LOCAL STORY pushing forward is that syringe access programs, such as the one I oversee, have a good relationship with neighbors. We know that people need to be a good neighbor in the community and have folks rise to that occasion. [Critics] were concerned that [the center] would increase inappropriately discarded syringes in the neighborhood. We have safe disposal here, so it’s better to be within a mile of a syringe access program because people can take those used syringes and properly dispose of them here. What happens is there’s a lot of misinformation. I’m always on the defense rather than being able to be on the offense. Misinformation comes out and people just start spewing it. It’s very difficult to come back to them with evidence, science and public health, and things like that. Ultimately, people don’t want to hear you’re going to be a good neighbor; they want to see it. That’s why it’s so important for us to be a good neighbor in the communities in which we serve. Our folks are invested in being that good community member because they want to be part of a community; they want to keep us safer and healthier. I want to be really clear: in the state of Colorado, when we talk about an overdose prevention site, it’s simply a program arm of an already flourishing syringe access program. We can do everything possible to prevent and eliminate the transmission of HIV and Hepatitis C — resources, referrals, naloxone (Narcan), fentanyl testing strips — but it’s not legal for them to inject on my property. Use and possession on the property can get seized. So [our participants] go a few blocks away to an alley or a business bathroom and they inject there, often alone. Then they’re dying in these public places. We can do better than that. HOW DO OVERDOSE PREVENTION SITES BENEFIT THE WHOLE COMMUNITY? Everybody that overdosed was found by somebody. We know that RTD transit stations struggle. They’ve had 13 overdose deaths in the last two-and-a-half years in a transit station in Denver. Who’s coming up on people overdosing in the transit station? Is it a transit worker, or is it a community member? WHO’S TALKING TO THAT PERSON AFTER THAT? It’s a larger community trauma issue that no one’s really talking about. We want to reduce that larger community trauma. I want [it to be safe and legal for] people to inject at my place. I want them injecting with me present. When has anyone said something like that? It’s safer [to inject] when experts are present. We want to take that off of the businesses and the larger community, as well. It reduces public injecting and promotes public safety. Harm reduction increases public safety. Drug use is already happening. We want to reduce the harms associated with public injecting; we want to reduce the harms associated with overdosing and dying of overdoses. When people are alive, there’s hope. So, 284 drug-related deaths in Denver in 2020 is unacceptable; 225 in 2019, unacceptable; 209 in 2018, unacceptable. We need to be chipping away — we’re getting worse, not better. WHAT HAS CONTRIBUTED TO THE PUBLIC’S PERCEPTION OF SYRINGE EXCHANGE PROGRAMS? The United States has never done a good job with the war on drug users. The war on drug users has been incredibly racist and classist. The DEA, the police, they can’t arrest their way out of drug use. They continue to try stigma, shame, and incarceration. Incarceration never should have been the answer and never worked. Stigma and shame haven’t worked, either. We’ve never had a good conversation in the United States, in general, about drug use. There’s so much misinformation out there. There’s a lot of misinformation even among health care CREDIT: GILES CLASEN providers about chaotic drug use. Health care providers have a lot of terrible information, too. Here’s the thing: I don’t want it to have to affect you for you to give a fuck. I don’t want to give the example of, “What if it was a family member?” That shouldn’t even matter. People should not have to die of preventable overdoses. People matter, even if they use drugs. So many people have such misinformation about people who use drugs like, “Oh, they’ll never go to a syringe access program, they don’t care about their health.” Actually, [our participants] do. That’s all we talk about sometimes: necrotizing fasciitis, osteomyelitis, endocarditis, Hep B, Hep C, HIV. My people thirst for factual health information. I think there’s just so much misinformation, and then, it just perpetuates that stigma. DO NEEDLE EXCHANGES AND OVERDOSE PREVENTION SITES ENABLE DRUG USERS? People talk a lot of shit about “enabling.” I’m not sure where that comes from. Rock bottom is death. We need to have a better conversation about that. We’re enabling folks for a healthier and safer “them” today. We are engaging with folks with dignity and compassion. When [drug users] want to do something different, we’re the first folks they come to. WHAT WILL CHANGE WHEN MEDICAID BEGINS COVERING DRUG ADDICTION? I think a lot of people are thirsting for an inpatient setting. Twenty-eight days, though, isn’t the greatest inpatient that’s ever lived. That’s all that usually the insurance companies will pay for. But 28 days to give you some time to figure out what life is going to look like without using substances has value. But there aren’t a lot of great solutions to drug use. Medicationassisted treatment is a possible answer. The problem is that you have millions of people using drugs, and you only really have a few treatment modalities: inCREDIT: GILES CLASEN patient, AA/NA, LifeRing or Lifeline, and medication-assisted treatment. That’s about it. WHAT IF TREATMENT DOESN’T WORK? There is a lot of relapse that happens for folks in recovery, but also sometimes, people are like, “Oh, I don’t know, I failed treatment.” And it’s like, “No, what that sounds like is treatment failed you. So how can I be supportive?” We need to be supportive. Our staff doesn’t talk about treatment unless participants bring it up with us. The world wants [the people using drugs] abstinent, and for one reason or another, today may not be the day. And abstinence may never be in the cards. But today is the day to do something healthier and safer and engage with folks who are just, quite honestly, fucking rooting for you. We’re rooting for you. WHAT HOPE IS THERE FOR OPPORTUNITIES TO HELP DRUG USERS? 2020 has been a hard year for being optimistic, I got to tell you. But I think there’s still hope. There are still opportunities for people to find solace in one another, to find mutual aid opportunities to save people’s lives. We continue to train drug users to help one another, to use Narcan. People who use drugs are the true first responders in midst of this overdose crisis. I also see people testing their drugs with fentanyl testing strips and being, like, “Yeah, I did a behavior change; there was something I did differently because I knew what was in my drugs.” That’s overdose prevention. Fentanyl testing strips test to see if fentanyl or fentanyl analogs are present in your drug before you use your drug. It just shows if it’s positive or negative. It doesn’t say how much or anything like that. Once you know what’s in your drug, you can do something about it. Sometimes, they’ll throw the drug away entirely. Sometimes they do a little bit — they don’t do as much as they were initially going to do. Once you know what’s in your drug, then you can do something about it, and that’s an overdose prevention technique. They’re quite literally lifesavers. ■ January 2021 DENVER VOICE 7
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