Sooner or Later, We All Intersect

Many of us remember when “running errands” was a bigger project than it is today. Even now, when most of us have free time to go and take care of stuff, there is a list a mile long: 1) Buy the week’s groceries 2) Make a deposit at the bank 3) Get a new pair of mittens [it’s December, and you’ll be darned if you don’t usually put the pair inside your pocket together] 4) Get the oil changed in the car 5) Stock up on thank-you notes.

Though this list is scattered, it is fairly representative of what many have to do on errand day. We used to spend entire Saturdays criss-crossing town, from service station to clothing store to grocery store, to the optometrist, to the bank.

I’ll bet I’m not the only one who felt great relief at the emergence of a certain store which shall remain nameless, but that is in nearly every town in America, at which we became suddenly able to accomplish multiple errands in one stop. Suddenly, taking care of our lives became markedly easier.

I do not have enough space in this article to address the various arguments that have arisen about this store since its genesis. However I chose to focus on the store as a metaphor for a key ingredient in social improvement and harm reduction efforts: intersectionality.

Intersectionality is a phenomenon embodied by every individual. It is the unique combination of one’s (often involuntary) espousal of multiple identities including those that are socioeconomic, racial, geographical, gender-based, and healthcare-driven. Put simply: none of us have only one identity. We ourselves are intersectional, as we are a unique compilation multiple perspectives and multiple characteristics.

Okay, So I’m Multifaceted. So What?

One of the most harmful things to real social progress is the mistake many of us make: identifying ourselves only by to one facet of our intersectional selves. In our quest to protect the interests of the identity that we have deemed most important, we often overlook other parts of ourselves that also have contributing needs. For example, if I vote in an Arizona election, I may choose to think of myself primarily as a taxpayer, and vote for policies that best protect my interests regarding taxes. But if I am an environmentalist as well, I may choose to subsume that part of my identity in favor of my identity as a taxpayer. Because most policies cannot reflect our intersectional identities, we end up choosing to represent only the part of our identity that seems most important to us.

Unfortunately, as we attempt to whittle our own identities down to one dimension, we tend to begin viewing others around us as singular, as well. Moreover, in seeking to protect ourselves and our families, we tend to identify others according to their characteristics we view as most dangerous. Thus, someone who is a resident of Phoenix, a mother, and a user of intravenous drugs tends to get labeled by members of her community merely as an intravenous drug user. The other parts of her identity that need support? They get swept under the rug.

It is crucial for all of us, we members of the intersectional human race, to understand is that we all have multiple needs and multiple motivations. But others who may seem dangerous to us must be treated as residents of the communities that we share. In order to make our state safer, we need to keep safe all of the residents of our state. In order to protect my interests as a resident of Phoenix, I need to consider all of the residents of Phoenix as part of the equation. Just like the famous store, our communities are made up of many different sections, many of which do not affect us personally.

When we are able to see all lives as intersectional and having various needs, we are better equipped to support policies and programs that may affect some of our fellow Arizonans, but perhaps not us directly. We in the Harm Reduction community seek to remind our fellows that programs empirically proven to help members of marginalized social arenas, help all of us. If we want to make all of Arizona safer and healthier, we must seek to bring safety and health to all Arizonans. None of us has only one identity; we must focus on the parts of identity that we share.


What Would Jesus Do?

“And the King answering, shall say to them: Amen I say to you, as long as you did it to one of these my least brethren, you did it to me.”  --Matthew, 25:40

Many of us heard this quote often growing up, and many have unconsciously incorporated it into our daily outlook on life.  We try our best to be considerate to passersby, to those we meet in service positions, and perhaps most crucially, to those we feel have wronged us or those we love.  Regardless of personal religious affiliation, people would overwhelmingly argue that this idea, resting deep inside millions and millions of hearts, is a tool that helps us—all of us—live in a healthier, more peaceful world.

But some aspects of our world seem decidedly unhealthy, unpeaceful, and downright dangerous.  Such situations, circumstances and people are those that seem to have fallen victim to unspeakable evil; some things, we think, are so far gone that no effort, no matter how God-centered, will bring any aid or relief.  But a collective voice of religious conviction is rising, reminding all of us—all children of God, that we need to double down in tough times and translate our faith into works.

The opioid epidemic is running rampant across America.  People in positions of legal, medical and intellectual authority are testing any possible remedies for the opioid crisis that they can find.  Some relief has been found, but by and large the drug problem this country faces is still of epic proportions.

Yet the barest glimmer of hope has begun to shine, as research has begun to show unequivocally that syringe service programs (SSPs: Mobile networks that provide users of intravenous drugs with clean needles) are helping to markedly reduce the spread of bloodborne infections (including Hepatitis C and H.I.V.) in places where they have been legally sanctioned. SSPs are not only helping reduce harm among those who actively use drugs, but also among members of the larger community, including law enforcement officers and medical technicians. SSPs help benefit the fellowship of men and women in which we all live.

