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What's the Hook? Diary of a Drop-In Center

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What's the Hook? Diary of a Drop-In Center HARM REDUCTION COMMUNICATION What’s the Hook? Diary of a Drop-in Center by Marcus Day In St. Lucia (a small island in the British West Indies), our DOH was supporting the establishment of a drop-in center in Central Castries (the capital, the center is located in George the Fifth Park, commonly referred to as “the Gardens”), in an area frequented by dysfunctional, chaotic and mostly home- less crack users. In 2001 DOH director Uli Kohler instructed me to spend a good por- tion of my time getting the drop in center up and running. The Hook! Many of us have discussed what it takes to get crack users into a drop-in center. One ad- vantage programs working with injectors (heroin, cocaine or speed) have is the lure of needles; this by itself is frequently enough to get users into the center, where other services can then be offered. We have always looked for that attraction with crack users. Some pro- grams give out smoking kits containing filters and other paraphernalia; a few have created safer crack use brochures. Sometimes we make the mistake of confining our efforts to elements of users’ lives that are most obviously drug-related; unfortunately the harm that’s brought about by drug use in a society that doesn’t approve of it can be much more all-encompassing. The more in- teraction you have with your clients, and the continued on page 4 HARM REDUCTION COALITION SUMMER 2002 NO. 14 THE HARM REDUCTION COALITION (HRC) is committed HARM REDUCTION to reducing drug-related harm among individuals and communities by initiating and promoting local, regional, and national harm reduction COMMUNICATION education and training, resources and publications, and community Summer 2002 NO. 14 organizing. HRC fosters alternative models to conventional health and human services and drug treatment; challenges traditional client/ provider relationships; and provides resources, educational materials, Table of Contents and support to health professionals and drug users in their communities to address drug-related harm. The Harm Reduction Coalition believes in every individual’s right to 1 What’s the Hook? Diary of a Drop-in Center health and well-being as well as in their competency to protect and help by Marcus Day themselves, their loved ones, and their communities. 8 The Card Game Editorial Policy by Chris Catchpool Harm Reduction Communication provides a forum for the exchange of practical, “hands on” harm reduction techniques and information; pro- 10 User-Driven Overdose Prevention in Santa Cruz County motes open discussion of theoretical and political issues of importance by Emily Ager and Heather Edney to harm reduction and the movement; and informs the community through resource listings and announcements of relevant events. Harm 14 Dispatch from the Drug War’s Front Lines Reduction Communication is committed to presenting the views and opin- ions of drug users, drug substitution therapy consumers, former users by Arun Prabhakaran and people in recovery, outreach and front-line workers, and others whose voices have traditionally been ignored, and to exploring harm re- 17 Deconstructing the Dark Side of Circuit Parties duction issues in the unique and complicated context of American life. by Robert Felt Since a large part of harm reduction is about casting a critical eye to- ward the thoughts, feelings, and language we have learned to have and 23 Managing HCV among IDUs: Overcoming the Politics of use about drugs and drug users, Harm Reduction Communication assumes Exclusion that contributors choose their words as carefully as we would. Therefore, by Allan Clear we do not change ‘addict’ to ‘user’ and so forth unless we feel that the author truly meant to use a different word, and contributors always have 26 Hep C Activists and Advocates Needed last say. The views of contributors to Harm Reduction Communication do not by Alan Franciscus necessarily reflect those of the editorial staff or of the Harm Reduction Coalition. Any part of this publication may be freely reproduced as long 28 Living with HIV and Hepatitis C as HRC is credited. by Beri Hull Design and Layout: James Pittman Printing: Dodge-Graphic Press, Utica, NY 29 Scoring Treatment: A Prisoner Beats the System Artwork Contributed by: Bert Gossen (cover, pp.8, 16), Joshua Lunsk by Michael Paulley (pp.22-36), Johnny Edney (p. 14) Photos: Stills from The Dope Operas, courtesy SCNEP (pp.10-12) 32 Hepatitis C Drug Therapy for People on Methadone Maintenance by Matthew Dolan Please write in your comments, feelings, responses—we want to hear from you. If you would like to submit an article, or photos or artwork, we would be happy 33 Treatment of HCV in the Methadone Patient to look at your material. (See our website www.harmreduction.org/news/ by Diana L. Sylvestre submission.html for submission guidelines.) HRC gives a voice to communities that are ignored by conventional media: drug users, people of color, individu- 36 HCV Healthtips als who are HIV or Hepatitis C positive, and sexual minorities. If you have never by James Learned written something for publication, assistance is available: just ask for it. (You can call the editor at 212 213 6376, or include a note with your submission.) 