Episode Transcript
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Speaker 1 (00:01):
You are listening to
Street Speak Podcast, where we
answer your burning questionsabout homelessness and poverty
in San Francisco.
This podcast is produced by theStreet Sheet newspaper.
Speaker 2 (00:18):
Hi there, welcome to
Street Speak.
This is the podcast of StreetSheet, the street newspaper in
San Francisco that is sponsoredby the Coalition on Homelessness
.
We have today on our show areally wonderful life-saving
topic called harm reduction, anda lot of people, you know, are
kind of confused about what harmreduction is.
(00:39):
Harm reduction is under attack.
Under attack.
It's actually a reallybeautiful, very successful model
to engage folks who arestruggling with substance use in
you know how to reach theirgoals and improve their health.
And so we have with us here twoawesome guests.
We have Laura Guzman, who isthe director of the National
(01:02):
Harm Reduction Coalition, and wehave our very own, shakima
Stryker, who is an organizer onhuman rights and housing justice
and has a background working onharm reduction issues.
And so what we wanted to do isstart with you, laura, and have
you introduce yourself and yourbackground and just tell us a
little bit about you.
Speaker 1 (01:23):
Know who you are and
just tell us a little bit about
you.
Know who you are.
Well, good morning.
I'm very excited to be herebecause, in my role doing Hummer
Action work in San Francisco,this is my 30-year anniversary.
So I've been doing for 30 yearsthis work.
I'll talk in a minute about howthe coalition was founded,
actually in 1994.
And we did so much work in SanFrancisco actually in 1994, and
(01:49):
we did so much work in SanFrancisco.
My career has been always as anadvocate for unhoused people and
always in the intersection withhealth.
So I was for 17 years thedirector of the Mission
Neighborhood Resource Center inthe Mission and then have moved
to the coalition to direct ourCalifornia work initially and
now as executive director at thenational level.
I wanted to also say that Ihave this awesome memory that
(02:12):
when I started to work withcoalition and I met Jennifer in
1997, it's because I was invitedto do this clinics we were
doing throughout the city so wecould preserve the benefits of
people who receive socialsecurity and SSI who are going
to lose it because of welfaredeform.
This is back in the Clinton erawhere we were going to get
(02:34):
these folks to actually losetheir benefits if they had a
history of drug and alcohol use,so my history goes way back of
doing this work in closecollaboration with the coalition
.
And then just to name who weare the National Harm Reaction
Coalition that was founded inOakland, california, in 1994.
(02:54):
It's a national capacitybuilding organization and we
promote the health, dignity andrights of people and communities
impacted by drug use uponcommunities impacted by drug use
Amazing, and we had so much funworking on preserving people's
social security benefits.
It was really going to be quitedevastating and actually worked
(03:16):
with the mayor's office andMayor Willie Brown was really
helpful in those efforts as welland if you remember, I think we
were the only jurisdiction inthe entire United States that we
managed to preserve I think itwas almost 90% of people who
were SSI recipients on benefitsas a result of our collaboration
throughout the city.
Speaker 2 (03:35):
Yeah, because almost
everybody on disability had some
element, some percentage oftheir disability was granted
because of substance use, andthat was really common in those
days, and because you wanted toadd up to 100% and you know all
of that.
So that was really, that wasreally important work.
And the work continues and isso beautiful.
So, kima, tell us a little bitmore about yourself.
Speaker 3 (04:00):
So my name is Shakima
, but I typically go by Kima,
and my journey with harmreduction actually started about
15 years ago at a rave, and sothis was before I even knew what
I was doing was called harmreduction.
I just felt naturally drawn toeducating people about
substances and providingemotional support and it really
(04:22):
just felt like a way forsupporting and showing up for my
community.
Um, and then I met someone umout here in Oakland at a rave
who was, and I was talking tothem about my work and how I
wanted to kind of expand it inthe underground scene and she
was like, have you ever heard ofharm reduction?
Um, you know, I run anorganization.
I'd love for you to be a partof it.
(04:42):
And so the journey reallystarted there.
And I'd love for you to be apart of it.
And so the journey reallystarted there and I kind of
started diving headfirst intotrainings and workshops so that
I can learn about the principlesof harm reduction.
