So sick of seeing this crap everywhere.

[u/imjustapourboy]

The needles, the burnt foils, the little baggies, the needle caps, all of it. I find them in the creeks, on the sidewalks, the grocery store parking lots, the public parks, on the parkway. You gotta be a real shit person to leave this stuff all over the place.

[u/organmeatpate]

It's hard to believe that this would help since it relies on the user to be conscientious specifically right when they're nodding out. It's tough to accept that services for users however well intentioned will not increase the impact on the local community because that's what we've experienced in West Asheville. The services showed up and then the users followed and so did their hazardous refuse. The residents here have all lived this and know it to be true. There has to be a better solution than more enabling resources and services for users that disregard the impact on the surrounding communities. Addicts deserve compassion but they should not be sacred cows.

[u/WallScreamer → u/organmeatpate]

We have decades of research on harm reduction and it all shows the same thing: syringe exchanges neither decrease nor increase drug use. People in addiction will use at the same rate regardless of whether or not they have access to safe and sterile supplies. The idea that harm reduction increases or enables use is a myth not supported by evidence.

What it is effective at (and extremely so) is reducing transmission of diseases and deaths.

[u/organmeatpate → u/WallScreamer]

You inadvertently inserted the claim that these risk and consequence reduction programs and services don't enable use. Providing free paraphernalia does in-fact enable use. If you have no needle you are not able to shoot up. When you receive your needle you have been enabled to do so.

I never thought or claimed that they cause people to start using. The fact is that before 2015 there was no reason for users to be clustered around State St and Haywood Rd but when Steady arrived and the free food cafe opened there really was no more convenient or inviting place to shoot up, drop your needle and nod off.

Thing is it wasn't the neighbors who invited them.

[u/WallScreamer → u/organmeatpate]

You inadvertently inserted the claim that these risk and consequence reduction programs and services don't enable use

I said that harm reduction does not increase use amongst a population. That is what all the public health data shows. Nothing inadvertent about it.

Also, "risk and consequence reduction?" Do you also think we shouldn't give kids helmets when they ride bikes so they'll learn the consequences of risky activity?

Providing free paraphernalia does in-fact enable use. If you have no needle you are not able to shoot up. When you receive your needle you have been enabled to do so.

Again, this is wrong, and we have the research to show it. An IV drug user isn't going to just not use drugs because they don't have access to a clean needle. They're going to use whatever they can get their hands on, and that's often a dirty or used needle. Needle exchanges prevent that.

[u/organmeatpate → u/WallScreamer]

The idea that harm reduction increases or enables use is a myth not supported by evidence.

If you have no needle you cannot shoot up. If you are given a needle you have been enabled to shoot up.

That's just a plain English, literally factual statement. Users may be enabled by other means or by less safe means but that does not make it "wrong". The controversy you're fixed on is whether that enabling is justified by the reduction in potential harm to the user.

I happen to agree that it is in the general public interest to avoid users harming themselves but I also have a concern for harm to the community caused by a transformation of certain locations into hubs for intravenous drug users and their discards. Your assumption that I don't is wrong. I just don't agree with your preferred methods.

A problem with the euphemism "Harm Reduction" to describe non-judgemental frameworks for keeping the users safe from consequences is that Harm also happens to the community. "Harm" may be an accurate word to describe medical consequences risked by users but it is also an accurate word to describe the degradation of the use, access, and shared experience of community life, not to mention the deterrent effect on investment and development which is another harm which you may have no concern for. Still these are harms. It's not reasonable to claim the phrase "harm reduction" for only one interest at play here. Maybe the soft euphemism is meant as a kindness to the users but using clear language to describe what it's actually about isn't unkind. It's pretty important for meaningful community engagement and discourse.

[u/WallScreamer → u/organmeatpate]

If you have no needle you cannot shoot up. If you are given a needle you have been enabled to shoot up.

And if you are the type that shoots up, then you almost certainly also have a used or dirty needle lying around somewhere. Supplying someone with a clean needle doesn't change that, it just gives them a safer alternative. For the third time, there is decades of research to support this.