Of course, at first glance the idea of offering clean needles to people using intravenous drugs seems counterintuitive.  After all, wouldn’t giving people the tools needed to use drugs in effect say to them, “Using drugs is okay! You have society’s blessing to carry on in your misery”?  And because overdoses, infections and deaths from injectable drug use continue, it seems to many that SSPs aren’t accomplishing anything apart from spreading drug use. And spreading drug us is not helpful at all.  Indeed, it seems rational to declare a War on Drugs; to declare a war on a phenomenon that has declared war on our world, and left many of us for dead.

But as people of faith, this is precisely the time to put our convictions to the test.  We must momentarily set aside the fact that research shows SSPs to be an effective weapon against the harms perpetuated by intravenous drug use, and answer a deeper call.  Even though our own struggles may not on the surface resemble those of millions of people grappling with intravenous drug use, we must remember how we have felt in our own darkest hours.  We must remember our own yearning, our own defeated pride, our own crushed confidence. Most importantly, we must remember what it was like to feel the constant weakening of our last hope: that God would send His mercy our way, no matter the form that mercy might take.

We are all members of the same human family. We must recall the ways in which family members can cause us grief; many of us and those we hold dearest may have been devastated by opioid use. As Jesus advised, we must turn the other cheek.

Many religious leaders have begun to echo the sentiment that when fighting the spread of drug use, our pervasive spirit of punishment is wrong.  Instead, they argue, the highest motivation should be “our religious principles of compassion, healing, forgiveness, reconciliation, and love.”

Syringe Service Programs show us at least one way to adopt such attitudes while still effectively fighting drug use and the harm it brings.  By supporting legislation allowing SSPs to operate legally in Arizona, we of earnest faith are doing something to help those who are suffering.  Just as God’s laws seek to save people from their own misguided behavior, so should our laws here on Earth seek to help—not to condemn.

As people of faith, our highest calling in this lifetime is to act according to the examples of best model yet to appear.  To live a satisfying life that is orchestrated by God, we must remember to follow His teachings. To offer our support to those who desperately need our helping hands.


Florida Expands It's Miami-Dade Needle Exchange Program

On May 1, the Florida legislature voted 40-0 to expand a pilot needle-exchange program from Miami-Dade county to
all Florida counties.  The measure will allow Syringe Service Programs (SSPs) to operate statewide, widening the distribution of unused needles, Naloxone, H.I.V. testing and treatment referrals.

We here at Sonoran Prevention Works fully support this measure, and we applaud the efforts of the lawmakers and advocates who have worked to bring about this legislation.  Like Arizona, Florida is a conservative state; the similarities between the two states give us great hope that the evidence-based, lifesaving steps taken in Florida are possible in Arizona, as well.

Florida’s lawmakers wisely examined the data related to SSP use in various areas, including in Miami-Dade county, where they elected to run a test SSP program.  Unsurprisingly, in areas where SSPs have been put in place, rates of H.I.V. infection have dropped dramatically, the presence of improperly-discarded needles has decreased, and opiate overdoses have been sharply curtailed by the distribution of Naloxone (Narcan) and its use by people who use drugs.

Arizona and Florida are two of the states reported to have had the greatest increase in overdose deaths between 2016 and 2017.  But while Florida’s increase was a mere 5.9%, Arizona’s increase was 9.4%.  With no further steps taken in Arizona to slow the effects of the opioid epidemic, we can expect the death rate to continue to increase.

We at Sonoran Prevention Works wish to re-assert our evidence-based, data-driven support for the legalization of SSPs, the implementation of which is the single most effective weapon we Arizonans can wield against the deadly drug problem that grips our whole country, and our state in particular.


Legalize Syringe Service Programs: Protect Tourists, Protect Ourselves

In 2018, 43.9 million people made the decision to come to Arizona and visit. It is a safe bet that of those 43.9 million, the vast majority would cite the sheer beauty of Arizona as one of their main reasons for coming here. Not only is the rural landscape immensely appealing, but the action and diversity of our streets--in the cities, in small towns, on our college campuses, and most importantly, our neighborhoods--make Arizona a place to take great pride in.

But in order to preserve our state’s beauty and appeal, we need to keep it clean. And one way to improve cleanliness all over this lovely desert is to institute and legalize Syringe Service Programs (SSPs).

SSPs are often referred to as “Needle Exchange Programs.” They are outreach programs that distribute health and safety supplies such as unused syringes, alcohol swabs and Naloxone (Narcan), as well as offer guidance and referrals to other organizations that may provide further assistance and advice to people currently using drugs. Moreover, SSPs provide safe spaces for people to safely dispose of their used syringes and needles, thereby removing them from public areas in our communities.

SSPs are staffed by professionals trained not only in lifesaving measures such as the administration of Naloxone, but also in how to talk in a matter-of-fact, non-judgmental manner to clients about addiction, recovery, and other life challenges that may stand in the way of self-improvement.

