Safer Space: A Front Line Harm Reduction Intervention


All right. We’re going to get
this party started.>>All right. Hi, everybody. My name is Kristy and I work in
the public health division in the director’s office. I’ve
been one of several people helping to plan this week’s
event. Thank you so much for joining us today. And thank you
for the people joining us on the live stream. Before we begin, I wanted to
give a few quick announcements about public health week. For
those of you with competitive nature, we have a little
passport surprises game. So if you are playing along, you
are here and turn it in there’s a box on the table by the display board in
the lobby and lots of fun stuff at the end
of the week. Second, there’s a week-long
scavenger hunt in the building being put on one of our student
interns. So there’s more information about that coming in
the daily emails. Feel free to grab a few
colleagues and play along. There’s also an opportunity to
take part in a recorded audio
conversation.>>>THIS IS SIMILAR TO NPR STORY
BOARD. BEING PUT TOGETHER BY JASMINE AND JULIE IN THE
BUILDING. SO IF YOU ARE INTERESTED, LOOK
FOR MORE INFORMATION IN THE DAILY EMAILS. TO HAVE A CONVERSATION. AND FINALLY, FOR THOSE OF YOU
WHO ARE INTO SOCIAL MEDIA, WE ARE
LAUNCHING A NEW HASH TAG. IF YOU ARE TWEETING, WE
ENCOURAGE YOU TO USE THAT. GREAT WAY TO CELEBRATE WHAT WE
DO IN PUBLIC HEALTH AND WHAT WE TALK ABOUT. WE WILL ALSO BE SENDING OUT AN
ONLINE EVALUATION EARLY NEXT WEEK. SO FOR THOSE OF YOU WHO WORK IN
THE DIVISION, LOOK FOR THAT, TAKE A LOOK AND LET US KNOW WHAT
YOU THINK. SO THANK YOU FOR YOUR FEEDBACK. AND FINALLY, THANKS FOR BEING
HERECOLLEAGUES AND PARTNERS THAT HAVE JOINED US AND DEMONSTRATING
YOUR COMMITMENT. SO I AM REALLY VERY EXCITED
ABOUT THIS EVENT.>>HI. I’M ACTUALLY GOING TO READ SINCE
I GET NERVOUS WHEN THERE’S A CAMERA. SO WELCOME TO OUR WORKSHOP THIS
AFTERNOON.AND A SPECIAL WELCOME AND THANK YOU FOR THOSE JOINING
US OVER THE INTERNET. MY NAME IS JUDE.I DID WRITE THAT DOWN. HEPATITIS PREVENTION WORK ORDER
IN THE PUBLIC HEALTH DECISION HERE. I WOULD LIKE TO GO OVER THE
AGENDA FOR OUR WORKSHOP SO THOSE ARE ABLE TO WATCH THE
DOCUMENTARY USING THE LINK AND JOIN US FOR A FOLLOW-UP PANEL
QUESTION/ANSWER DISCUSSION. WE ARE DISCUSSING SPACE
CONSUMPTION SPACES. PEOPLE CAN GO TO CONSUME MEANING INJECT OR
SMOKE OR ANY OTHER WAY, USE DRUGS THAT ARE OBTAINED
ELSEWHERE UNDER SAFE CLEAN CONDITIONS AND UNDER THE
SUPERVISION OF TRAINED STAFF. THE DOCUMENTARY AND THE AMAZING
EXPERT PANELISTS ARE GOING TO PROVIDE A LOT MORE DETAIL ABOUT
THIS IN A FEW MINUTES. SO FOR OUR AGENDA, PARTICULARLY