And then I went back to schooland now I'm finishing my
master's of social work and overthe years I've worked with
several organizations throughoutthe Bay Area, like Harm
(05:02):
Reduction Therapy Center at MPLSan Francisco, which serves more
of the LGBTQ plus community.
And now I'm here at thecoalition as a housing justice
organizer and I'm stillcontinuing to find ways to, you
know, tie in harm reduction intomy advocacy work.
That's exciting, kima, to hearyour story yeah it's a lot of
(05:28):
education, but also livedexperience as well.
Speaker 2 (05:32):
Yeah, you know, this
is, you know, two local heroes.
I am so happy to have you bothon here.
So, lawada, why don't you juststart out a little bit talking
about some?
People are kind of confusedabout what harm reduction is.
What are the basic tenets ofharm reduction?
And it's an evidence-basedpractice.
Maybe some examples?
Speaker 1 (05:53):
Sure, and I like to
start always with phrases.
We do that a lot, we'retrainers, but there's a phrase
from Edith Springer, who wasactually my mentor and was one
of the founders of the HarmReduction Coalition, that said
harm reduction is loving peopleback to health.
And I love to start that waybecause it gives the dimension
(06:13):
of the importance of harmreduction, because it is a
public health strategy.
But for us it's also socialjustice imperative and we are
working always in theintersection of overdose, hiv,
hepatitis C, stigma andcriminalization and confronting
structural inequities that drivedrug-related harm, and that
(06:34):
includes racism, poverty, lackof housing and the limited
access to health care bymillions of people in this
country, by millions of peoplein this country.
We also believe the war ondrugs has always been a war
against poor people, inparticular Black, native and
Latina, and that war strategycombines criminalization,
stigmatization and structuralracism to cause harm.
(06:58):
So I just want to be very clearthat for us it's public health
plus.
We believe that it's alsosocial justice imperative In
terms of the services that, bythe way, almost all of them have
been proven to be quote unquoteevidence-based meaning that
science supports harm reductionincludes syringe access and
(07:22):
disposal, safer drug usesupplies.
So the ability to supply, youknow, instruments or suministros
, things that help people tostay safe when they use drugs,
overdose prevention and responseand I want to pause for a
minute to say overdoseprevention and response, the
positive naloxone happen by harmreductionists in this country
(07:44):
and I want to always uplift thegodparents of our movement, like
Dan Biggs, who were the firstto bring naloxone and distribute
it illegally in the UnitedStates so we save lives.
It was actually part of the HarmReaction Coalition and our
networks that we started savinglives way, way before 30 years
(08:05):
before that the governmentdecided that it's a good thing.
And then linkages andcollocation of substance use
treatment housing first, werereally adamant.
And in San Francisco, let's say, we had all of the new exchange
and all of the you know what isconsidered syringe service
programs growing and all of theyou know what is considered
syringe service programs growing.
But we also, from the beginningsince 1995, we started imbuing
(08:28):
the notion that people who usesubstances are they should get
in housing, we should protectthem, we should support them and
they should stay in housing.
And then, last but not least,safer consumption sites are also
part of our repertoire of youknow the kind of services that
we consider harm reduction.
Speaker 2 (08:49):
All right.
Well, shakima, do you haveanything to add to that in terms
of you know the tenets of harmreduction?
Speaker 3 (08:57):
No, I completely
agree with everything that was
said, especially about the waysin which harm reduction realizes
social inequities.
So, you know, it takes a momentto consider poverty and racism
and trauma and how all thosethings impact, you know,
someone's vulnerability tosubstance use and also their
(09:21):
ability to find stability andaddress it effectively, and I
think that all those things areimportant to helping people
understand their relationshipswith substances and how those
factors have affected theirlives so that they can find
recovery and stability.
Yeah, and I think that that'sreally important.
Speaker 1 (09:40):
Thank you, akima.
I want to add one thing that Iforgot and tell me, akima, also,
if you agree, I think one ofthe biggest pieces of Hummer
Action because it was broughtfor people with lived experience
, researchers, you know, queerpeople, people with HIV, aids in
the United States is that webelieve the leadership of those
impacted by substance use is keyto transformational change and
(10:06):
also we're big believers thatyou know, in order to bring
long-lasting change, not only weneed people impacted at the
table actually recommending whatneeds to happen, what do they
need to develop that change, butwe also think that it's very
important that you know this isa liberatory practice and that
(10:28):
there is choices in what wechoose to do with our bodies.