Research has shown that in areas where SSPs are active, referrals to treatment options for people who use drugs have increased dramatically, and new infections of bloodborne diseases such as HIV have plummeted. Far from being an encouragement of drug use, SSPs have proven in other states to be the single most effective weapon against the devastating effects of opioid use--not least of all syringe litter, which is not only unsightly but also dangerous to the general public.

One of the most common concerns faced by people confronted with the possibility of introducing an SSP into their community, is the increase of needles in circulation; after all, it seems logical to assume that giving out syringes will increase the number of discarded, used syringes in public areas, thereby increasing risks of bloodborne infection for ordinary citizens.

However, Syringe Service Programs have had the opposite effect. In multiple communities where SSPs have been introduced, the number of used syringes that are improperly discarded actually goes down. This decrease is largely due to the SSPs offering, in addition to syringes, safe spaces for people using drugs to dispose of them. Moreover, if Syringe Service Programs allow legal transport of syringes, people who use drugs are more likely to hold onto a used needle until a safe disposal site can be found.

It is true that one effect of the opioid epidemic has been a noticeable increase in publicly discarded syringes; finding these items in highly-trafficked areas is naturally of great concern to average citizens, who rightfully worry about the accidental spread of bloodborne diseases that can be transmitted through used syringes. At first it seems that the obvious answer to these disposal risks is to decrease the number of syringes (used or unused) in the community by any means necessary.

However, closer scrutiny reveals that although Syringe Service Programs cannot claim to rid an area of used syringes entirely, the implementation of SSPs does in fact decrease the number of improperly discarded syringes, offering clients a safe place to dispose of used syringes and thereby keep the streets safer. In short, Syringe Service Programs are one of the few tools proven effective against the destructive community effects of intravenous opioid use.

In our Arizona legislature, a bill has come up for consideration that would legalize SSPs in our state. We owe it to ourselves to support the legalization of such programs, as they have produced empirical evidence of their useful impact. We Arizonans should take full advantage of the improvement opportunities that SSPs offer; we owe it to our neighbors and our visitors; to our tourists and our residents; to our parks and our streets; to the beautiful desert we proudly call home.

Maggie Maurer
SPW Policy Intern


Intersection of Faith and Harm Reduction

“And the King answering, shall say to them: Amen I say to you, as long as you did it to one of these my least brethren, you did it to me.” --Matthew, 25:40

Many of us heard this quote often growing up, and many have unconsciously incorporated it into our daily outlook on life. We try our best to be considerate to passersby, to those we meet in service positions, and perhaps most crucially, to those we feel have wronged us or those we love. Regardless of personal religious affiliation, people would overwhelmingly argue that this idea, resting deep inside millions and millions of hearts, is a tool that helps us—all of us—live in a healthier, more peaceful world.

But some aspects of our world seem decidedly unhealthy, unpeaceful, and downright dangerous. Such situations, circumstances and people are those that seem to have fallen victim to unspeakable evil; some things, we think, are so far gone that no effort, no matter how God-centered, will bring any aid or relief. But a collective voice of religious conviction is rising, reminding all of us—all children of God, that we need to double down in tough times and translate our faith into works.

The opioid epidemic is running rampant across America. People in positions of legal, medical and intellectual authority are testing any possible remedies for the opioid crisis that they can find. Some relief has been found, but by and large the drug problem this country faces is still of epic proportions.
Yet the barest glimmer of hope has begun to shine, as research has begun to show unequivocally that syringe service programs (SSPs: Mobile networks that provide users of intravenous drugs with clean needles) are helping to markedly reduce the spread of bloodborne infections (including Hepatitis C and H.I.V.) in places where they have been legally sanctioned. SSPs are not only helping reduce harm among those who actively use drugs, but also among members of the larger community, including law enforcement officers and medical technicians. SSPs help benefit the fellowship of men and women in which we all live.

Of course, at first glance the idea of offering clean needles to people using intravenous drugs seems counterintuitive. After all, wouldn’t giving people the tools needed to use drugs in effect say to them, “Using drugs is okay! You have society’s blessing to carry on in your misery”? And because overdoses, infections and deaths from injectable drug use continue, it seems to many that SSPs aren’t accomplishing anything apart from spreading drug use. And spreading drug us is not helpful at all. Indeed, it seems rational to declare a War on Drugs; to declare a war on a phenomenon that has declared war on our world, and left many of us for dead.

But as people of faith, this is precisely the time to put our convictions to the test. We must momentarily set aside the fact that research shows SSPs to be an effective weapon against the harms perpetuated by intravenous drug use, and answer a deeper call. Even though our own struggles may not on the surface resemble those of millions of people grappling with intravenous drug use, we must remember how we have felt in our own darkest hours. We must remember our own yearning, our own defeated pride, our own crushed confidence. Most importantly, we must remember what it was like to feel the constant weakening of our last hope: that God would send His mercy our way, no matter the form that mercy might take.