FOR PEOPLE ON THE INTERNET. WE ARE GOING TO AT THE LATEST
START THE MOVIE HERE AT 2:25. SO WE’LL BE DONE BY 3:00. AND WE ASSUME AT 3:00, WE ARE
GOING TO DO QUESTION AND ANSWER WITH THE
PANELISTS. THE GOAL OF OUR WORKSHOP TODAY IS TO INCREASE
UNDERSTANDING OF THE SYSTEMATIC BARRIERS THAT PEOPLE USE DRUGS
FACE AND THE HEALTH CONSEQUENCES RELATE TODAY DRUG USE WITH A
DISCUSSION ON THE CONSEQUENCES OF DRUG USE IN PUBLIC SPACES. WE HOPE TO INCREASE YOUR
AWARENESS OF CONSUMPTION SPACES AND THEIR
ROLE ALONG THE CONTINUUM UPON REDUCTION INTERVENTION. AND
ALSO INCREASE OUR UNDERSTANDING OF HOW SAFE CONSUMPTION SPACES
CAN REACH AND MAINTAIN CONTACT WITH HARD TO REACH EXTREMELY VULNERABLE AND
STIGMATIZED POPULATIONS AND PROMOTE THE HEALTH OF THIS POPULATION BY PROVIDING
STERILE AND CLEAN INJECTION EQUIPMENT. DRUG RELATED RISK BEHAVIOR
THROUGH THE PROVISION OF TOOLS AND EDUCATION AT THE SITE. REDUCE THE INCIDENTS OF
INFECTIOUS DISEASES RELATED TO INJECTION DRUG USE INCLUDING HIV, HEPATITIS C AND
OTHER TYPES OF INFECTIONS. ALSO FACILITATE THE ACCESS TO HEALTH
PSYCHO SOCIAL AND SUBSTANCE ABUSE PROGRAMS. AND THEN ALSO
MOST IMPORTANTLY PROVIDE A NONJUDGMENTAL SPACE WHERE PEOPLE
WHO USE DRUGS ARE TREATED WITH
RESPECT AND DIGNITY. AND NOW, I’M GOING TO ALLOW THE PEOPLE ON THE PANEL TO INTRODUCE
THEMSELVES IN >>MY NAME IS DAN. I IDENTIFY AS RECOVERY OR FORMER
DRUG USER OR HOWEVER. I WORK IN THE SUBSTANCE USE
DISORDER SERVICES FIELD AS A PEER SUPPORT SPECIALIST AND I’VE BEEN IN
RECOVERY FOR COMING UP ON TEN YEARS. THAT’S ME.>>I’M HAVEN. I’M A LONG-TIME
HARM REDUCTIONIST. I’VE BEEN WORKING WITH PEOPLE WHO USE
DRUGS SINCE 2002 SPECIFICALLY HERE IN OREGON FOR THE LAST 11
YEARS. AND DRUG USERS ARE MY FAVORITE PEOPLE IN THE ENTIRE
WORLD. JUST GOING TO THROW THAT IN
THERE. I ALSO AM AN MPH FELLOW WORKING
UNDER THE BLOOMBERG>>I’M ELONA. I’M A NURSE IN ADULT ACUTE CARE
AND A VOLUNTEER IN HARM REDUCTION SERVICES WORKING WITH SYRINGE EXCHANGES
AROUND TOWN AND I ALSO LOVE DRUG USERS.>>I’M MARTINA. I’VE BEEN
WORKING IN DRUG USER HEALTH ON AND OFF IN DIFFERENT CAPACITIES
FOR ABOUT SIX YEARS, I THINK. THE PRIMARY HEALTH CLINIC FOR
PEOPLE WHO INJECT DRUGS AND MORE AROUND HIV
AND HEP C PREVENTION. IN HEP C TREATMENT.>>SO I WANTED TO SAY A LITTLE
ABOUT SUBSTANCE USE AND INFECTIOUS DISEASE BEFORE WE
START. SUBSTANCE USE DISORDERS ARE RECOGNIZED AS CHRONIC
RELAPSING MEDICAL CONDITIONS. HOWEVER, PEOPLE LIVING WITH
SUBSTANCE USE DISORDERS STILL EXPERIENCE
STIGMA. ACCORDING TO THE SUBSTANCE ABUSE MENTAL HEALTH SERVICES
ASSOCIATION, STIGMA INFLUENCES THEIR HEALTH OUTCOMES AND MENTAL
WELL BEING. THE FEAR OF BEING JUDGED