So we also have a very you know, a very adamant stand around,
you know, voluntary, choosingwhat works for us, right?
Speaker 2 (10:44):
Yeah, yeah, beautiful
.
So you know, you know this nextpiece is around.
You know why harm reduction isimportant, and I just want to
know, you know, back in againunder Willie Brown, you know,
going back, we did the treatmenton demand campaign out of the
Coalition on Homelessness, andat that time, there was, you
(11:05):
know, nafta had just been passed, and the heroin prices had
dropped down.
Our overdose rates started toskyrocket.
Actually, san Francisco had the, at that time, had the highest
overdose rates in the country,and that effort really led to a
lot of different things, notleast of all the reduction of
fatal overdoses, and one of theprojects is actually under
(11:28):
national harm reductioncoalition dope, which does a lot
of education and elevating ofpeople who use drugs as trainers
of others on how to preventoverdoses.
And part of that, though, isthat, when you know, when we
started that out, we basicallyhad a system that was kind of
just only social model, veryinstitutional, very kind of a
(11:55):
process, where the idea would beto break people down, and so
they would have these kind ofattack therapy kind of thing,
and then, when people werebroken down, and then they would
build them back up, and thatwas it did work for some people,
but very few, and a lot offolks were left out in this
whole idea that you had to dotough love kind of the opposite
(12:18):
of what we're talking about hereand that people had to hit rock
bottom before they could gethelp and you have to.
You know, I mean, it's just thiswhole philosophy that was
actually proven to not be veryeffective for most people.
And so you know, kind oflooking at what the system used
to be, now looking at, you know,now we have a, you know, growth
(12:40):
and learning and really a lotof change in how we address
substance uses, shakima,starting with you.
Why do you feel that harmreduction is important?
Speaker 3 (12:54):
Very strictly because
of you know what you just said
exactly.
I think that harm reductionrecognizes that recovery looks
different for everyone and italso recognizes that, you know,
abstinence might work for some,moderation might work for others
, medicated assisted therapymight work for others, and every
(13:14):
single one of those are, youknow, valid approaches and valid
reasons for someone to be ableto access services or even just
find stability in their lives.
And I think that harm reductionis important to act as like a
stepping stone towards recovery,because people may not engage
with those traditional forms oftreatment, especially if it
(13:35):
requires abstinence, and thentherefore they're not able to
get and receive the servicesthat will really help them get
to where they need to be.
And I think that harm reductionrecognizes that, even without
complete abstinence, peopledeserve the dignity and respect
and ability to improve theirhealth, to find stable housing,
to be able to reconnect withtheir family and rebuild their
(13:57):
lives.
And I think that that is whatmakes it so important to me.
Speaker 2 (14:02):
Yeah, yeah, and I
mean there's this idea too.
I just want to add that wetalked about a lot in the early
days about, you know, if we'rethinking about substance use as
being a and you know a medicalissue, when people have very you
know severe addictive disordersand they're using more, that's
a symptom.
And so if you're looking at anykind of other medical approach,
(14:24):
when your symptoms areincreasing, usually you increase
the treatment to address thosesymptoms, and we had a system
back in the day that basicallypulled away treatment, that
denied treatment as symptomswere appearing, and I think that
is a really important thing forfolks to understand.
(14:45):
Laura, do you have anythingelse to add to that, Any stories
about folks you know who havebeen on this journey of harm
reduction, or any data andresearch that you want to add to
this conversation?
Speaker 1 (14:59):
Well, I think Kima
said it so well, but I wanted to
just add a couple of things.
I directed a drop-in center for17 years in San Francisco, so I
was working with our housecommunities, by the way, which
not all engage in usingsubstances.
I know we're going to talklater about the stigma and the
language, but I want to say thatit's important to know.
(15:24):
Besides that it's like Shakimasays, it's an entry point, it's
also a continuum right.
The importance of harmreduction is that not only we
reach most vulnerablepopulations that are the target
of the war on drugs, primarilyright through poverty, through
racism to transphobia, but alsothat we keep those, you know
(15:45):
communities engaging care.
