Will Sam Work For People Who Use Drugs?

By Joella Striebel

A certain mayoral candidate seems to be dropping a trail of breadcrumbs leading to the vilification of people who use drugs intravenously. When he stopped by my house a few weeks ago while canvassing my neighborhood, we got to chatting about substance use concerns in La Crosse. With more than a decade under my belt as an addiction professional, I have a few thoughts on the matter. He (OK, it was Sam Schneider) asked me if I’d ever heard of Narcan training.

Indeed, I have. I’ve even coordinated a few of them locally, with the wonderfully helpful folks at Vivent Health (formerly the AIDS Resource Center). He seemed surprised to learn that we have Narcan, and Narcan training, available locally. For free. 

I told him about the important work being done at Vivent Health, about the Narcan distribution and training, and about the sterile injection equipment distribution and injection equipment exchange. I made sure it was clear that this seasoned addiction professional (and most others in the field) support these programs. We know that these programs reduce the harms associated with substance use, particularly the use of opioids and other commonly injected drugs. They reduce overdose deaths, injection injuries, and the transmission of diseases like HIV and Hepatitis C. They also, and this is important, give people who use drugs access to spaces where they are treated with dignity and respect, and where they can make connections to professionals who, when and if they are ready, willing, and able, can connect them with resources for treatment and support. 

He begged to differ, claiming that a friend of his had found a needle in his yard and had moved out of town because of it. I asserted that without these programs, we’d actually be likely to see more stray needles in public spaces. In the Ope! Publishing zine on the mayoral candidates, under the heading “Indignation,” he claims, with no other context, that a “friend was stuck by a dirty needle in a park.”

People who tell stories like these rarely seem to aim their indignation at the roots of the problems that lead to needles ending up in parks and yards. They aim their indignation at the people who use drugs intravenously, and often think the solution is locking up IV Drug users until there are no more IV Drug users to lock up.

I don’t relish being the bearer of bad news, but there will always be people who use drugs intravenously (just like there will always be people who drink too much alcohol, which, by the way, kills a lot more people than IV drug use does). Humans have sought to alter our state of consciousness from the beginning, and we will continue to do so until the end. We cannot, and should not, arrest our way out of IV drug use. All substance use, from caffeine to heroin, should be treated as the health issue that it is, and not as a criminal or moral issue.  

Finding needles in public is not an argument against injection equipment distribution and exchange. Ending these programs would not decrease IV Drug use. Ending these programs would increase needles found in public, and more tragically, ending these programs would increase transmission of HIV and Hepatitis C. It would also increase injection injuries, increasing the cost to all of us for emergency medical care for the uninsured. 

People do not leave needles in public because injection equipment exchanges exist. People leave needles in public places because they do not have safe places to use substances. We need to start having conversations about supervised consumption sites (also known as overdose prevention sites), and we need to look critically at our approach to homelessness and extend housing to people regardless of their readiness for sobriety. If we really want to stop finding needles in our parks and yards, we need to accept that people are going to continue to inject drugs, and we need to give them safe places to do so. 

Joella Striebel is a Clinical Substance Abuse Counselor and harm reduction advocate. She serves on The La Crosse County Alliance To HEAL’s Workgroup 9, which focuses on increasing naloxone (Narcan) access and improving sharps collection practices. Top image credit: Mark Oniffrey/CC BY-SA 4.0.

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