PREVENTS PEOPLE WITH SUBSTANCE USE DISORDERS KEEPING THEM FROM
GETTING THE HELP THEY NEED. AND IN POSITIONS TO HELP FROM
PROVIDING THE NEEDED SERVICES INCLUDING MEDICAL CARE. SERIOUS AND COSTLY ACUTE AND
CHRONIC DISEASES ARE LINKED WITH SUBSTANCE USE DISORDERS AND
ELEVATED RISKS ASSOCIATED WITH SPECIFIC DRUGS SUCH AS METH
AND CERTAIN TRANSMISSION SUCH AS INJECTIONS. IN OREGON, WE ARE
EXPERIENCING AN INCREASE AND NEWLY REPORTED CASES OF
HEPATITIS C UNDER PEOPLE OF 35 YEARS OF AGE. AND THESE CASES
WERE MORE LIKELY TO BE RECENTLY ACQUIRED THROUGH RISK
BEHAVIORS THROUGH SHARED INJECTION TREATMENT. OVER THE
PAST DECADE, OREGON EXPERIENCED THE NUMBER AND RATE OF PERSONS
DIAGNOSED WITH OPIOID USE DISORDER AND SIMILAR TO OTHER
STATES, WE HAVE ALSO EXPERIENCED INCREASE
IN HEROIN RELATED OVERDOSE DEATHS. SHARP INCREASES IN INFECTIOUS
DISEASES CAN BE EARLY WARNING SIGNS OF NEW OR EMERGING POCKETS
OF DRUG USE WHERE AREAS OF DRUG USE HAS NOT BEEN AN
ESTABLISHED PROBLEM. INFECTIONS SUCH AS ABSCESSES
WHICH CAN LEAD TO HOSPITALIZATIONS FOR MORE SEVERE SKIN AND SOFT TISSUE INFECTIONS
AND INFECTIOUS ENDOCARDITIS. OR OR OBSERVED MORE THAN A
FIVE-FOLD INCREASE IN THE PERCENTAGE OF IN-PATIENT
HOSPITAL VISITS AMONG PEOPLE WHO INJECT FOR THESE TYPES OF
INFECTIONS. AND WE ARE HERE TO TALK ABOUT
SAFE CONSUMPTION SPACES. AND HAVEN IS GOING TO TALK ABOUT
HARM>>SURE. I CAN DO THAT. HOW MANY PEOPLE ARE FAMILIAR
WITH THE TERM HARM REDUCTION JUST TO GET A SENSE OF WHO IS IN
THE ROOM? OR A BROAD FRAMEWORK WORKING
WITH FOLKS THAT IS A TERM THAT’S BEEN AROUND FOR A LONG TIME. THE IDEA PEOPLE ARE GOING TO DO
HARMFUL THING ALL THE TIME.DONE SOMETHING DANGEROUS TODAY. HOWEVER, WE DO THINK TO MITIGATE
THOSE. PETER, YOU ARE MAKING ME NERVOUS. YOU ARE. YOU ARE JUST SO SMART. SO THE TERM ORIGINALLY CAME
AROUND HIV AND IDENTIFIED IN THE 80s THAT
HIV WAS A THING. INJECTION DRUG USE WAS A RISK FACTOR FOR HIV. HIV WAS TRANSMITTED THROUGH
SHARING SYRINGES. WHEN WE TALKED ABOUT HARM REDUCTION, IT WAS SPECIFIC TO DRUG USERS
WHO AS A WAY TO PREVENT THE SPREAD OF HIV. THAT PROGRESSED ONCE WE
IDENTIFIED HEP C — IT INCLUDED SOME OF THAT. TODAY IT’S A TERM THAT’S USED IN
MANY DIFFERENT WAYS ABOUT MANY DIFFERENT HEALTH OUTCOMES. AND
HERE IN THE WORK THAT I DO, IT’S STILL FOCUSED ON PEOPLE WHO
INJECT DRUGS.BECAUSE I THINK THEY ARE MY FAVORITE PEOPLE IN
THE WHOLE WIDE WORLD. BUT WE SPEND A LOT OF TIME TALKING
ABOUT ALL THE OTHER RISK FACTORS. AND IT’S REALLY BEEN
DRIVEN BY THE CONCERNS OF THE COMMUNITY. SO I SPEND WAY MORE TIME TALKING
ABOUT OVERDOSE THAN I DO HEPATITIS C
OR HIV. I SPEND MORE TIME TALKING ABOUT HEPATITIS THAN HIV BECAUSE IT’S
