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by Peter Moskos

January 23, 2009

Harm Reduction

I enjoyed attending “New Directions for New York: A Public Health & Safety Approach to Drug Policy” sponsored at the New York Academy of Medicine and the Drug Policy Alliance.

I was speaking on the Harm Reduction – Coordinating Strategies panel. Unfortunately, because I broke one of my rules and wrote on the back side of a copied piece of paper (rather than in my notepad), I left my notes at the conference.

You can see the full program here.

The instructions I received, and I chose to accept them, were these:
The role we’d like for you to play on this panel is from a public safety perspective. We would like you to speak about where or how a harm reduction strategy would and could fit in the public safety sector, as well as what the barriers are. It would be tremendously useful to hear your thoughts on this matter as one who is an expert in the field of criminal justice and an ex-police officer that patrolled in an area with a disproportionately high rate of drug use.

There were six on out panal and we each had about eight minutes.

I made the following four points (or at least I tried to):

When I arrived in Baltimore, Harm Reduction as it was perceived was seen as a failed program and Kurt Schmoke, a very smart man and advocate of Harm Reduction, was seen as a failed mayor.

I support drug legalization (though I prefer to use the term regulation). I think it would reduce harm. But to play devil’s advocate to a room of harm-reduction supports I tried to make these points:

1) It’s probably a safe bet that most academics and policy makers who support Harm Reduction don’t live in neighborhoods where Harm Reduction causes harm.

As an example, in both Cambridge, Mass, and Baltimore I lived near methadone clinics. It wasn’t the end of the world, but I certainly prefer not living near a methadone clinic. Nobody wants to live next to a methadone clinic... and often for very good reasons. So if harm reduction involves methadone clinics, people who make policy need to understand the needs of all those affected, and not just those in the target population.

For Harm Reduction to work, it’s very important to understand the opposition to it.

2) Harm reduction needs to be judged with a multivariate perspective. That is to say, harm is a many faceted thing. For instance when it comes to drug addicts and a public drug market, there are a) the potential health harms to drug users, b) the harms of drug-trade (prohibition) violence, and c) to quality of life issues. If you’re just a normal working stiff, you very well might care most about the latter issue. But research, especially in the public-health fields, tends to be public-health oriented. In this case that means a lot of A and a little B.

3) Though I’m happy to back in an era of science, understand that many people oppose Harm Reductions on moral grounds, for instance: drugs are evil. Public-health people aren’t very good at conceiving of or talking about thing in moral terms.

To find common ground, emphasize the impact on saving lives. That is common ground. Previously, Jill Reeves had given a powerful speech about her own perspective as an addict. She mentioned that one of the greatest needs for addicts is a nine-one-one Good-Samaritan law. In other words, you shouldn’t risk arrest by calling for an ambulance to save a life. That might be a good place to start forming common ground.

4) Police generally are not sympathetic to Harm Reduction because, well, among other things, it’s not job. To ask police to care about clean needles for the health of addicts, well, it’s not their job. It would be like the police asking a doctor for help in bringing down a drug shop. It’s just not gonna happen. Public health messages geared to police need to focus of public safety and officer health.

Clean needles, for instance, should be any easy sell. It’s easy to see the link between dirty needles and officer safety. When an officer is sticked, you really hope that needle is clean. I hated seeing officers crush needles in the gutter. Do any addicts get clean by virtues of a police officer crushing their needles? I don’t think so.

In a different session, P. David Soares, Albany County District Attorney, made a very good point: if we want to stop young boys from working for drug dealers, it would help matters if we didn't make it illegal for anybody under 16 to work at all.

By far the loudest and longest applause (at least for what I attended) went to a CUNY colleague, Queens College Professor Harry Levine. He brought down the house (at least as much as you can at such a conference -- but this conference was open to the public, so it was a little more rambunctious than the average academic fair).

Levine ending his (precisely-timed) 10 minute speech by noting that if Obama had lived in New York under current NYPD arrest practices, he could easily have been arrested and, by having a criminal record, had no chance of becoming president. How many potential Obama’s lives out there right now, asked Levine, have we ruined through aggressive arrest policies in our war on drugs? The crowd, as is almost everybody in my New York world, was very pro-Obama.

Levin is co-author of "Marijuana Arrest Crusade: Racial Bias and Police Policy in New York City 1997-2007." I learned a lot about New York State marijuana law and police practice regarding said law. And it's very readable.

I don’t think Levine is on the NYPD Chief's Valentine’s-Day mailing list this year.

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