We are all members of the same human family. We must recall the ways in which family members can cause us grief; many of us and those we hold dearest may have been devastated by opioid use. As Jesus advised, we must turn the other cheek.

Many religious leaders have begun to echo the sentiment that when fighting the spread of drug use, our pervasive spirit of punishment is wrong. Instead, they argue, the highest motivation should be “our religious principles of compassion, healing, forgiveness, reconciliation, and love.”

Syringe Service Programs show us at least one way to adopt such attitudes while still effectively fighting drug use and the harm it brings. By supporting legislation allowing SSPs to operate legally in Arizona, we of earnest faith are doing something to help those who are suffering. Just as God’s laws seek to save people from their own misguided behavior, so should our laws here on Earth seek to help—not to condemn.

As people of faith, our highest calling in this lifetime is to act according to the examples of best model yet to appear. To live a satisfying life that is orchestrated by God, we must remember to follow His teachings. To offer our support to those who desperately need our helping hands.

- By Maggie Maurer,
SPW Policy Intern


Syringe Service Programs: The Best Way to Protect Law-Enforcement Officers

Syringe Service Programs (SSPs) are comprehensive health resource points for people experiencing addiction. SSPs are an evidence based strategy for communicable disease and overdose prevention through providing sterile syringes, safer use supplies, syringe disposal, HIV and Hepatitis C testing, and referrals to treatment.

Unfortunately still many people believe that giving people who use drugs (PWUD) a non-judgmental place to care for their health brands drug use as acceptable and therefore must increase drug use overall. This is despite decades of studies that have shown SSPs actually curtail the use of drugs and increase the number of PWUD seeking and entering treatment. Moreover, SSPs save taxpayers thousands of dollars in healthcare costs brought about by drug use; an analysis published in 2014 showed that every dollar spent on clean syringes for SSPs saved at least six dollars in medical costs for the treatment of H.I.V. alone. Most notably, SSPs greatly reduce the risks faced by those fighting the opioid crisis in the trenches every day: law enforcement and first-responders.

Most people know that used needles are a major cause of blood-borne, infectious diseases such as H.I.V., Hepatitis B and Hepatitis C. However, such danger impacts those trying to enforce the law as much as those who are using drugs. Statistics collected in multiple studies across multiple states show that on average, approximately one in three police officers has suffered at least one accidental needle stick, caused by I.V. drug users carrying dirty syringes.

For every accidental needle-stick, the cost to law-enforcement agencies is great, for in such cases officers who have potentially been exposed to Hepatitis C, Hepatitis B and H.I.V. must necessarily seek medical attention, including multiple tests for each illness that must continue for at least six months. Additionally, medication treatment must be used, including antiretroviral drugs to combat potential H.I.V. infection, and vaccination to work against potential Hepatitis B infection.

It goes without saying that other great costs of law enforcement’s accidental needle-sticks are psychological and interpersonal. No one should have to bear the emotional weight that comes with the possibility of infection, nor should people have to carry the stress involved with preventative treatment for the period of time it takes to take such measures. Every needle-stick suffered by law enforcement erodes feelings of professional security and adds to an atmosphere of uncertainty in exchanges involving intravenous drug-users, those which pose the risks of accidental needle-sticks.

In 2015, Vice-President Mike Pence (then Governor of Indiana) was presented with the opportunity to bring SSPs into law, after the effects of the opioid epidemic had wreaked havoc on counties in his home state. Though at first he had grave reservations about such programs, he soon connected with law enforcement officers. They assured him that, though the idea of legalizing SSPs may seem on the surface to be counterintuitive and, frankly, radical, they were actually the best way to help their fellow officers prevent risks to their health and safety. As Sheriff Dan McClain of Scott County, Indiana said, “Before this, I never would have considered needle exchange. But once this outbreak happened, it became clear that it was one of the main ways to stop the spread.”

Vice-President Pence changed his attitude after speaking with law enforcement all over the state. At the ceremony announcing the order to allow a needle exchange program in Scott County, Vice-President Pence stated, “I will tell you, I do not support needle exchange as antidrug policy, but this is a public health emergency.”

No one who has devoted his or her professional life to helping those in need of protection and to making communities safer should be presented with the costs, stressors and dangers presented by the very crisis that they are working hard to eradicate. SSPs are the most effective way yet found to reduce these risks and therefore provide support to the law-enforcement community. We Arizonans owe it to our law-enforcement guardians to take whatever measures we can to help them do their jobs more effectively and most importantly, more safely.

-Maggie Maurer, SPW Policy Intern


What Happened With Last Year’s Syringe Service Bill?