A BIGGER ISSUE FOR THE COMMUNITY. AND REALLY, IT’S
LIKE A SET OF TOOLS AND STRATEGIES TO HELP PEOPLE
IMPROVE THEIR HEALTH IN WHATEVER WAY FEELS BEST FOR THEM AT THAT
MOMENT. AND ALSO IDEA IF YOU CAN ENGAGE
PEOPLE AND BUILD THOSE THERAPEUTIC RELATIONSHIPS, YOU
CAN HELP NUDGE THEM INTO HEALTHIER BEHAVIORS. OFTEN,
PEOPLE USE THE TERM MEETING PEOPLE WHERE THEY ARE AT WHEN
THEY TALK ABOUT HARM REDUCTION.I DON’T THINK THAT’S ENOUGH. I
DON’T THINK THAT’S ACTUALLY WHAT WE DO. WE’RE MEETING THEM WHERE THEY
ARE AT AND EITHER STANDING WITH THEM THERE WITH DIGNITY OR
HELPING THEM MOVE FORWARD. AND ALL OF THAT IS REALLY
IMPORTANT. HAVE THREE REALLY AMAZING HARM
REDUCTION SERVICE PROVIDERS. ALL KIND OF ENGAGING IN
DIFFERENT WAYS AND DIFFERENT SCOPES. AND IT’S PART OF THE CONTINUUM
OF CARE FOR PEOPLE WHO USE DRUGS. I THINK OFTEN IT’S LIKE HARM
REDUCTION GETS PITTED AGAINST DRUG
TREATMENT IN A IF WE UNDERSTAND THAT ADDICTION
IS A CHRONIC RELAPSING CONDITION. IF IT IS EITHER YOU ARE IN
TREATMENT OR YOU ARE NOT, WHAT HAPPENED TO THOSE PEOPLE WHO
RELAPSE? HARM REDUCTION SERVICES ARE ON
THAT CONTINUUM AND PEOPLE CAN MOVE BACK AND FORTH THROUGHOUT
THAT CONTINUUM. MUCH AS PEOPLE CAN MOVE THROUGH FINDING OUT THEY HAVE HIV AND
BEING ON MEDS FOR A WHILE. THOSE ARE ALL THINGS REALLY COMFORTABLE HEARING THINGS
THROUGH DIABETES. STRUGGLE TO GET BACK. WE PROVIDE SERVICES FOR PEOPLE
WHO ARE ON THIS END OF THE SPECTRUM. THEY MAY OR MAY NOT WANT TO STOP
USING AND THAT’S OKAY.>>WHEN I WAS PREPARING FOR
THIS, I WAS LOOKING THROUGH MY NOTES AND I HAD A NOTE OF
SOMETHING THAT HAVEN SAID SOMETHING ON A CALL THAT WE WERE
ON. AND I’M GOING TO QUOTE YOU. PREVENTION OF HARM, NOT THE
PREVENTION OF DRUG USE. SO THAT YOU MEET PEOPLE WHERE YOU ARE AT
AND YOU STAND WITH THEM. >>DO PEOPLE HAVE QUESTIONS
AROUND HARM REDUCTION? ASKING QUESTIONS IN THE MIDDLE
OF THIS.>> THE PREVENTION OF DRUG USE.I
DON’T REMEMBER SAYING THAT.>>I THINK IT’S IMPORTANT WHEN
WE THINK ABOUT PEOPLE WHO USE DRUGS. SO OFTEN ESPECIALLY IN
PLACES LIKE THE PUBLIC HEALTH DIVISION OR A HEALTHCARE
SETTING. WE’RE SO QUICK TO SILO THESE
INDIVIDUAL HUMANS INTO DISEASE STATES. THE VIRAL HEPATITIS PEOPLE, HOW
OFTEN DO YOU MEET WITH THE HIV PEOPLE? AS SOMEONE WHO GETS INVITED TO
ALL OF THOSE MEETINGS, IT’S REALLY
DEHUMANIZING. AND IT’S LIKE IN DRUG USE IS A
MITIGATING FACTOR IN ALL OF THOSE THINGS. SO I THINK ONE OF THE THINGS
THAT HARM REDUCTION DOES IN A WAY THAT I
ACTUALLY DON’T REALLY SEE HAPPENING IS
REALLY KEEPING — IT’S NOT ABOUT THE DISEASE STATE OR THE
INFECTION. IT’S ABOUT THE HUMAN BEING SITTING IN FRONT OF YOU.
