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A Diary of a Harm Reductionist

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July 11, 2024

Diary of a Harm Reductionist

“Harm reduction is a sophisticated term for something fundamental: helping people.“

AHCH Hro Specialist

What do you wish everyone knew about Harm Reduction?:

Harm Reduction Specialist: Harm reduction is a vital component in preventing the spread of infectious disease, reducing the risk of serious health conditions, and building bridges for clients to meet their goals at whatever capacity they are comfortable with. But it’s so much more than just the syringe exchange.
Meeting our clients where they are and creating familiarity by just showing up and asking how things are makes a huge impact for our clients every day. We do our best at making every interaction count, help to meet immediate needs as much as possible, and hold space for clients when they need it.

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Diary Entry for Friday, 6/14 Scattered Clouds, 85F. International District Library HRO. “Today we dealt with wind, heat, and rain. Spin the wheel and whatever it lands on is how the weather will behave for 11 minutes! Despite that, everyone was in good spirits, and we saw more than 150 people, which is about average. The good news is no flat tires this week. Big win!”

How do you see your Harm Reduction activities helping to overcoming some of the barriers our population faces?

Harm Reduction Specialist: Harm reduction is a sophisticated term for something fundamental: helping people. Harm reductionists are acting on the ceaseless compulsion to help anyone and everyone. We are the controversial bastion which chooses to help individuals who are a part of the community experiencing substance use disorder. These individuals grapple with the everyday challenges of living while in the midst of crisis.
Our clients often meet these challenges without the supports that society takes for granted. As harm reductionists, we seek to restore those supports. We seek to restore health care. We seek to restore community. We seek human interaction with community members who are not lost to us. By providing supplies that reduce the health risks of substance use, we are able to renew a relationship which transforms us. We do this without hesitation because we are not hardened or discouraged by the crisis of drug use in our community.

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Diary Entry for Monday, 6/17. 96F, Roving Outreach with Medical. “[Northeast Heights] — Found a couple in the park. Distributed survival supplies. Found campsite in an open space in the foothills. It was extremely hot. There’s no escape for us with the sun beating down, even with a little shade from the trunk of the van. But [there is] especially no escape if you’re surviving outside.”

Diary Entry for Tuesday, 6/18. 92F, West Side Outreach. “Still very hot. Not many folks in the usual spots we hit up on Tuesdays. Gave 6 people supplies. Hope they’re ok.”

Some people would say that Harm Reduction encourages Substance Use Disorders. How would you respond?

Harm Reduction Specialist: Part of the value of Harm Reduction model is that it centers an individual’s autonomy and right to choice. Sometimes that means that they will use substances forever. It is our job to celebrate any steps someone takes towards making informed decisions that are best for them and fit realistically into their lives, reducing risk for themselves and others, and gaining more insight and information about their own behaviors and practices.
Harm reduction is often misunderstood as something else, but I tend to come at it from a public health perspective. We are a healthcare organization, and abstinence-only education or refusing to provide services to people based on their substance use status services is not good health care.
While there is still a lot of ambivalence around Harm Reduction, Harm Reduction is integral to the community. I believe there is a way to hold the complexity of it all while modeling compassion, centering autonomy, and having a commitment to reducing needless suffering.

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Diary Entry for Wednesday 6/19. Roving with Medical. “Got to follow up with a client we’ve been missing for a while. Oakley was able to attend to his feet. Got him supplies and water. Saw 34 people in one spot. Gave out everything we brought with us.”

Diary Entry for Thursday 6/20. On-Site Syringe Service Program. “I guess pigs are flying today–We were early! Served 15 clients and all went well. More traffic than usual for a Thursday and we aren’t complaining!”

What has your biggest challenge been on Harm Reduction Outreach?

Harm Reduction Specialist: The biggest challenge has been having to watch a person’s progress be halted due to a lack of resources or years-long waitlists that prevent them from meeting goals like getting into housing. These systems make people extremely vulnerable, as well as lose faith and hope in the interventions set in place to help them.

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