9th - Harm Reduction Coalition

9th
National Harm Reduction Conference
FROM PUBLIC HEALTH TO SOCIAL JUSTICE
Moving from the Margins: Challenging the Isolation of Harm Reduction By The Mainstream
This panel would be one I moderate and present on, which would emphasize the need for harm reduction to have greater
currency among decision makers in the drugs field, and propose steps to get us there. I have some ideas for participants,
and I’m sure you have also received appropriate proposals. My presentation would identify several areas where we have
failed to communicate harm reduction as an approach effectively. Specifically, in both national and international arenas
harm reduction is 1) mischaracterized simply as a set of interventions like needle exchange, without recognizing that the approach
requires working with drug users in a way that recognizes that they are rational actors, that they have the capacity to
manage risk, that they should be treated as full participants in every aspect of services involving them. As needle exchange
and other health interventions targeted to drug users have moved from their grass roots origins to top-down, centralized
programs by large international donors, a recognition of the philosophical orientation of harm reduction and the critical role
of drug users and outreach workers cannot be taken for granted; 2) Locked out of major technical assistance streams and
guidance, such as that provided by SAMSHA. By allowing practitioners of treatment orthodoxy to define what constitutes the
mainstream, we have allowed the marginalization of harm reduction; and 3) Misrepresented by those who claim it is enough
to call their work HIV prevention for drug users, but in reality create programs that go “behind the backs” of drug users,
define “peers” in epidemiological terms but ignore drug user social networks, and focus not on drug user generated ideas
of change but on “getting” clients to participate in predetermined unit of services. The presentation includes suggestions
for how to move forward from the margins, in the process remaking the mainstream rather than diluting the spirit of harm
reduction.
Richard Elovich holds a Ph.D. in medical sociology and a Masters in Public Health. He is a specialist in public policy and program
development and implementation in HIV/AIDS and substance use, with an emphasis on harm reduction and innovative and lowthreshold
treatment services for at risk populations. He has over twenty years’ experience in the U.S. and internationally. In New
York, he was Director of HIV Prevention programs for GMHC, the oldest and largest non-governmental AIDS organization in the
U.S. He is an experienced advocate, having been appointed to the Mayor’s HIV Planning Council of New York City, and chairing its
substance abuse services work group from 1991-1996. Elovich was an organizer of underground needle exchange programs in
New York City and San Juan, Puerto Rico. He has been a full-time instructor in the Urban Public Health program at Hunter College’s
School of Health Sciences, City University of New York and a guest lecturer at numerous universities and colleges. Since
2003, Elovich has worked as a consultant on HIV/AIDS and drug use issues throughout the former Soviet Union, including Central
Asia, Nepal, Thailand, Indonesia and Mexico.
Ervin, Sonja, Central City Concern, Portland, OR
sonja.ervin@ccconcern.org
Harm Reduction & Integrated Care Environments; Challenging Staff’s Bias to Focus on Outcomes
The experience and expertise of the Community Engagement Program (CEP), a program that has utilized a harm reduction
approach for the past 9 years. CEP has been nationally recognized for its services which include a community outreach approach
to the most vulnerable individuals who are experiencing chronic homelessness and significant disabilities. Pulling
from the experiences of staff who come from varying backgrounds including their own addictions, mental health concerns
and homelessness, we will provide an interactive discussion to address struggles faced by individual staff, programs and
agencies to define harm reduction and develop reportable outcomes for a model that demonstrates success individually.
Design and Outcomes of an Integrated Harm Reduction Approach
Poster presentations will provide an overview of the Community Engagement Program including the Mission statement
developed by the program staff, outline of the integrated services provided in the program, staffing –types and levels, case
studies of program participants benefiting from a harm reduction approach and presentation of a cost avoidance study conducted
with program participants as well as other data that demonstrates long-term stability for individuals in the program.
Sonja Ervin is the former Program Manager for the Community Engagement Program (CEP) and Housing Rapid Response (HRR),
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