IF I HAVE A CLIENT SITTING IN FRONT OF ME WITH A SOFT TISSUE INFECTION,
MIGHT NOT BE THE RIGHT TIME TO TALK TO
HIM ABOUT MY HEPATITIS.ALTHOUGH IT’S REALLY IMPORTANT.THAT SOFT
TISSUE INFECTION IS GOING TO KILL HIM FASTER THAN THE
HEPATITIS WILL. IF HE’S NOT GOING TO GO TO THE DOCTOR FOR THE SOFT TISSUE INFECTION
BUT MAYBE I SHOULD MAKE SURE HE HAS
NALOXONE HE’S USING WITH SOMEONE ELSE. AND SO TALKING TO PEOPLE ABOUT
WHAT THEY NEED AND WHY. AND I THINK GIVING PEOPLE THAT
VOICE IS REALLY HELPFUL. DID I MISS ANYTHING, YOU GUYS?>>I MIGHT ADD, IF YOU DON’T
MIND. IN ADDITION TO LOOKING AT THE INDIVIDUAL AND REALLY BEING
PRESENT WITH THAT PERSON, ACKNOWLEDGING THE
CONTEXT THAT PEOPLE USE WITHIN IS SOMETHING THAT REALLY STANDS OUT TO ME ABOUT
HARM REDUCTION. RECOGNIZING THAT PEOPLE AREN’T
FRAGMENT DISCONNECTED FROM THEIR SURROUNDINGS. PEOPLE USE FOR
ALL KINDS OF REASONS. AND SOME OF THOSE REASONS ARE
WORKING FOR THEM. I’VE MET AN UNCOUNTABLE NUMBER
OF PEOPLE WHO ATTRIBUTE THEIR
SURVIVAL AND ABILITY TO MOVE FORWARD IN THE WORLD TO THE
DRUGS THEY ARE USING. IF THAT MEANS THAT SOMEBODY CAN
SURVIVE WHAT IS HAPPENING IN THEIR LIFE, DEAD PEOPLE CAN’T
MAKE CHANGES. AND IF WE FAIL TO RECOGNIZE THE
REASON THAT PEOPLE COME TO DRUG USE AND SUBSTANCE USE AS A DISORDER
WHICH I THINK IS OFTEN KIND OF LUMPED
TOGETHER, NOT EVERYBODY THAT USES DRUGS
WOULD MEET THE CRITERIA FOR SUBSTANCE USE DISORDER. BUT FOR THOSE THAT DO, I THINK
THAT MEETING THOSE FOLKS WITH COMPASSION AND SUPPORT WHETHER
THE DRUG USE IS WORKING FOR THEM OR NOT AND RECOGNIZING THAT’S A
DYNAMIC THING, THAT IS VERY SITUATIONAL IS ONE OF THE MOST
PROFOUND LESSONS THAT WORKING IN HARM REDUCTION HAS OFFERED TO >>I THINK RESPECTING PEOPLE’S
AGENCY ALSO PEOPLE THAT USE DRUGS, THEY
IMAGINE SOME KIND OF BEEF SCENARIO AND
THEN IT ENDS UP BEING THIS WHOLE
PATRONIZING INTERACTION. SO, YEAH, HARM REDUCTION IS VERY
MUCH ABOUT RESPECTING PEOPLE THAT YOU CAN SEE. >>AND I WAS GOING TO SAY I ONLY
MADE TEN COPIES. ONE OF THE THINGS I THINK IS REALLY
IMPORTANT WHEN WE TALK ABOUT HARM REDUCTION IS JUST ABOUT IT’S
PEOPLE FIRST. WE HAVE SO MANY LABELS THAT WE PUT ON PEOPLE WHO ARE USING DRUGS THAT
KEEP THEM FROM WANTING TO TALK WITH
US ABOUT WHAT’S GOING ON OR BELIEVE THEY ARE WORTHY OF
SEEKING HELP.>>I FEEL LIKE I’M THE ONLY ONE
WHO HASN’T SAID ANYTHING. I GUESS IT’S CAUSE I AM. EVERYTHING IS HARM REDUCTION,
REALLY. I WORK IN A MEDICATION’S PORT OF
RECOVERY PROGRAM. WE DO TREATMENT WITH SABOXONE
AND VIVITROL TO WORK WITH OPIOID
REPLACEMENT THERAPY I SEE PEOPLE COME IN THAT ARE
ABSOLUTELY BROKEN. AND BEATEN.PEOPLE DON’T —
NOBODY BELIEVES IN THEM. AND AS A SOCIETY, WE SEE THE
OPIOID CRISIS. THAT’S WHAT IT IS. IT’S THIS BIG THING, THIS
BIG TITLE. BUT UNTIL YOU GET YOUR HANDS
DIRTY, THAT’S ALL IT IS, REALLY. IT’S JUST A BLUR THAT YOU HEAR
OVER AND OVER AND OVER LIKE TERROR.