Despite widespread and bipartisan support for Arizona’s Syringe Service Bill, House bill 2389 stalled in Legislature last session after being amended in the Senate. Republican Representative Tony Rivero of Peoria sponsored the original bill which would legitimize Syringe Service Programs (SSP’s) throughout the state. The bill’s intent was to combat the spread of infectious diseases such as HIV and Hepatitis through legal operation of SSP’s, where IV drug users can obtain clean syringes and safely dispose of their used hypodermics. The bill would have defined legality regarding SSP’s in what is now considered to be in a “grey” area of operation through the eyes of the law. Currently, and in spite of law enforcement’s widely permissible attitude towards these programs, volunteers and participants alike are at legal risk and can technically be charged with distribution/possession of drug paraphernalia, a felony in Arizona.

What happened:
Republican Representative Tony Rivero initially introduced HB-2389 back in February of 2018. The bill was supported unanimously in-favor-of and immediately passed in the State House, uncontested. Despite overwhelming support for the bill in its original form, the AZ Senate Committee on Government imposed an amendment, making it necessary to first wait for a public health emergency to occur before legally allowing SSP’s to operate. Although there is no definitive explanation for the amendment, there is speculation that bill would simply not gain the support of Arizona’s Governor, Doug Ducey. The bill was sent to a Special Committee for further discussion of the amendment and it eventually became overshadowed by a wave of political activity within the state such as the Red for Ed movement, and the fact that it is an election year. Subsequently, this is where the bill died. Meanwhile, Arizona remains exposed.

The Amendment/Remember Indiana:
The amendment to HB-2389 was intended to make it necessary to first declare a public health emergency prior to sanctioning legal operation of SSP sites. This means that Arizona would need to demonstrate a significant increase in “significant” outbreaks of infectious disease to constitute as a public health emergency, according to the US Department of Health and Human Services. This very occurrence unfolded in 2014 in Scott County, Indiana where over 200 HIV incident cases were reported among IV drug users from 2014-2015. The Indiana State Department of Health initiated an investigation in early 2015 and declared a public health emergency by springtime, 2015. It wasn’t until that point in which Governor Mike Pence authorized state officials to establish programs aimed towards prevention of new HIV infections. Pence has been a longtime opponent of syringe service Programs and he viewed the decision as an exception to his moral calculus in an attempt to balance his personal faith and public health. Consequently, Pence remains under a level of political and public scrutiny on the basis of inaction, which resulted in what many deem a preventable outbreak of HIV within his home state.

Backed by Research:
Syringe Service Programs date back to the 1970’s, with the first government approved initiative taking place in the 1970’s, Netherlands. The onset reduction in the spread of infectious diseases was noticeable and the concept naturally made its way to the West by the 1980’s. Statistically and scientifically, SSP’s efficacy in reducing the transmission of infectious diseases is palatable and evidence based, and even backed by numerous government studies. The Institute of Medicine, National Research Council concluded that SSP’s “can be an effective tool for preventing HIV transmission and do not increase drug use”. The Office of Surgeon General found “conclusive scientific evidence” that SSP’s are an effective strategy for reducing HIV transmissions. In 2002, the Institute of Medicine, National Academy of Science noted that “Improving access to sterile injection equipment is a critical component of HIV prevention” while also noting SSP’s as being “highly cost effective”. The report also concluded that SSP’s do not lead to increased drug use, criminal activity, or discarded syringes.

Back to Indiana:
The Indiana incident back in 2014-2015 is one of many examples that demonstrate an overwhelming need for syringe service Programs in the US. The spike in infectious disease cases came without warning and it’s irresponsible to think it won’t happen again. The local government’s position on SSP’s and the subsequent delay in action to mobilize SSP’s in the face of a public emergency was a monumental failure that sustained meaningful consequences for the community. Scott County’s scar mustn’t rest in vein and Arizona has an opportunity to reap the benefit of a hard lesson learned. syringe service Programs and harm reduction techniques prevent the spread of infectious diseases and save lives, respectively. A reactive mentality has proven to be ineffective and dangerous, while showcasing why it’s even more crucial to not attach conditions surrounding them such as the need to produce evidence of an outbreak. The damage is done, and damage control is hardly a strategy.

Law Enforcement:
In a 2009 report released by amfAR, The Foundation for AIDS research concluded that SSP’s protect law enforcement from needle stick injuries. Other key takeaways from the report included:

* SEPs reduce needle stick injuries among police officers and can help lower the number of contaminated syringes in communities
* A study of police officers in Rhode Island found that nearly 30 percent of them had been stuck by a needle at one point in their career, with more than 27 percent experiencing two or more needle stick injuries
* A study of Connecticut police officers found that needle stick injuries were reduced by 66 percent after the implementation of syringe exchange programs

SSP’s and Harm Reduction/Stigma:
Syringe Service Programs however, are much more than what the name merely suggests. They are also the leading distributors of the opiate/opioid reversal drug, Naloxone. Also known by the brand name Narcan, Naloxone is an opiate antagonist that quickly counter effects the deadly symptoms of overdose, particularly suppressed or ceased respiration. Shot In The Dark, a Maricopa County based volunteer organization with 9 SSP sites throughout the Valley has reported over 5500 overdose reversals with the use of naloxone so far in 2018. Participants of SSP’s can also take advantage of screening options for infectious diseases such as HIV and Hepatitis, while receiving results in as little as 20 minutes.

