The District Attorney has a presentation from Maia Szalavitz, author of Harm Reduction /

Author and journalist Maia Szalavitz spoke virtually with the Berkshire District Attorney’s Office last week about harm reduction techniques to tackle substance abuse. Szalavitz excerpted his own experiences in his latest book “Undoing Drugs.”

Berkshire District Attorney Andrea Harrington said her office was not prosecuting for possession of “personal use” amounts of the drug. But prosecutors recognize a gap between letting people go and getting them services.

PITTSFIELD, Mass. — Maia Szalavitz first experimented with the use of “harm reduction” in 1986 when, in the grip of her addiction, an acquaintance advised her to disinfect a shared needle for intravenous drug use.

She later credits this person for saving her life, as she would have likely contracted HIV in this case without the advice.

Decades later, Szalavitz’s book “Undoing Drugs: The Untold Story of Harm Reduction and the Future of Addiction” was published, bringing home the once radical view that people deserve to live, that they break down or not.

The best-selling author and journalist has written about addiction, recovery, childhood trauma, and empathy (including several books with Dr. Bruce D. Perry). Last year’s “Undoing Drugs” is his latest look at drug addiction and the history and use of harm reduction techniques.

On Thursday, Szalavitz spoke virtually with public health professionals and prosecutors from the Berkshire District Attorney’s Office.

The harm reduction principles are backed by District Attorney Andrea Harrington, who is bothered that there are evidence-based solutions that aren’t being adopted at all levels, especially since the county has saw an increase in overdoses eight times greater than the state as a whole.

“So our community, we have a significant opioid problem, 6% of the population here is addicted to opioids,” she said. “According to recent statistics, we have seen a large increase in fatal overdoses. This office is responsible for investigating all of these overdoses. We had a 44% increase here in this county, that was in 2021, fatal overdoses and across the state, there was only a 5% increase, so we’re in a tough spot.

“I meet the parents of people who have died of fatal overdoses here in this room and the big thing they share with me is that it was the shame and the stigma their children felt that kept them from really getting the help that would keep them alive.”

Harrington prioritizes substance abuse as a health issue. Rather than following the “war on drugs”, a phrase for strict policing and condemnation of drug-related crimes, she calls for allocating resources to address the issues that lead to substance use and solutions for the users.

“In this office, we do not pursue possessions of amounts for personal use,” she said. “We think this makes a strong statement that we should be treating substance use disorders as a public health issue and not a criminal matter, so I’m proud of us that we’ve been leaders in this domain.”

Harm reduction aims to reduce the negative consequences associated with drug use. It applies the core of the Hippocratic oath to “do no harm” to drug treatment and drug policy, Szalavitz said.

A local example of the approach is Berkshire Health System’s Healthy Steps program which works with active injection drug users to dispose of used needles and provide them with sterile supplies in hopes of preventing the transmission of HIV and ‘Hepatitis C.

This method is well supported, as the United States Centers for Disease Control states that needle service programs reduce HIV and HCV infections and are an effective part of comprehensive community-based prevention and intervention programs that provide additional services.

“When we practice harm reduction as a philosophy, it’s transformative because we all have gifts to give, and we all contribute to the world and yet we all do harm too, even when we try not to. do it,” Szalavitz said. .

“Harm reduction is a gift from people who use drugs to all of us, it says you matter whether you take drugs or not, it says you deserve to live whether you get high or not, and that says you can contribute and you can reduce harm, and that’s really what we all want to know, how to make a difference, to heal, to cure to be cured…

“We don’t usually change overnight and we all take risks that can hurt, but if we work together we can minimize that and empower ourselves to do better.”

Szalavitz was using heroin with a friend in an East Villiage, NY apartment more than 35 years ago when his worldview changed. His friend’s girlfriend, who flew in from San Francisco to make sure her partner got help, taught Szalavitz to protect herself by not sharing needles and if there were no d Another option is to disinfect them with bleach.

Although she is a regular reader of the newspaper, Szalavitz said she had no idea that intravenous drug use put her at risk of contracting the human immunodeficiency virus. She took the advice to heart, becoming “compulsive” to disinfect her needles, she said, and spread the word to others.

She was furious that no one had told her about the risks.

Shortly after the incident, Szalavitz’s friend in the East Village fell ill with AIDS and she knew the stranger’s words had had a huge impact on her life.

Szalavitz would later identify – and contact – the woman as Maureen Gammon in 2020 after extensive research. Gammon worked to spread the gospel of harm reduction on the West Coast in the 1980s.

This simple act of compassion led Szalavitz to take care of herself until she recovered, and then cover American harm reduction from its roots.

Szalavitz highlighted the origins of modern harm reduction, which originated during the AIDS (acquired immune deficiency syndrome) crisis, and the activists who helped shape the movement.

These include a Puerto Rican activist who instigated hunger strikes in the AIDS ward at Riker’s Island prison and led ACT UP NY to become involved in a needle exchange, a group of individuals in San Francisco who promoted the idea of ​​cleaning needles with bleach to save lives, and working-class drug addicts in Liverpool, England, who publicized the principles of harm reduction .

She also claimed that reducing the supply of medical opioids – which has reportedly been reduced by 60% since 2011 – to reduce overdose deaths has actually done the opposite and increased the prevalence of fentanyl.

“Harm reduction specialists predicted that this approach would backfire. restore; second, because smaller drugs are easier to smuggle, crackdowns tend to push dealers toward more potent and therefore riskier products,” Szalavitz said.

“Our policy also increases disability and suicide in pain patients because stopping medical opioids does not cure pain either. Studies now show that forcibly reducing or stopping opioid prescriptions can be deadly.”

An assistant district attorney asked Szalavitz if there was anything prosecutors could do in the courtroom to reduce the stigma and shame of drug users, expressing feelings of having their hands tied.

“We already reject simple possessions and when we do, the case is called, and obviously the Commonwealth is not going to move on, and then when the person turns to leave, I always say ‘Good luck, Mr or Miss so and so. “, she said.

“Sometimes they say thank you, and sometimes they don’t and it’s frustrating because it’s still a crime and there’s no public health treatment, and so it’s kind of frustrating. and not very helpful I can fire them over and over again but the other thing that’s hard is sometimes I dismiss their case they go out and I don’t see them again because they’re overdosing .”

Szalavitz suggested having outreach activities available in the courts or non-compulsory support options for people whose cases are dismissed.

“People often don’t quit because they’re afraid the treatment will be horrible, and often they’re right and they’re afraid to give up the one thing that makes life worth living for them and then have nothing,” she said earlier in the presentation.

“You’re talking about the population, at least 50% mental illness, at least 50% serious history of childhood trauma, huge amounts of despair, it’s not a population of people who say they’re “I need more fun, and I’m ‘I’m really lazy,’ So kind of acknowledging that helps de-stigmatize, acknowledging the pain that people are trying to deal with, however, ineptly.”

Key words: drug abuse,

Lola R. McClure