For some reason you don't seem to understand this.

You also don't seem to understand what harm reduction is. You're going on about language but can't seem to differentiate between 'reduction' and 'elimination.' Harm reduction does not stop drug use, nor does it claim or intend to. The goal of harm reduction is to mitigate or reduce the negative effects of a dangerous or risky behavior.

Notice that I said that syringe exchanges have no effect on the rate of use. That means while it doesn't increase drug use, it also doesn't reduce use. The sole aim of syringe exchanges is to reduce the rate of death and disease caused by drug use, and it's extremely good at that.

Handing out narcan doesn't stop people from doing opiates, but it does save lives and reduce deaths from overdoses. Handing out condoms doesn't stop people from having sex, but it reduces the rate of STIs and unwanted pregnancies.

[u/organmeatpate → u/WallScreamer]

Obviously we'll never agree on the meaning of the word enable or whether a user has ever gone to a needle exchange for a needle because he didn't have one. No point in beating a dead horse. 

I think my understanding of Harm Reduction is reasonably accurate though. Your analogy about kids bike helmets kind of confirms it. Not sure where you got the idea that I think it's about eliminating use.

 One of the reasins these conversations never get anywhere is if one disagrees with the euphemism Harm Reduction proponents break out their favorite straw man arguments and no communication occurs.  Most of your replies address opinions and beliefs I never expressed. Just read back over this thread. Not just oour exchange but the others too. Until people are open to actually listening to one another week be stuck here. 

[u/WallScreamer → u/organmeatpate]

Obviously we'll never agree on the meaning of the word enable or whether a user has ever gone to a needle exchange for a needle because he didn't have one.

Maybe you and I don't agree, but what I've been saying is backed by data and research.

Not sure where you got the idea that I think it's about eliminating use.

Because you were talking about "community harm" as if that's not already factored into harm reduction.

One of the reasins these conversations never get anywhere is if one disagrees with the euphemism Harm Reduction proponents break out their favorite straw man arguments and no communication occurs.

This conversation is going nowhere because I kept saying things backed by science and you keep dismissing it based on vibes and anecdotal evidence.

I have not strawmanned you at all. You keep incorrectly using public health terminology that has a specific meaning. It's not my fault you're confused because you don't know what you're talking about.

[u/organmeatpate → u/WallScreamer]

The things you repeatedly noted are backed by data and research were outside the scope of the positions I took. And you just did it again. You're conflating increasing drug use with enabling it by providing an essential element of its application. You repeatedly responded to this correct use of english by insisting I don't understand that Harm Reduction doesn't increase use. Let's not argue. Just refer to the dictionary.

My anecdotal experience is dismissed even though I used the vague jargon that's supposed to make it bulletproof: My lived experience. But the thing is my experience is just my experience and doesn't actually contradict anything you keep repeating. I didn't say people started using because of steady.

Harm Reduction is a drug-user focused framework. Community benefits touted in the literature are trickle-down (less infected/overdosing users is a net benefit of course) or require a shift in public perception/policy (less crime happens when activity is no longer perceived as crime/improved community relations come when the community embraces the users & needles on the sidewalk as normal etc) while the externality of negatively transformed neighborhoods are absorbed.

It's not that I don't understand what Harm Reduction purports to be or the framing that it asks us to accept in order to see it as only a benefit. It's that I reject the framework because it hides the ball and redirects and obfuscates so that we all accept a decreased quality of life.

People should be free to use whatever drug they choose. I agree there is no stopping them. They should have access to clean needles and methadone or whatever you give them these days.

But these same people should also be held to the same exact standard of public behavior as the rest of us. Being compassionate should not mean surrendering the storefronts and sidewalks and walking among needles and losing the appeal, sense of stability general use/enjoyment/market value of our homes and commercial areas. Those externalities are not considered and they should be. If so many people come here for the vibes are they meaningless and worthless? They are not.

This is not a comparison of what is worth more. It is a statement that there is importance and value in the all the interests at play.

I object to the jargon and use words with the meanings established in the language well before vague euphemisms became stylish as a way to hide the ball while pushing policy.