And this is so importantbecause in a lot of the
traditional notion not onlyabout how much do you treat
someone for what, and in fact Iwould say people who use
substances tend to be always inthis separate category than any
other people that have you know,any other particular disorder,
(16:06):
if the person has a substanceuse disorder.
But I think that keepingindividuals engaged in care and
also responding to the impact onyou know the impact of
substance use.
So when I was at the ResourceCenter, we, you know, we used to
see 300 people a day, out ofwhich I would say maybe a
(16:27):
quarter of our community wasreally impacted At the time was,
you know, injection.
It was in the mission, so itwas speedballing.
You know it was the traditionof injecting heroin and meth and
we did some work.
That was amazing.
We had our women, for example,who were really interested in
(16:47):
kicking heroin and so wecollaborated to get them on
methadone.
This was before Medi-Cal wascovered in methadone and
therefore people had to pay forit and therefore we had our
women, through our women'sprogram, really engaged in
trying to, you know, stay onmethadone so they could actually
attend to other health needs orany other needs in their lives.
(17:09):
We also had to respond to adisproportionate impact of
alcohol in Latino immigrantsthat were on the street sleeping
under a freeway and, you know,for 17 years very unable to
enter into any housing, until weopened, you know, casa Quesada
and other programs that we wereable to support them and
(17:30):
therefore, you know, having realconversations about alcohol and
actually support because we hada medical clinic for those that
were already willing and able.
I think the need for harmreduction is huge in what we
call this arena of drug userhealth, because the bottom line
is still people are mistreatedby medical doctors, by
(17:52):
therapists, by the treatmentprograms, by the overall systems
of care that it's veryimportant that we still have so
much work to do to really insome ways make sure that this
continuum, this framework, isembedded.
(18:13):
And talking about data I mean Icould spend a whole hour
talking about data but I cantell you that you know, up to
the harm reduction is no longer,you know, a fringe kind of
thing, because we have had theCDC and SAMHSA and the National
(18:35):
Institute of Health and NIDA allshowing through study after
study that harm reduction, thescience supports harm reduction,
that we've seen a continuousand consistent decrease on
HIV-HCV incidence, that thedecrease of overdose death
actually is directly related tooverdose responses through
(18:57):
naloxone, in particular in thehands of those most impacted.
And linkage to treatment andactually retention into
treatment.
We did this study in Californiaat the California Hummer Action
Initiative 2021 to 2023.
Who were otherwise givenlinkages or an appointment to do
substance use, in particularwhat is called
(19:33):
medication-assisted treatmentfor opioids.
Access and retention tohealthcare I mean I served in a
clinic, that we had a clinic andactually by treating with
dignity and respect the peoplewho were impacted by substance
substances.
We managed to get them to doprimary care right to address
other medical conditions,because we don't talk enough to
(19:54):
say when people are on thestreets their medical condition
worsens because of the, you know, violent conditions, that is,
living outdoors, housing.
First, we have the data andthere's also data about overdose
prevention sites across theworld that shows that it
diminishes crime and actuallysaves lives.
So to close, in this pieceabout data research, I want to
(20:15):
say that there is an interestingquote.
When we were doing work inSkull County, kentucky, very
conservative, those folksactually got it and we had a
legislator that says, after Ireview the science and the data,
harm reduction is a no-brainerfor me.
So I think that it'sinteresting that we keep pushing
the data that is there.
(20:36):
But of course, because this isa war on poor people, the data
sometimes is not enough and whenpoliticians are getting
reelected or law enforcementpushes to reopen jails, the data
goes down.
You know, down the drain, butthe data is there.
Harm reduction is a no brainerfor us.
Speaker 2 (21:00):
Yeah, absolutely, and
I know we're.
Unfortunately, a lot of thesestudies are going to get halted
at this point, but the data, asyou said, is there.
I think this is a good place tosegue into stigma and kind of
what you know.
How does stigma affect overdoseand drug use and what are some
(21:22):
common myths and misconceptionsthat permeate our perception of
the overdose crises and drug useor substance use disorders?
Shakima, do you have anythoughts on this?
Speaker 3 (21:35):
Yeah, I think the
biggest one really is like
hearing that you know aboutabsence being the only real
recovery, real version ofrecovery, and I don't think
people realize that absence canalso be a harm reduction goal.
