Is California really that liberal ?

Two needle exchange activists in California have found themselves in court this week accused of operating an unlawful needle exchange service in the Modesto region of California. The two defendants, Kristy Tribuzio and Brian Robinson are part of an organisations called “off the streets” which seeks to prevent disease transmission through the sharing of dirty needles among drug users. Despite needle exchanges being legal in many countries and within many California municipalities, the practice remains illegal in Modesto and as such, the two activists may be forced to go to trial. 

This case shows how despite the positive rhetoric coming out of the current Obama administration about tackling drug use through treatment rather than enforcement, there are still considerable problems facing activists seeking to engage in harm reduction measures. Activists in the United States have been engaged in a long standing battle against the consensus developed under the Reagan administration that the government shouldn’t play any role intervening in the lives of drug addicts. The legacy of the Reagan approach which saw the closing of treatment centres, stopping of the supply of sterile needles and methadone to those wanting to get off heroin, is still prevalent throughout large sections of the United States, particularly in the republican dominates states. The infamous campaign “just say no” lead by Nancy Reagan, when she was the First Lady remains the dominant theme of much of the United States drug bureaucracy. The mass incarceration culture which has resulted from such an ideology has seen prison populations soar, with many first time offenders receiving mandatory sentences, making the United States the most incarcerated country on the planet. 

These moves against harm reduction activists echo the steps being taken against similar activists throughout Eastern Europe. Doctors, patients and activists in Ukraine have been increasingly persecuted by the authorities in recent years. Mass detention of opioid substitution treatment (OST) patients, medical staff arrests, disclosure of confidential information and police initiated provocations, have become a constant occurrence in Ukraine as well as in other former soviet bloc countries. Indeed, this type of discrimination consistently occurs throughout many of the former Soviet Union countries and is undoubtedly part of the reason for the drastic rise in HIV rates among drug users. However, these repressions are not solely the preserve of Eastern European governments as has been shown by this case in Modesto California and as such, activist pressure must also concentrate on the repression going on in developed countries as well as in the developing world. 

This widespread repression of “harm reduction” services continues despite the overwhelming realisation that these services reduce the spread of disease and do not infact increase drug use. This idea has been successfully communicated by the recent International AIDS 2010 conference; however, this consensus is not a new development. The former US Surgeon general, David Satcher concluded in 2000 that “After reviewing all of the research to date, the senior scientists of the Department and I have unanimously agreed that there is conclusive scientific evidence that syringe exchange programs, as part of a comprehensive HIV prevention strategy, are an effective public health intervention that reduces the transmission of HIV and does not encourage the use of illegal drugs."

What is therefore particularly worrying in the harm reductionist field is that despite their being a long standing realisation of the need for these services, activists in the most progressive states in America are still facing incarceration for operating these services. Ideology has consistently triumphed over evidence. Indeed, the vast social and economic cost of the failed “war on drugs” will continue to until this conflict is reversed and evidence begins to dominate the discourse surrounding drugs, and not ideology.