By focusing on the harm reduction aspect of today’s drug related crises and epidemics, groups like Shot in Dark make a measurable impact on the reduction of casualties experienced as a result. Perhaps one of the more powerful features of syringe service Programs often evading recognition, is the sanctuary from stigma that so many users experience from the outside looking in. Maybe it’s not that it goes unnoticed, but rather that it’s just too multifaceted and complex to be commoditized. It’s not a clean syringe, it’s not naloxone and it’s not an HIV test. It’s safe environment for personal and communal connection and growth for people who use drugs.

Call to Action:
As we can see, Arizona needs Syringe Service Programs. Representative Tony Rivero will be reintroducing the Syringe Service Bill this January and we need to make sure our legislators understand how crucial SSPs are in reducing overdose and supporting those who have nowhere else to go for services. We need to act, raise our voices, and reduce harm at the legislative level.

Sonoran Prevention Works has numerous opportunities to get involved and advocate for SSPs in AZ. Check out their website at Advocate and get plugged in. On February 4th there will be an Advocacy Action Day at the State Capitol in Phoenix where myself and advocates from across the state will be deploying in teams of two to speak with our state legislators about the need to support SSPs. Join us and make your voice heard!

- Jay Dassele


Stigma Culture in the Overdose Crisis

As it trends today, the US is currently tracking approximately 130 opiate/opioid related deaths per day. Despite the staggering figure, the societal cry, once a piercing shrill, seems to be settling globally into the duller waters of an ever-more-painful and long-term form of simple acceptance. Darker, and a much more dangerous and depressing implication in that it suggests that there are simply just differences between you and me, right and wrong, good and bad. Even more disheartening is that it sort of implies that you (me) might in fact be, alone.

The debate about how to address the opiate epidemic is vast and varied and typically met first by responses that derive from fear, evidenced by enhanced law enforcement, more arrests and increased sentencing. Not far behind lies potential for the issue to be exploited in order to further serve other narratives like immigration, therefore creating a smoke-screen effect with ungaugable progress and a whole new eco-system of distractions. What’s left over is what existed from the beginning, the stigmatic attitude towards the sick, which alone perpetuates a cyclical divide.

I can’t help but notice that as a society, we tend to feel that people need to learn lessons, and hard ones goddamnit! And as spectators, the harder the better. Hell, we take great pleasure in consuming the pain you excrete while you learn your little lessons in life. And us? In those moments, we’ll simply block our own internal circuit boards that carry even the slightest bit of relatability to you, further impending your sense of isolation. Our lessons in life were hard learned and we’d feel deeply cheated if they weren’t for you too.

But as a society and a species, are we truly sadistic in nature, or is it that we simply just fear the unimaginable discomfort of self-reflecting, relating and connecting? Do we really insist that our fellow suffers in order to progress, or are we merely hyper-vigilant in protecting our own state of vulnerability? An objectionable notion, but possibly one that plays an influential role in the stigma of a drug user, or any unparalleled lifestyle that doesn’t make “sense”. Psychologically, it’s common to write-off a suspected user immediately. Age-old thinking can carve a neural algorithm that basically translates to a quick and common determination: “You’re not like me, and probably got what you deserved”. With that said, it’s no surprise to learn that the most effective asset in combating addiction, is another recovering addict. They understand firsthand what it’s like to have judged and to have been judged, and often times possess an intuitive duality of the two vastly different perceptions. An incredible gift to behold. Carl Jung dubbed this concept “The Wounded Healer”, where he implies that to effectively treat the sick, Jung had to be consciously aware of his own personal wounds. Another common judgement levied upon users are speculations as to why they use – usually summed up by simple pleasure-chasing and evading responsibility. Thankfully, this novel generalization isn’t holding up and as it slowly weakens, a little more light gets shed on the true origin of a user’s pain.

In some states like Arizona, efforts are in place to focus on the overdosing aspect of the opioid crisis. Non-profit groups such as Sonoran Prevention Works distribute lifesaving supplies to the public, such as Naloxone and clean syringes. Naloxone is an opiate/opioid antagonist that essentially acts as an antidote to lethal doses of heroin or opioids by restoring abnormal respiration. Shot In The Dark (SITD) is another non-profit organization that focuses on clean-needle exchange programs, giving users the opportunity to acquire clean syringes while safely and properly disposing of old hypodermics.