38 Book Review: Harm Reduction Psychotherapy. Send all submissions and correspondence to: A New Treatment for Drug and Alcohol Problems Editor, Harm Reduction Communication, Harm Reduction Coalition 22 West 27th Street, 5th Floor, New York, NY 10001 39 Witches’ Brew Or email: [email protected] by Donna Odierna HARM REDUCTION COALITION Allan Clear, Executive Director Paul Cherashore, Publications Coordinator Alvaro Arias, Director of Finance Erin Grothues, Operations Manager Don McVinney, Director of Education & Training Miranda Chiu, Administrative Consultant Amu Ptah, Director of Policy OAKLAND OFFICE Donald Grove, Technical Resources Coordinator Maria Chavez-King, California Training Director Paula Santiago, National Conference Organizer Jenine M. Guerriere, Eastbay Program Coordinator Emily Winklestein, National Training Coordinator Micah Frazier, San Francsico Program Coordinator Adrienne Brown, HRTI Program Manager Daisy Buel, California Office Manager Main Office 22 West 27th Street, 5th floor, New York, NY 10001, tel.212.213.6376 fax.212.213.6582, e-mail: [email protected] West Coast Office 1440 Broadway, Suite 510, Oakland, CA 94610, tel.510.444.6969 fax.510.444.6977, http://www.harmreduction.org 2 themselves.” While I agree with him in principle, I also recognize that given the drug war, the game is rigged. Even if we were to stop all further transmis- sion tomorrow, there would still be millions of people already infected who face potential illness and death from this virus. Those of us working in harm re- rom duction have a contribution to make: we can help level the playing field. At FromF least that way users have a chance. thethe editor editor —Paul Cherashore LettersLetters his is the promised second installment of the missing Fall 2001 issue THOSE WE LEAVE BEHIND: DRUG POLICY AND THE POOR of Harm Reduction Communication. And again I’m not writing about T drug use in the harm reduction workplace. Instead, we’re going to de- To the Editor: vote a future issue to this and related subjects, so please send submissions my Thank you for publishing the article “Those We Leave Behind: Drug Policy and way. Because I have abbreviated space for this editorial (we’ve received a the Poor.” As a direct service provider and harm reduction practitioner, I worked few letters we want to print, along with an author’s response), I’m going to re- in the Lower East Side for many years. One of the biggest challenges I dealt strict my comments to a specific portion of this newsletter’s content. with was the continuous evictions of family members whose adult children were About half of this issue is devoted to hepatitis C. This is great timing, be- arrested and convicted for drug related crimes. I could never understand how cause at the Second NIH Consensus Development Conference on Manage- evicting someone’s 80 year-old grandmother from her residence would con- ment of Hepatitis C (June 10-13, 2002 in Bethesda, Maryland) there was a tribute to the fight against illegal drug use and sale. Not only does this not help, great deal of discussion about treating active drug users. In fact, the draft ver- but now it displaces another person on a fixed income, thus adding to the home- sion of the new 2002 NIH HCV Consensus Statement says, “Recent experi- less population. People change; not all persons addicted or dependent on a ence has demonstrated the feasibility and effectiveness of treating HCV in controlled substances are dangerous to the community. people who use illicit injection drugs (IDUs)...” If the language in the current In a great metropolis like NYC the only approach to intervention contin- draft version holds up, we should see greater accessibility to treatment for ac- ues to be punishment of individuals and families suffering from addiction. The tive users –and ex-users. Unfortunately, the current treatment is hard on the law recognizes alcohol dependency as an illness (disease) but continues to healthiest and most stable individuals; without sufficient support from either the imprison and break up families who have an active addict in their home. medical providers supplying the treatment, therapists, service providers, Many times the only form of support for someone addicted comes from their friends or family many active users may find it impossible to stick it out. If that families. Families are the strongholds of any neighborhood; by providing happens on a fairly large scale, we’re likely to see the medial and public some social services and related interventions and assistance, we strength- health professions concluding that their original decision to exclude users was en our society.
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