IT’S SHOCK VALUE, THE OPIOID CRISIS. AND UNTIL YOU GET DOWN AND
DIRTY, YOU DON’T HAVE ANY IDEA. I USED HEROIN INTRAVENOUSLY FOR
18 YEARS AND I DIDN’T START WITH THAT. THAT WAS THE END OF THE ROAD.
IT WAS LIKE WHOA, HERE WE GO. THIS IS THE ONE. I FOUND OPIOIDS AND IT WAS LIKE
BEING HUGGED BY JESUS. I DON’T KNOW HOW ELSE TO PUT IT. AND THE BEST THING EVER. AND I WAS WILLING TO PUT EVERYTHING ASIDE IN A WORLD
TO KEEP THAT UP. AND I THINK, YOU KNOW, WE NEED
TO REALLY UNDERSTAND THAT ADDICTS,
WHATEVER SUBSTANCE THEY ARE USING, THEY ARE HUMAN BEINGS
WITH DREAMS AND GOALS AND WANTS AND NEEDS. AND I WAS TALKING TO ELONA AND SOMEBODY SAID IT WAS A NURSE
THAT SAID IF ADDICTS COULD, THEY WOULDN’T BE ADDICTS. LIKE WHEN YOU ARE GOING THROUGH
THAT SHIT, IT’S MISERABLE. IT’S HORRIBLE. BUT LOOKING BACK, TEN YEARS
BACK, I WOULDN’T CHANGE A THING. IN PRISON, THE NIGHTS LITERALLY
IN THE PENITENTIARY, THE NIGHTS HOMELESS. THE DAYS WAITING IN THE COLD AND
THE POURING RAIN ON THE CORNER FOR THE CONNECT TO PULL UP AND
HIM BEING 45 MINUTES LATE AND ME HAVING TO SWALLOW THAT SHIT.
