Feature:
The
North
American
Syringe
Exchange
Convention
4/29/05
Front-line harm reduction workers from around the country converged on Tacoma, Washington, last week for the North American Syringe Exchange Convention, the annual gathering of the North American Syringe Exchange Network. More than 150 people gathered for three days of networking, meetings, and nuts-and-bolts information on what works and what doesn't in America's growing needle exchange movement. While a funding crunch led to the cancellation of the last scheduled national conference in 2003, NASEN head Dave Purchase said that was just a bump in the road. "We're here, we're meeting again, we're not going away," he said. With more than 200 needle exchange programs now operating across the country -- many legally -- the harm reduction intervention indeed seems increasingly well-entrenched. And even where needle exchanges are still criminalized, they are occurring anyway. And it was a diverse group that gathered in Tacoma -- more diverse than usually seen at drug policy conferences -- both racially and culturally, with a significant African-American contingent, people representing major countercultural movements (socially conscious punks from Chicago, dread-locked hipsters from California), and multiple genders and sexual orientations in the house. Precisely because of that diversity, the needle exchangers were grappling with issues all too rarely confronted by the broader drug reform movement: How does needle exchange fit into the largely gay-based AIDS movement? How do people of color fit into the needle exchange movement? How does needle exchange fit into the broader drug reform movement? Participants grappled with those questions and much more during a busy, presentation-packed weekend, with down to earth workshops on topics such as "How to Run a Needle Exchange," "Wound Care Among IDUs and Problems With Receiving Care," and "Berkeley Needle Exchange Emergency Distribution: An Example of an All-Volunteer Collective Syringe Exchange Program."
Pasco was adamant about not strictly adhering to the exchange part of NEPs. "You don't have to turn in a needle to get a needle from me," he said. "We don't force gay people to carry used condoms around and we don't force addicts to carry dirty needles just to have one to trade. Why should people be forced to carry potentially deadly instruments around with them?" the burly, longhaired Midwesterner asked. While Pasco's Indiana program is walking the legal tightrope, other NEPs are unambiguously illegal -- but going ahead anyway. In Orange County, California, for example, local officials have refused to declare the health emergency required to authorize needle exchanges, but local activists refuse to wait. In an underground program there that began in January 2004, some 400 people are now receiving an average of 2,500 clean needles each month. "Many of my friends are recovering heroin addicts, and I've lost a few to the drug, too," said the Orange County exchanger, who asked to remain anonymous. "I never slammed, but most of the people I ran with did. I was a painter, but I broke my hand, so I was looking to do something with a larger impact. Here was a place where something needed to be done. These people were sharing needles and sharpening them on matchbooks. Before I started the exchange, maybe one in 10 had severe abscesses and two in 10 had severe tracking from repetitive shooting-up," he told DRCNet. It's not just handing out needles, said the Orange County worker. "I educate them, give them literature and information about how to use safely," he said. "It's strictly underground; I don't have any interaction with the cops. But that also means it's strictly home-delivery because we can't have a fixed site. The cops already hassle and search people constantly." In Orange County, it may be primarily heroin that people are injecting, but there, as elsewhere, methamphetamine increasingly looms large on the horizon. Meth was certainly on the minds of conference participants. In a Saturday afternoon session, Naomi Braine of New York's Beth Israel Medical Center discussed risk behavior among speed shooters in NEPs, while Luciano Colonna of the Harm Reduction Project explained links between meth users and HIV and Hep C infection rates in the West and Midwest. The issue will be explored in much greater detail at a national methamphetamine conference set for Salt Lake City in August, Colona was eager to point out. Relations with the larger AIDS movement were also a hot and sensitive topic at the conference. With attendees complaining that mainstream AIDS activists treat NEPs like the red-headed step-child of the movement, NASEN devoted an entire morning session to discussing whether and on what terms to accept an invitation to participate in the Campaign to End AIDS (C2EA). In the end, the organization agreed to sign on to the campaign, but only after obtaining promises from organizers that its input would be sought and its issues included in the C2EA platform. Foremost among those issues are lifting the ban on federal funding of NEPs. "The AIDS groups don't want to recognize us," said Pasco. "They're scared about their funders. They call what they do harm reduction, but harm reduction came from small actors, from ACT-UP, from grassroots gay and lesbian groups that did the actual work of harm reduction. Harm reduction without needle exchange is not harm reduction," he said. Though its members spend time in the trenches daily dealing with some of the most outrageous unintended consequences of drug prohibition, NASEN devoted little time and discussion to the bigger picture. Among the numerous panelists at the event, only Cliff Thornton of Efficacy, the Connecticut-based anti-prohibitionist group, drew the explicit connection in his presentation, "Beyond Needle Exchange and Prohibition." "We have to talk about race, class, and prohibition," Thornton told DRCNet. "The answer is not federal funding of NEPs or lifting laws on syringe sales, the answer ultimately is ending prohibition." While Thornton was disappointed the issue didn't get more play in Tacoma, at least the needle exchangers were facing it, he said. "The drug reform movement in general is not prepared to grapple with these issues, and that's a mistake." NASEN may not be ready to slay the giant of prohibition, but after three days of meetings, workshops, and informal networking, participants at the conference came away refreshed, invigorated, and ready to continue the good fight.
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