Organizations such as SPW and SITD are becoming lauded as the tip of the angel’s spear in combatting the opioid crisis. In addition to minimizing the spread of disease and reducing overdose related deaths, these programs communicate an even-more powerful message to the sick. It highlights that they are anything but alone. More importantly, they are accepted and within a short period of time, connected. They’ll take it from there and need not to be “fixed”, at least not by underdeveloped opinions that evolve throughout one’s lifetime, uninformed judgements, or any ideology. We sometimes think that we teach our children to physically speak during development, but they do that on their own. They’re human beings and the most intelligent organism we know of so far in the universe. Parents still play the most vital role however, and I’d argue that role is more along the lines of being an influential conduit for love and support, unconditionally. Perhaps our role in this existence is less defined by our external virtues and subsequent will to align with the like-minded and indoctrinate others, and better defined by our ability to first humble constantly through reflection, then influence with affection.

- Jay Dassele


Sonoran Prevention Works Surpasses 100,000 Naloxone Doses Distributed

For Immediate Release: August 15, 2018
Contact: Sarah Fynmore, (480) 532-8768, sfynmore@spwaz.org

Phoenix, AZ - Sonoran Prevention Works (SPW) is pleased to announce that it has distributed over 100,000 Naloxone doses since January 2017, with 4,553 reported lives saved.

Naloxone, also known as Narcan, is an emergency response medication that is used to reverse an opioid overdose and was approved for layperson distribution in 2016. Sonoran Prevention Works has reached this benchmark in ensuring access to Naloxone through partnerships with AHCCCS, public health providers, community organizations, families, and individuals.

Not all reversals are reported, thus the reported amount of lives saved is conservative. Since June of 2017, the Arizona Department of Health Services reports that there have been 1,613 suspected opioid deaths, without Naloxone, this number could be incredibly higher. It is crucial to continue efforts to get this live saving medication out to those who need it.

The SPW team is thrilled to continue distributing naloxone across the state. Turiya Coll, SPW’s Northern Arizona Overdose Coordinator says, “It is refreshing to see us hit this landmark number, and at the same time I truly believe that until we have naloxone in the first aid kit of every home in AZ, in every person who uses drugs hands, we will continue to see overdose and death. Rural AZ is where my heart lies, and I will continue to advocate and educate and empower up here until we have ended overdose death!”

SPW operates the state’s largest free naloxone distribution and overdose prevention program offering education and resources to behavioral health agencies, hospitals, law enforcement, family members, and people who are at risk for overdose. Any organizations or individuals wishing to have naloxone on hand, please contact Sonoran Prevention Works today.


The Intersection of Drug Policy and Immigration Justice

The battles faced by advocates for immigration justice and drug policy reform have many overlapping and intersecting elements. What has been thought-provoking is how the prioritization of the opioid crisis in the current political agenda has played out in dialogues over immigration control enforcement and border security. Below I will detail a couple recent events that exemplify the intersection of drugs and immigration policy, the underlying theme of culpability, and how advocates must work together to reduce the harms of oppressive policies.

At the National Level

Administrations tie the narrative of drug supply with immigrants smuggling from Mexico, giving ground to enforcement agencies to act on racial biases and further prey upon people of color. In February a congressional hearing was held to discuss how sanctuary cities impede efforts to combat the opioid epidemic because of ordinances that keeps police forces and ICE from sharing information. The purpose of sanctuary city ordinances to limit cooperation with federal immigration forces is to build and maintain trust between local law enforcement and the communities they serve.

During the hearing, titled “The Effect of Sanctuary City Policies on the Ability to Combat the Opioid Epidemic”, questioning by Representative Raul Labrador (R-ID) made it clear that he is of the belief that if we further embolden ICE and law enforcement agents in their capabilities to deport migrants, it would decrease the amount of drugs in the US.

While it is evidenced that heroin and other drugs do make their way north from Mexico and other southern countries, as former white house drug policy advisor and professor Keith Humphreys stated during this hearing, “Few people spontaneously decide to use heroin, and even less so heroin laced with fentanyl. But many people get pushed to that point after first becoming addicted to prescription opioids… Arresting heroin dealers from other nations will thus never eliminate the root of our problem.”

While Arizona does not have any sanctuary cities, this hearing is an important recent example of the ways in which politicians and decision makers attempt to focus the narrative on how drugs come into our country, to tie blame to immigrant communities rather than consider how addiction and dependence on illicit drugs like heroin, for many began through use of prescription opioids.

In Our State

Last month, Donald Trump got angry after a news story about a group of Central American immigrants traveling North to seek asylum reminded him how his wall isn’t happening. This resulted in the Dept of Homeland Security approving funding for up to 4,000 national guardsmen to be sent to the border. Governor Doug Ducey got on board and sent 338 state national guard forces.

It was a highly political spectacle with discussion over militarization of the border, asylum seekers fleeing violence but what was clear was that in the motivation for all of this were the words, “immigrants” “drugs” “crime”. The way that these words are constantly tied together demonstrates the narrative formation that melds immigration and drug policy.