PARDON ME. I WOULDN’T CHANGE ANY OF THAT. I WOULDN’T. IT
DEFINES WHO I AM TODAY. AND HARM REDUCTION, SOMEBODY MAY
NOT BE READY TO STOP RIGHT NOW. THEY MAY NOT BE READY. AND WHO ARE WE TO TELL THEM THEY
HAVE TO? HUMAN BEINGS THAT MATTER AND
HAVE A PURPOSE ON THIS EARTH JUST
BECAUSE YOU USE DRUGS DOESN’T MAKE YOU SOME
INHUMAN VILE DISGUSTING BEAST. AND I FEEL LIKE SOCIETY, A VAST
PORTION OF IT, THAT’S HOW THEY LOOK AT PEOPLE. I DON’T KNOW.>>SO WHAT WE’RE GOING TO DO.ARE
YOU GOING TO PUT UP THE LINK? SO THERE’S GOING TO BE A LINK ON
THE INTERNET SO PEOPLE CAN GO WATCH THE MOVIE. AND WE WILL BE
BACK IN APPROXIMATELY 34 MINUTES. 35 MINUTES. SO WE’RE GOING TO MOVE OVER. [ VIDEO ] THE TIME WORKING IN HOME
REDUCTION SERVICES. AND THEY CAME TOGETHER TO MAKE
THIS FILM. I THINK IT WAS 2013, 2014 THIS
FILM WAS MADE AND, YOU KNOW, THEY
REALLY — I THINK THIS FILM IS REALLY GOOD. ONE THING I FIND INCREDIBLY
STRIKING. ONE WORD WE TALK ABOUT OPIOIDS OVERDOSE AND THE
OVERDOSE CRISIS RIGHT NOW, THERE’S A LOT OF WORDS THAT IS
REALLY COMMON TODAY THAT WAS NOT ONCE MENTIONED IN THIS FILM. SO THAT GIVES ME GOOSE BUMPS TO
SAY IT OUT LOUD, ACTUALLY. WHEN WE TALK ABOUT THOSE NUMBERS
AND THE INCREASES IN THOSE NUMBERS AND THE NUMBERS THEY MENTIONED HERE, ALL
OF THAT IS PRE-FENTANYL. FOR THOSE THAT DON’T KNOW, IT’S
A POWERFUL OPIOID THAT SOMETIMES BEING SOLD ON ITS OWN AND BEING USED
BY FOLKS IN A SERIES OF ANALOGS OF
PHARMACEUTICAL GRADE FENTANYL. IT IS NOT PART OF DOCTORS
MIS-PRESCRIBING. IT’S BOUGHT ON THE BLACK MARKET AND BEING USED
THAT WAY. AND DRAMATICALLY INCREASED OVERDOSE DEATH RATES. MOSTLY SO FAR, KNOCK ON WOOD, ON
THE EAST COAST IN MIDWEST. WE HAVEN’T SEEN A LOT OF IT HERE
YET. HOWEVER, THAT IS CHANGING. HAVE BEFORE. AND I FEEL LIKE IT’S ONLY GOING
TO GET WORSE. SO IN TALKING ABOUT HOW IMPORTANT IT IS TO BE
TALKING ABOUT THESE THINGS. LIKE, WE ACTUALLY ARE IN A GOOD
SPOT. THIS IS GOING TO GET WORSE AND
OVERDOSES ARE GOING TO GET WORSE AS WE SEE
MORE FENTANYL IN THE DRUG MARKET. AND I DON’T MEAN TO BE LIKE
CRITICAL OR FEAR TACTIC BASED ON THIS. I
WATCHED MY FRIENDS ON THE EAST COAST LIVE THROUGH. I HAVE
FRIENDS ALL OVER. THE HARM REDUCTION COMMUNITY IS SMALL AND
TIGHT AND WE LOVE EACH OTHER A LOT WHICH IS GREAT. BUT THAT
MEANS I DO HAVE FRIENDS WHO ARE WORKING IN VANCOUVER BC
RIGHT NOW WHO IT’S JUST PEOPLE ARE JUST DYING LEFT AND RIGHT. I HAVE FRIENDS WHO HAVE LOST —
THIS YEAR I PERSONALLY LOST AT LEAST ONE CLIENT EVERY WEEK THAT
I PERSONALLY KNEW. THAT’S NOT THE SAME AS THE NUMBERS. THESE ARE PEOPLE I HUG THAT ARE
NO LONGER WITH US WHETHER IT’S FROM HEPATITIS OR SKIN
INFECTIONS OR ACCIDENTS OR OVERDOSE. WIDE RANGE OF THINGS HAPPENING. AND SO THESE NUMBERS AND THESE PROJECTIONS ARE THINGS — THAT’S
PRE-FENTANYL. IT’S ALL BIGGER NOW. I THINK THE OTHER THING THAT —
I MEAN, THAT WAS THE BIGGEST TAKE AWAY FROM THIS FILM IS THAT
PIECE. BUT I ALSO THINK IT’S REALLY
AWESOME AND HELPFUL. CONSUMPTION SPACES OPERATING?
