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Going Where No One Else Can

PEERS GATHER FOR 2014 PDSE CONFERENCE!10428605_10152159806861906_2506530699429016271_n

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Going Where No One Else Can: Peers Gather for 2014 PDSE Conference

Peers, participants, harm reduction program staff, and others working in harm reduction gather for the 2014 PDSE Conference.

Peers, participants, harm reduction program staff, and others working in harm reduction gather for the 2014 PDSE Conference.

“What do we do?”
“Save lives!”
“What do WE do?”

Last week’s Peer-Delivered Syringe Exchange (PDSE) Conference, “Leave No Peer Behind,” began and ended with this call and response cheer. Leading the chant, Robert Suarez of VOCAL-NY, who is also Co-Chair of the Peer Network of New York, took the opportunity to remind peers – workers recruited from the communities harm reduction programs serve – of the important and irreplaceable role they play in harm reduction efforts. Suarez emphasized that “peers go where no one else can go” and encouraged peers to take pride in their work. Stressing that they are a vital voice that is often missing, Suarez said, “When it comes to anything that has to do with drug use, there needs to be a peer there – are you up to it?”

But the content was much more than cheers and motivational speeches. A memorial and poem reading brought attention to arguably the biggest challenges facing people who use drugs: the loss of lives in their communities and the discrimination they face on a daily basis.

Douglas Bryant reading his poem, titled “The Life in Harm Reduction.”

Sessions throughout the conference focused on the variety of challenges faced by peers and participants, such as seeking employment and losing custody of children. Conference attendees explored how harm reduction programs can better respond to these issues.

Transitioning from a participant receiving services from a syringe access program (SAP) to a part-time peer worker can be a useful pathway to employment, but the limited number of staff positions within programs means this opportunity does not exist for everyone. As alternative models of PDSE evolve and begin to replace traditional SAP structures, the opportunities for employment are expanding. According to Liam Gibson, Co-Chair of the Peer Network of New York, “PDSE is going to be the way needle exchange is done in the future,” as this model is more effective at reaching people who use drugs, particularly people living in rural areas and those unwilling to go into a SAP. An additional benefit is the absence of stigma in PDSE, as peers understand the drug use of participants in a way that most staff cannot.

The value placed on PDSE is evident in Tina Wolf’s newly launched SAP, Community Action for Social Justice (CASJ), the first PDSE-only syringe exchange in New York State. To Wolf and others at the conference, the no-staff/peers-only model at CASJ is expected to become much more common over the next several years. Cheryl Russell and Fraizzell Brown, peers from New York Harm Reduction Educators (NYHRE), believe that harm reduction programs can increase employment opportunities by employing peers in less traditional roles and departments. With more peers than staff, NYHRE has peers working in every department except admin (a department Russell and Brown said they wouldn’t want to work in anyway). “Case management, hepatitis C and HIV testing, counselling, support groups, front desk, outreach – we’re trained to do it all, and we’re paid for that training!” said Russell.


NYHRE peers Cheryl Russell and Fraizzell Brown (left to right).

For mothers and fathers who use drugs, regaining custody of children can be a devastating challenge. Myths such as “mother and fathers who use drugs don’t care about their children,” “a history of drug use makes you a bad parent,” and “parents who use drugs cannot actively participate in child-rearing” are common in society, but even among parents who use drugs. Conference attendees expressed how they bought into these myths and as a result, missed out on a time with their children that is now lost forever. Yet difficulty recognizing that they are able to be loving parents is a small problem when compared to lost custody. Harm reduction programs can aid participants that face these types of problems by providing support groups and legal services. NYHRE currently has a program called “Bumps and Babies” for people who use drugs that are pregnant or have a newborn. The group meets weekly, but similar programs are still a rarity at SAPs and need to be scaled up to address the magnitude of this problem.

Despite the many positive activities of SAPs, the programs themselves can also pose challenges for peers and there have been reports of peers having problems at their agencies. Terrell Jones of NYHRE, a Co-Chair of the Peer Network of New York, expressed that for some, “peer has become a demoralizing and stigmatizing word.” According to a group of peers that asked to remain anonymous, peers often sense an “unspoken prejudice” from staff at SAPs: “Every problem that comes up, staff members think you are using [drugs] again. Even if they don’t say it, you can sense that it’s always in the back of their minds.” Most peers feel uncomfortable bringing attention to this perceived judgmental attitude in what is supposed to be a judgment-free zone, but even those that do call attention to it find that this often has no results: “Staff members become defensive if you bring it up to them and deny that they are prejudiced.” The group believed that for some staff this prejudice could never be eliminated. For the rest of the staff, if peers present themselves in the best way possible, continued interaction with peers should resolve this staff prejudice.

Washington Heights CORNER Project peers in front of the New York City Department of Health and Mental Hygiene where the PDSE Conference was held. Photo courtesy of the Washington Heights CORNER Project Facebook page.

Washington Heights CORNER Project peers and staff in front of the New York City Department of Health and Mental Hygiene where the PDSE Conference was held. Photo courtesy of the Washington Heights CORNER Project.

Fortunately, this unspoken prejudice isn’t the case at all harm reduction programs. Brown spoke of the support peers have at NYHRE, stating that, “our Director always tell us, if any staff treats you as less than what you are, you tell me.” When asked if it had always been this way, Brown expressed that when peers first became employed by NYHRE eight years ago, there were some challenges like those currently being experienced by other agencies. With time, a positive attitude and open dialogue, NYHRE now seems to represent one of the best practices in New York for peer engagement at SAPs.

This year’s PDSE conference was attended primarily by peers, a shortcoming in the eyes of some attendees. Ideally, peers will take what they have learned and pass it on to participants. However, for Russell, the importance of having participants at PDSE conferences is largely because it is an opportunity to encourage them to become peers. If PDSE keeps gaining the traction it deserves, participants will be an even more essential attendee at future PDSE conferences.

Listen to the podcast below hosted by Allan Clear from Harm Reduction Coalition for reflections on the PDSE Conference and the upcoming 10th National Harm Reduction Conference in Baltimore from Liam, Brian, Davian and Karen.

By Nazlee Maghsoudi, Intern at Harm Reduction Coalition and International Drug Policy Consortium


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