On Friday, October 20, AIDS United’s Director of Advocacy Drew Gibson took part in a panel entitled “Syndemic Care is Connected Care: Addressing Infectious Disease & Drug User Health Care Through A Community Lens.” Gibson was joined by Nick Voyles of the Indiana Recovery Alliance, Tonja Catron of Miami Valley Harm Reduction and Michelle Charonnier of MoNetwork.
The panel tackled how traditional health care interventions are often at odds with harm reductionist approaches. Often, this results from fundamental and philosophical differences towards addiction and societal pressures that only punitive measures can solve the crisis. These roadblocks stem from various sources, ranging from a lack of lived experience within clinical facilities, time-limited interactions with patients for the sake of “efficiency” or even little interest in tackling these problems to begin with.
Harm reduction, as a movement and health care intervention, has historically been built on the following principles:
- Provider-participant collaboration.
- Participant driven service provision.
- Non-judgemental provider-participant relationships.
- Fluidity of roles between providers and participants.
- Prevention of stigmatization and criminalization of participants.
The discussion highlighted a recent study by Khan, Et Al, “Integration of a Community‑Based Harm Reduction Program Into a Safety Net Hospital: A Qualitative Study.” This study examined how harm reductionists functioned within a hospital-based program. This program included a harm reduction in-reach program, an addiction consult services and a hospital observation unit. These were some of the themes they found:
- Traditional U.S. health care neglects social determinants of health and values expediency, which conflicts with harm reduction’s focus on holistic care at the client’s pace.
- Hospital staff stigma toward patients creates mistrust of medical systems from patients while also leading to despondency and burnout from harm reduction workers.
- Power hierarchies in clinical environments are much stricter and status-based, which is unfamiliar and unwelcoming to community-based harm reduction specialists.
People who use drugs often feel ignored, shamed and trapped in traditional health care settings.
Centering the agency and needs for people who use drugs is at the heart of harm reduction. The panelists called for non-judgement, non-coercive provision of services and resources to people who use drugs and in the communities in which they live. They also called for these people to have a real voice in the creation of policies and programs designed to serve them, and that people who use drugs as the primary agents of reducing their own harm and to empower and support one another in strategies which meet their actual usage conditions.
Read more about AIDS United’s work in harm reduction here.