While Trumps focus was on stemming movement of people across the border, Governor Ducey honed in on drug control. An Arizona Capitol Times piece spoke with Ducey’s spokesman Daniel Scarpinato, who “downplayed an immigration crackdown, instead focusing on drug smuggling, pointing to ongoing efforts by a state police task force to help the Border Patrol catch drug smugglers.”

Governor Ducey reinforced that in an article he penned for USA Today where he said “The majority of illegal drugs in this country come through our southern border. If you know someone impacted by drug addiction, there’s a good chance their last ‘hit’ came from drugs that flowed through Arizona.”

After an address to national guard troops, Ducey stated in an interview, “The people that are suffering the drug overdoses, often times these products are coming over the border and through our state.”

This example is noteworthy because it demonstrates the ease in shifting dialogue to place blame on immigrants for presence of drugs in our communities. Politicians appear to believe that stopping immigrants and stopping drugs can be one in the same. But they aren’t.

Scapegoating

It is truly remarkable how carefully yet callously politicians and decision makers connect the topic of drug control to the anecdotes used for anti-immigration agendas.

There are plenty of examples of ignorant leaders legitimizing their claims based on stereotypes that dehumanize individuals and disregard context. As Laura Pegram of the Drug Policy Alliance so eloquently explains, “Racial and cultural stereotyping aims to create and permeate repressive immigration strategies using inaccurate and conflated drug war rhetoric.  In the end, this is an attempt to justify the use of racial profiling when it is used in relation to drug issues and scapegoats immigrant communities as somehow responsible for the presence and use of drugs within America – a stereotype that is blatantly false.”

The dialogue regarding how the war on drugs disproportionately targets communities of color is acutely nuanced and well evidenced. Kevin Johnson is the Dean of UC Davis College of Law and in his astute article, “It’s the Economy, Stupid: The Hijacking of the Debate Over Immigration Reform by Monsters, Ghosts, and Goblins (or the War on Drugs, War on Terror, Narcoterrorists, Etc.)” he describes how in the US, immigrants of all backgrounds have received blame for effectively every social, economic, and political issue across the spectrum throughout our nation’s history. Johnson writes of how racial profiling becomes a tool when police develop drug courier and gang member profiles that target young African American and Latino Men.

This takes on a deeper meaning for immigrant communities, due to risk of deportation.
According to Drug Policy Alliance’s fact sheet “The Drug War and Mas Deportation”:
- For noncitizens, including legal permanent residents, any drug law violation (except first-time possession of less than 30 grams of marijuana) can trigger automatic detention and deportation
- A 2015 report by Human Rights Watch found that deportations for drug possession offenses increased by 43 percent from 2007 to 2012.
- “barred from reentry, often for life – no matter if they have family members who are U.S. citizens or decades-long ties to their communities of residence in the United States.”

Opportunities for Intersectional Action

Typically the main focus in harm reduction communities is in decreasing the public health impacts of drugs, which are crucial endeavors that need all the support possible. But what if we take the core idea of harm reduction, accepting that people will use drugs and minimizing the negative consequences, and think about the harms felt by immigrant communities in the criminalization of drugs. What if we find ways to emphasize the intersectionality of our issues to collaborate and be stronger in the face of backwards and oppressive politics?

Some efforts of this nature are already being made. The Drug Policy Alliance assisted the Immigrant Legal Resource Center in their detailed report analyzing the impact of California’s Prop 64’s decriminalization of marijuana on immigrants. Prop 64 reduced the harms faced by immigrants through the protection decriminalization provided for individuals who previously would have faced severe consequences like deportation for minor marijuana possession offenses. It is a great example how immigration justice advocates and harm reductionists can collaborate to shine light on the nuances of drug policy as it relates to the immigrant experience.

There have also been efforts to apply harm reduction frameworks to immigration and drug trafficking issues. No More Deaths has distributed their own take on Harm Reduction kits of humanitarian aid to migrants found in the desert. Ronn Pineo of the Council on Hemispheric Affairs has expound on what a harm reduction approach to dealing with cartels in Mexico would look like. Both examples are based on the premise of working outside the system, accepting that migration and trafficking occur, to lower fatalities and violence.

In terms of supporting advocacy efforts, the Harm Reduction Coalition put out a blog post on how members can support Dreamers with resources for information and links of organizations to send donations. We need more supportive undertakings like this. For example, when events occur where politicians try to tie anti-immigrant rhetoric with drug policy, harm reductionists must raise their voice with the evidence based research that shows that the solution they are looking for lies in services and treatment, not criminalization and law enforcement.

These issues overlap with one another and advocates of immigration justice and drug policy reform can and should be allies. We are fighting many of the same fights, the more that we can collaborate the stronger our defenses will be.

 


Sarah Fynmore
SPW Member
fynmoresarah@gmail