Taking Harm Reduction Seriously

By Tessie Castillo 06/23/15

The Fix reports from the fourth annual Southern Harm Reduction Conference.


On June 5, the 2015 Southern Harm Reduction and Drug Policy Conference kicked off with a most unusual opening. Far from the drudgery of hotel lobbies, conference goers in bathing suits and towels met atop Hooker Falls in Asheville, North Carolina. In the swift, icy current, active drug users discussed policy reform with people who’ve never used drugs in their lives. Harm reduction heavyweights fraternized with starstruck newbies who had only just become acquainted with the term "harm reduction," a set of public health strategies designed to improve the health of people who use drugs by “meeting them where they are at.” The waterfall event was designed to build rapport, trust and a sense of solidarity among participants of diverse backgrounds and to emphasize that whatever challenges for the harm reduction movement lie ahead, they will not be faced alone. It was an unconventional start to an unconventional gathering.  

The Southern Harm Reduction Conference first convened four years ago in response to the absence of southern representation at the national harm reduction conferences. While states such as New York, Massachusetts and California steamrolled ahead on a wave of public health victories, the South was left in the dust, still a hodgepodge collection of underground activists who operated their programs, for the most part, illegally. Few panels at the national conferences addressed the specific needs of groups in the South: How does one run a syringe exchange or a naloxone program in a state where such programs are illegal? What if not a single harm reduction-friendly funder exists in your entire region? What if your whole program consists of two volunteers operating out of a clandestine van?

And so in 2011, the North Carolina Harm Reduction Coalition, in collaboration with other southern agencies such as Atlanta Harm Reduction, Women With a Vision of New Orleans, and Street Works of Nashville, Tennessee, organized the first Southern Harm Reduction Conference in Durham, North Carolina. It was specifically tailored to harm reductionists who work in hostile environments and could only dream of the kinds of public funding and support that their northern counterparts often take for granted. It was an event for the boots on the ground people. The ones who quietly go about their business because it’s the right thing to do.

Four years later, the southern landscape has changed dramatically. In 2011, not one southern state could claim a harm reduction-friendly legislative victory. Today, North Carolina, South Carolina, Georgia, Virginia, West Virginia, Mississippi, Florida, Tennessee, Kentucky, Alabama and Louisiana have all passed overdose prevention legislation. Last month, Kentucky shocked everyone by becoming the first southern state to legalize syringe exchange. The same week of the conference two overdose prevention bills—one from North Carolina and one from South Carolina—landed atop the governors’ desks to await signatures after passing state general assemblies overwhelmingly (and both have since been enacted). The conference this year buzzed with excitement, progress, and hope in a region that has long been dismissed as backward and unimportant.

But the mood was not all celebratory. Only a few days prior, Texas harm reductionists had triumphantly witnessed their drug overdose prevention bill, H 225, pass the Texas legislature overwhelmingly, only to be vetoed by Governor Abbott on June 1. One wry reporter from the Dallas Observer interpreted Abbott’s message as such: “Better that five junkies die of overdoses than 10 overdose and live.”

The unexpected defeat was a sobering reminder of what the drug policy and harm reduction movement is still up against. Not only does it confront reluctant politicians, corrupt systems, and a public whose support is tepid at best, but a deep, callous and unapologetic indifference to the lives of people who use drugs.

The media, the political field, and the criminal justice system are clogged with depictions that reinforce the view of people who use drugs as dispensable, unwanted, mistrusted and feared.

Let them die.

They knew the risks of taking drugs.

The world is better off without crackheads and dope fiends.

Such messages litter the airwaves and stain the comment section of every news article about drugs. Often the fight to merely be seen as human must be won long before any public health change can take place.

Perhaps fittingly, the conference took place against the backdrop of general unrest in the country. Newspapers scream out the latest police brutality scandal while the "Black Lives Matter" movement gathers steam. Yet, almost no one has faced more discrimination, harsh treatment and indignity at the hands of law enforcement and the criminal justice system than people who use drugs, particularly minorities. It’s no secret that one criticism against the growing popularity of drug overdose prevention efforts is that the acceptance of such programs occurs in direct correlation to how many white, suburban, middle-class mothers grieve the loss of their children. Even as the movement as a whole celebrates victories that represent a positive step towards saving all lives, there are murmurs of discontent. Despite progress, perhaps even because of it, drug users still find themselves in the unimaginable position of defending their right to live.

This theme ran throughout the conference from whispered side conversations in hallways to the booming voices of plenary speakers. Pastor Kenneth Glasgow, founder of The Ordinary People Society in Alabama and the conference’s opening speaker, delivered not a public health message, but a civil rights one with all the flare of a fiery Southern preacher.

“We have changed more laws in the past 10 years than the civil rights movement changed in 15,” he declared. “And we can change more. As long as directly impacted people are the voice of the movement, we will get things done.”

He likened the harm reduction movement to a game of chess in which advocates are not pieces, but the board across which powerful interests play a game. The game can’t be played without the board. And the pieces need some reminding.

His message of self-reliance and advocacy was reiterated by the two speakers who came after him: Dennis Gaddy, executive director of Community Success Initiative in Raleigh, North Carolina, and Cyndee Clay, executive director of HIPS, a sex worker outreach organization in Washington D.C.

Gaddy emphasized the importance of policies that help people who have had contact with the criminal justice system secure jobs so they can lead fulfilling lives again.

“Jobs are the number one resource people need to become positive and productive citizens,” said Gaddy. “And yet we as a society throw up barrier after barrier to formerly incarcerated people seeking employment. When society makes it hard to do the right thing, they make it easy to do the wrong thing.”

His message was clear: Everyone makes mistakes. But some are considered only mistakes, while others are seen as evidence of moral depravity, weakness or inferiority. And many think that such people need saving.

Cyndee Clay disagrees.

“We don’t need to rescue or save people,” she says. “We only need to provide resources so that people can handle their own business.”

That’s really what harm reduction is all about. It’s not about bringing people to where society thinks they should be. It’s about meeting them where they are at and creating a dialogue that results in any positive change, however the individual chooses to define it. It’s about recognizing that we are not in a position to judge the value of another human being or to decide whether their life is worth saving.

In the end, the message of the conference was that the South has a role to play in drug policy reform. Drug users, sex workers, incarcerated and formerly incarcerated people can and should be involved in changing policies that affect them:

We are not delinquents who need help being fixed. We are not so different from everyone else. We matter.

Tessie Castillo is the Advocacy and Communications Coordinator at the North Carolina Harm Reduction Coalition. She writes a regular column for The Huffington Post on overdose prevention, drugs, sex work, HIV/AIDS, law enforcement safety and health. She last wrote about sexism in the drug war.

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Tessie Castillo is a writer and drug policy advocate in Raleigh, North Carolina. Her articles explore topics such as criminal justice reform, drug policy, and harm reduction. Castillo previously served as the Advocacy and Communications Coordinator for the North Carolina Harm Reduction Coalition (NCHRC), a statewide nonprofit that advances drug policy and criminal justice reform. During that time, she played a pivotal role in helping to legalize syringe exchange programs and expand access to naloxone, a medicine that reverses opioid overdose. Find Tessie at her website or on Facebook, TwitterInstagram, and LinkedIn.