtown core of Seattle. Since the project began in October 2011, ETS, along with all other entities such as The Defenders Association, and SPD have been able to work together to assist individuals with their addiction problems, find stable housing and access the necessary services these individuals need. Working from the harm reduction philosophy, allows the individual to become engaged in supportive services and gain some form of stability. Eileen Corcoran is a recovering IDU, who has been providing HR advocacy and street based outreach to chronically homeless IDU since 2001. In that time Eileen has played a major role in the Seattle community as an advocate for street based sex workers, and low level drug dealers who operate in the open air drug market of downtown Seattle. Eileen is currently a case manager with the new LEAD program, and also an University of Washington MSW candidate class of 2013. Eileen say’s Harm Reduction saved her life. Cordova, Leonidas, Duke University - LGBT Task Force, Durham, NC lcordova@duke.edu Networking for Safe-T: a community effort to deliver primary health care to an invisible, marginalized, uninsured, undocumented, previously un-served transgender population. We describe local efforts by several individuals who have been establishing channels to reduce harm and provide basic care for Spanish-speaking transgender people living in the Triangle Area of NC (Durham, Raleigh, Chapel Hill). The essential thread has been the networking between local activists and certain concerned providers who work in community Health Departments, non-profit organizations, and Planned Parenthood Affiliate Clinics. These providers have access to key resources and provide services towards competent patient evaluations, legitimate prescriptions for medications and proper (WPATH, SOC-based) continuous medical care. Transgender people without insurance or access to health care are often desperate to correct their bodies to look and match their gender identities. Without proper, medicinal/exogenous hormones, they also take matters into their own hands and use what they can to attempt these corrections (e.g. orally taking or injecting illegal and dangerous synthetic hormones or other substances “off the street”). We hear from prospective patients that itinerant Latin “experts” travel around offering “silicone parties” in Mexico and the US, where industrial-grade silicone oils are injected into the bodies of male to female (MTF) transpeople for cosmetic enhancement (face, breasts, hips, gluteal muscles, etc). Some of them already have breast implants and silicone injections, known to be potentially toxic. They have done this for personal and/or “business” reasons, as some work as escorts and/or performers in drag shows at official and unofficial LGBT clubs, an increasing trend in the area (a few even do “modeling”). These environments are also known to foster drug/ alcohol abuse, and provide the links for risk-loaded sexual practices. By building a local network from people and resources that already existed in our community, we feel we have reduced expensive emergency room visits, lowered some risks and shifted the health care load to a preventive approach for those who use these services. These efforts serve as a clear example of how activists and health care providers can work together with harm reduction goals in mind and provide working “social preventive medicine” practices to this transgender population. 23
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