It's just not the only goal andI feel like that's really
frustrating because it's justvery limited and it doesn't
recognize that recovery can beself-defined down into people
(22:10):
who use drugs, where there'slike this hierarchy of people
not believing that those who areusing medicated assisted
treatment are actually likefully in recovery because they
are technically still usingdrugs, and I think that all the
stigma and misconception it'swhat prevents people from
seeking help, as Laura mentioned, especially within medical
settings.
(22:43):
As Laura mentioned, especiallywithin medical settings, a lot
of my experience while handingout safe use supplies has
actually been.
The next step was alwaysconnecting know condoms and
lubricant, because they were tooafraid to go to a clinic and
face judgment about their work.
There was actually an older,unhoused man that didn't even
use substances but he was, youknow, having like bowel
(23:05):
incontinence and he usedsanitary napkins, like pads, and
he just wanted to not feelembarrassed about asking for
those, and so we were able tobuild, you know, a really good
relationship and we're able toconnect him with the clinic and
realize that he also had someunderlying health issues.
So the stigma and the shame issomething that kind of like
(23:25):
spreads throughout society andit's something that keeps people
from living the lives that theycan live.
Speaker 2 (23:33):
Yeah and so so.
On point Laura, how has thepolitical landscape affected
harm reduction?
You know what's going oncurrently.
You know we saw Donald Trumpand his you know executive order
that demonized drug users,while he is slashing treatment
(23:57):
by cutting Medicaid, which willmean a lot of loss of access to
treatment for many, many folks.
But what trends are you seeingat the local level, state level,
national level, around thisissue?
Speaker 1 (24:10):
Well, I'd like to
start before Trump always,
because obviously we have beenseeing this trend I would say in
the last, probably like thistrend of what I would call
backlash, in the last two, threeyears after COVID.
And let me just say that duringCOVID, the people most
supporting and responding topeople on the streets were
(24:32):
actually syringe serviceprograms, because nobody else
was around.
I reached programs by citiesand counties, you know people
stay home and these were thepeople that actually saved lives
at the same time that we saw amuch more harmful drug supply
with the you know introductionof fentanyl in the West Coast in
particular in 2019, 2020.
(24:53):
But I would say the responseshould be criminalization to a
public health issue.
We have done it for over 50years and it doesn't work.
So the return tocriminalization as a strategy is
a political strategy, is afailed political and policy
strategy that we have been doingany time that again, you know,
(25:16):
I always say the empire iscollapsing.
So at this point we have to doany harsh measures to not show
the level of poverty andhomelessness and pain and crisis
that are, you know, the peoplemost vulnerable are in a, you
know, in a country that isreally starting to become a
third world country.
Having you know, having beenborn and raised in a third world
(25:39):
country, I can see theparallels.
So I would say thecriminalization is the response,
mandatory treatment is theresponse, jailing, you know, the
stick, not the carrot, becausealso there's no much carrot.
There has been never anamplification of the resources
needed to support, in general,the behavioral health needs of
(26:00):
poor people, in particular black, brown, native people, trans
and queer people who are poor.
We never done the scaling, harmreduction, scaling the
resources that we need, scalingtrauma-informed care.
So therefore, that's what we'veseen.
And so, at the local level, westarted seeing, definitely in
(26:23):
San Francisco, I think, philly,philadelphia, the Kensington
area.
You know, the new mayor cametwo years ago to say we're not
going to do syringe exchange,they don't allow mobile vans for
health care in Kensingtonbecause there is this, you know
this.
What they do is this screen Icall it the screen, what smoke
(26:45):
screen?
To show that if somehow we putpeople in jail which is again
that is exactly how racialcapitalism works then you're not
going to see them.
That doesn't mean that we haveaddressed either the overdose
crisis or the impact ofsubstance use disorder in those
folks that are heavily impacted.
The focus on the drugs knowwhat causes people to have
(27:09):
chaotic relationship with drugsthe pain, the trauma, right
Homelessness that actuallycauses all of this pain that may
get folks to be in reallydifficult relationship with
drugs.
The conflagration betweensubstance use and substance use
disorder.
That's what we see.
The word addicts and, by the way, there is no such a diagnosis
(27:31):
like addiction, it's actuallysubstance use disorder, alcohol
use disorder.
