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Needle Exchanges Save Lives but May Imperil Workers

Posted Jan 11 2009 3:49pm
From the Wall Street Journal:
Pete Morse devoted his life to saving the lives of heroin users. A dreadlocked community activist with a Ph.D in history, he bore a tattoo that read: "Injury to one is an injury to all."

So his friends and colleagues were shocked when he was found unconscious in 2007 on a bathroom floor with a needle by his side. Doctors pronounced the 36-year-old Mr. Morse dead from an overdose of heroin, alcohol and cocaine.

Mr. Morse spent more than 10 years working in drug-addiction programs that follow the principle of harm reduction. This philosophy argues that the best way to save users' lives isn't to force them off illegal drugs. Instead, its adherents teach safer ways to use drugs -- supplying clean needles to prevent the spread of disease, for example, or teaching how to avoid overdosing. The programs are credited with saving lives in cities across the U.S.

To my mind, this is no indictment of harm reduction per se. I see this as a symptom of one of my biggest reservations about many harm reduction programs--that they don't view addictive drug use as an illness. Rather, many programs treat it as a lifestyle choice and that to promote recovery is to moralize.

Because harm-reduction programs don't force their clients to quit, making employees do so would be "completely hypocritical," said Ms. McQuie, the West Coast director of the Harm Reduction Coalition, a New York-based nonprofit that trains workers to run needle exchanges and other harm-reduction programs....

...Mr. Morse never stopped identifying as a user. In counseling with clients, the tattooed and dreadlocked Mr. Morse listened silently and, based on his own use and drug knowledge, explained how certain prescription drugs interact with heroin, recalls Kirk Read, who worked with Mr. Morse gathering data for a drug-user study for the University of California.

I'm sure that some will disagree with me, but is it possible to for a program like this to effectively encourage recovery? I'm sure it gives lip service to recovery, but I can't imagine it's interested in doing so, and I doubt that it could if it wanted to.

It's unlikely that I'll be taken seriously, given that I'm viewed as an enemy of harm reduction, but harm reduction has a lot of house cleaning to do. (Just as abstinence oriented programs did when harm reduction began its ascension.) I hope to see more programs adopting recovery-oriented harm reduction approaches.

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