And then we hear peoplethrowing here oh, everyone on
the streets are addicts, they'reall alcoholics.
But basically the trends thatwe are now seeing ramp up by
Trump in a very, you know,fascist, authoritarian way.
(27:53):
We have been seeing it acrosslocalities and states.
In California we had actuallylawsuits by citizens with the
support of law enforcement inSanta Cruz against the Santa
Cruz Nail Exchange.
We saw also another assault inSanta Maria, in Orange County,
where now we cannot have asyringe service program as a
(28:14):
result of this political andreally misaligned strategy of
criminalization and the fantasythat not using substances is the
way to go for poor people.
Speaker 2 (28:28):
Right, yeah, I mean,
there's so much going on here
and you know, the ironic thingis is that our local politicians
, who often, you know, basicallyyou know, war on
criminalization of drug users,they do these massive sweeps
(28:58):
every Monday night where they dolarge numbers of arrests, san
Francisco had to open up a newjail to accommodate all of the
new arrests, not to mention thearrests of homeless people,
because we had, you know, athousand of those over the last
year for lodging.
So it's been very, veryintensive.
Speaker 1 (29:19):
Can I ask Shakima,
because I think this is an
important piece, shakima, whatis your impression?
I think there is also directcorrelation between, you know,
the systemic racism against ourcommunities and this new belief
in building jails and facilities.
Is there anything else you wantto add, because I feel that we
(29:40):
need to also name how this is.
You know, in some ways, thecontinuation of the targeting of
Black and brown bodies.
Speaker 3 (29:49):
Oh no, absolutely.
I think that these new policiesare going to impact vulnerable
populations the most, anddisproportionately.
It's going to affect peopleexperiencing homelessness,
people of color, the LGBTQcommunity and also people with
mental health conditions, andall these communities are
(30:10):
already facing significantbarriers to healthcare access to
service, access to resources,and I think that it's just going
to make this situation worsefor sure.
Speaker 2 (30:28):
You know fentanyl is
basically used as an excuse
because it's a stronger drug.
That then we therefore need togo back to these tried and
failed strategies.
Yet you know, if someone'saddicted to fentanyl or addicted
to anything else, there's goingto be those underlying issues.
Maybe they have severe trauma,adverse childhood events,
(30:50):
history of sexual violenceagainst them.
You know all of these things,you know, and, of course, as we
just talked about, living in,you know, under the structures
of extreme racism andtransphobia, and so how do we
organize against this?
And maybe you know, talk alittle bit about the power of
(31:11):
counter narratives.
Speaker 3 (31:19):
And maybe Shakima you
would want to start on that one
.
Sure, I feel like Laura kind oftouched on this earlier kind of
like using non-stigmatizing andpower force language I think is
important in combating thatstigma.
You know the difference betweenyou know saying someone that
calling someone a drug addictversus a person with substance
use disorder and things likethat, because when you do that
(31:41):
you're reducing someone'shumanity, reduce their identity
all the way down to just theirsingularly, their relationship
with substances.
And I think that language ispowerful.
It shapes, you know, ideas, itshapes how we perceive the world
around us, and not just for thepeople that are being called
these words, but for society,for the world that we live in.
(32:03):
And so I think that choosingwords deeply and being critical
about the words that we use isreally important in combating
stigma and negative bias.
And I think that maybe alsowithin the media, I think that
the media can do a better job ofnot focusing on the trauma but
(32:28):
also amplifying the voices ofthose who are being impacted and
sharing their successes as wellalso amplifying the voices of
those who are being impacted andsharing their successes as well
.
Speaker 1 (32:44):
Yeah, absolutely,
laura.
Do you have anything to add?
And specifically, how we canuplift voices of people who use
people living or livedexperience on the narratives,
and particularly in media orbroadly, is so impactful?
Because, you know, people don'ttake the bullshit right.
(33:05):
People talk straight up to saywhat their experience has been
and also, what is that we needto do?
What is that people with livedexperience, where are the folks
that are in the front lines need?
And I think the other piecethat we haven't talked a little
bit about is about what does ittake to support people with
(33:28):
living and lived experience toalso start joining organizing
efforts?
And so I think that both gohand in hand is how, like Kima
was saying, how do we challengenarratives?
I do continuously when I withthe media, I shift the narrative
or challenge or send themresearch or say, hey, you know.
(33:49):
In fact, this means this Irecently had a conversation with
Congress.
Is it the office that actuallydoes procurements?
I can't remember.
It's an independent office.
I sent them all the data we hadabout naloxone because you know
, as you know, one of thereasons why I think this
(34:11):
administration and othergovernment have been pushing, I
think it's called what is itNalmefim, which is this extra
powerful naloxone which what itdoes is actually is so strong
that actually get people inprecipitated withdrawal.
It's actually punishment andthey're trying to make money.
(34:32):
So, gao office, the GAO officeI actually had a meeting with
them and I sent them all thedata that we had because we had
our syringe service programsorganized in California sent
into California the note that wedon't want that particular form
of it's called high-dosenaloxone sold or either
(34:52):
distributed in California,because people with lived
experience are feeling like it'storture.
So just giving you an exampleof the kind of things we have to
be challenging across the boardwith government, with media,
and making sure that people whouse drugs have a real voice in
this fighting backlash.
Speaker 2 (35:14):
Yeah, absolutely.
You know it's playing out inSan Francisco.
This attack on harm reductionis, you know, has been in one of
our previous episodes.
If listeners haven't heard, itfocuses on housing first, but
there seems to be also, you know, this is kind of a theme that
(35:37):
we've been talking about.
That I just want to highlightis the profit involved in a lot
of these interventions and youknow, sometimes it might be a
big nonprofit that, because thequality of their services isn't
so great, wants forced treatmentas a way to fill their beds so
(35:57):
that they're able to bill.
It is the profiteering off offor-profit carceral systems in
prisons and it's also there's aprofit in some of the medication
pieces that are problematic.
Of course, a lot of medicationsare incredibly beneficial, you
(36:21):
know.
So many of this is, you know.
I mean, I think a lot of what'shappening is very greed-based
rather than coming from aperspective of actually solving
the issue.
So I just wanted to highlightthat for listeners, because I
have been hearing both of youmention that in your comments.
Speaker 1 (36:42):
Jenny, can I say
something since I had some data
I wanted to share for thispodcast and this is probably a
little older data, maybe from2020, 2021.
From Skull County.
A lot of studies have been donein Skull County because that was
very conservative back in thedays they had this peak of HIV
(37:02):
epidemic that resulted in themembracing home reaction for a
minute and basically the cost offour syringe service programs
that are funded across thecountry.
I think the top amount might be$135,000 a year.
That's their budget, which is$135,000.
(37:24):
But in Scott County at aparticular point in time they
also compare what a syringeservice program will cost with
what it will cost if 135 peoplewho were confirmed to have HIV
and hepatitis C will cost to thestate, and that was $48 million
.
This was again $48 million ayear for serving and treating
(37:47):
135 people who have contractedboth HIV and hepatitis C.
Most syringe service programsare still run by volunteers and
even in states like California,where we've done incredible work
trying to get funded by thelegislature, where we get
actually funding through OpioidSalmon funding, the most that
our programs get is $200,000 ayear.
(38:08):
Just to have some context abouthow much the folks who are
saving lives get paid versuswhat we are costing.
I just read that I think thisweek in Washington DC, last week
, every day, trump is spendingabout $400,000 on all that you
know photo shoots that they'redoing up in DC.
(38:32):
Just to show the contrast.
Speaker 2 (38:36):
Yeah, well, yeah, so
I think you know one of the
pieces we wanted to close outhere and hear from Laura you how
we can support, how listenerscan support, the National Harm
Reduction Coalition or any otherharm reduction efforts.
(38:59):
Um, I just also wanted to hearfrom both of you um any last
thoughts that you had um thingsthat you think it's important
for listeners to know about harmreduction.
Speaker 1 (39:10):
So I'll go on how to
support National Hammer Action
Coalition.
So if you want to get anyinformation, we have tons of
information in our website,which is wwwhammeractionorg.
That includes a Naloxone finderfor jurisdictions where people
need to know where to findNaloxone.
To some of our initiatives orspecial projects.
(39:34):
It's our 30-year anniversary.
We're going to very soon goviral, so any individual donor
support is greatly appreciated,because most of us, as you all
know, that depend on somegovernment contracts or some
particular foundations, neverget paid enough to keep our
(39:57):
business going.
So we will appreciate thatsupport and I just want to say
thank you to the coalition.
The ways in which unhousedpeople have been criminalized
and people who poor people whouse drugs have been criminalized
, and connecting those dots andworking together is critical.
(40:20):
And for those people who stillare on the fence, just read the
data, read what the facts are,listen to people who use drugs.
Those are the real experts inthis field.
Speaker 2 (40:32):
So thank you so much.
Yeah, and I just want to, justin case folks don't know what
naloxone is.
It's otherwise known as Narcanand it's the overdose reversing
drug.
Shakima, did you have anythingyou wanted to add?
Speaker 3 (40:46):
I think I just wanted
to encourage you know any
supporters or advocates orcommunity organizations to just
keep fighting.
I know that it's really easy tolose faith with all these
challenges, but we're aresilient bunch and we're here
to continue to keep serving ourcommunities.
We have the data on our side,we have each other, we have our
(41:06):
allies, so let's keep fightingand protecting our community,
especially the most vulnerable.
Speaker 2 (41:14):
Great, beautiful,
yeah, and I just want to kind of
highlight, you know, as weclose out here, another thread
that we were hearing a lotthrough this conversation, and
that is that you know drug usersand folks with addictive
disorders are a diverse bunchand that their paths are not
going to look exactly like theother Sometimes.
(41:34):
You know people are in recoveryand they think that their path
is the only path, and I thinkthat just doesn't play out.
They're only an expert on theirown recovery and so we need,
you know, there's a kind of afalse dichotomy right now
housing versus treatment.
Don't do housing, do treatmentinstead.
Well, we need both, right?
(41:57):
Folks are coming out oftreatment and ending up back on
the streets.
That doesn't work.
Folks who are in housing canaccess treatment, if they need
it, from housing and have a lotmore success, and the data bears
that out as well.
Lot more success, and the databears that out as well.
We also have to remember thathomelessness because of course
(42:17):
this is a coalition onhomelessness that homelessness
itself drives increasing ratesof addictive disorders.
It also drives higher rates ofmental health issues because of
that trauma and that experienceof homelessness, and so it
doesn't make sense to say thenokay, you know we have an
affordability crisis with regardto housing.
We as a people have not madesure in the United States that
(42:41):
people have access to safe anddecent housing, and so, now that
you're homeless, we're nowgoing to punish you for the
symptoms of homelessness thatare coming up out of that
experience, criminalize you, etc.
And so you know, the tried andfailed strategies are not going
to work today, just like theydidn't work yesterday.
So I do want to remind listeners, if you don't know already,
(43:06):
that we are having our annualart auction.
It's Art Auction 25 onSeptember 11th at SOMA Arts, and
we also have an online biddingthat opens up September 2nd.
We have incredible raffleprizes everything from tattoos
to Sonoma weekend to wine, andfolks can also buy those raffle
(43:32):
tickets starting September 2ndand start bidding on art.
And so we would love to see youat our event for information on
the art auction and alsolooking at all of our different
reports and research that we'vedone internally in collaboration
with universities, where youcan learn more about a lot of
these issues.
Go to cohsforg, so cohsforg, socohsforg initials for coalition
(43:57):
on homelessness,sanfranciscoorg.
So I want to really thank ourlisteners for tuning in and
taking the time to learn aboutthis important issue.
I want to thank our fabulousguests here today Laura Guzman
from the National Harm ReductionCoalition and Shakima Straker
(44:18):
from here at the Coalition onHomelessness.
And please, everyone rememberthat opening line from Laura
about love.
And now I can't rememberexactly what it is.
Speaker 1 (44:31):
Harm reduction is
loving people back to health.
Harm reduction is love Lovepeople back to health.
Speaker 2 (44:44):
Yeah, you know, and
yeah, and really that's what all
of us are bringing here is alot of love, and love will
counter the hate that folks arefacing out on the street.
So I know it's tough, and havea beautiful day.
Speaker 1 (45:01):
Thank you, jenny.
Thank you Lupe and Shakima.
Love, mad love and crazy times.
Thank you, talk to you soon.
Speaker 2 (45:11):
Thank you for
listening to Street Speak.
Join us again soon for more.