OKAY, SORRY. 98. SO THAT NUMBER IS NOW ALMOST
200.>>THAT IS NOT TRUE. VANCOUVER
HAS FOUR OPERATING SPACES. THERE’S ONE IN TORONTO,
EDMONTON, ONTARIO MAYBE. I’D HAVE TO LOOK. THEY’VE OPENED
MANY SITES IN THE LAST YEAR AND-A-HALF TO ADDRESS THE
FENTANYL CRISIS. THERE ARE CURRENTLY NONILLEGALLY OPERATING
IN THE UNITED STATES. ALTHOUGH, THERE ARE SEVERAL CITIES THAT
HAVE SAID THEY ARE GOING TO MOVE FORWARD WITH THEM. SO A YEAR AND-A-HALF AGO SEATTLE
SAID AND FUNDED FOR OUR TWO SAFE
CONSUMPTION SPACES IN KING COUNTY. A COUPLE MONTHS AGO AT THIS
POINT, SAN FRANCISCO SAID THEY WERE GOING TO SHOOT TO OPEN 7 IN
SAN FRANCISCO. AND PHILADELPHIA IS THE MOST RECENT TO COME OUT
AND SAY THEY ARE GOING TO OPEN. NONE OF THEM HAVE ACTUALLY
OPENED. THERE IS AN ILLEGAL UNDER GROUND
SITE OPERATING IN THE UNITED STATES REPORTED IN THE LITERATURE AND BEING
FOLLOWED FOR ALMOST THREE YEARS NOW. THE COOL THING ABOUT THAT IS A
LOT OF THE CONCERNS PEOPLE HAVE ABOUT
SAFE CONSUMPTION SPACES THAT IT’S GOING TO BRING CRIME. IF
THIS SITE HAS BEEN ABLE TO RUN UNDETECTED IN A NEIGHBORHOOD FOR
THREE YEARS, THAT SAYS SOMETHING ABOUT THIS FEAR THAT COULD COME IF WE
OPENED A SITE; RIGHT? AND I DEFINITELY KNOW THERE ARE
OTHER PLACES, THERE ARE MANY HARM REDUCTION PROGRAMS SHOWN
HERE THAT PEOPLE KNOW ARE USING. OF TAKING CARE OF EACH OTHER. TODAY, I TOOK MY 1700 OVERDOSE
REVERSAL REPORT SINCE WE STARTED HANDING
OUT NALOXONE. 99% OF THOSE WERE DRUG USERS
SAVING OTHER DRUG USERS. IT IS A TIGHT KNIT COMMUNITY
THAT IS BEAUTIFUL AND CARES ABOUT EACH OTHER. I’M SURE
THERE ARE HOMES WHERE PEOPLE ARE LETTING PEOPLE USE THEM AND
TAKING CARE OF EACH OTHER IN THAT WAY. THERE’S NONE THAT ARE
OPEN WITHOUT A NETWORK. STILL RISKING ARREST. DID THAT ANSWER YOUR QUESTION?>>SO THE FILM HAD A LOT OF
PERSONAL STORIES TOLD. AND I WANTED TO ASK YOU, DAN,
HOW YOUR STORY RELATES TO THE FILM AND
THE DIFFERENCES IN TIME AND LOCATION
AND THE >>I WAS ON THE WEST COAST. PORTLAND AND LOS ANGELES. NARCAN WASN’T AVAILABLE WHEN I
WAS ACTIVELY USING. IT WAS DIFFERENT, YOU KNOW. AND SAFE INJECTION SPACE IS A
BATHROOM WITH A LOCK. THAT WAS IT. LIKE STARBUCKS IS REALLY GOOD
AND THEY WERE CLEAN AND HAD LOCKING BATHROOMS. THEY WERE MY
FAVORITE. JUST KEEPING IT REAL. NARCAN WAS NOT AVAILABLE. I REMEMBER GOING OUT TO THE OREGON HEALTH
AUTHORITY, THE DOUBLE TREE RIGHT THERE. IN THAT BATHROOM. COMING TO IN THAT BATHROOM WITH
MY SPOON ON THE TOILET PAPER RIGHT
THERE TO AN EMPLOYEE. HEY, OH, MY FUCKING GOD, I’VE
GOT TO GOVERNMENT PARDON MY LANGUAGE.THAT’S TERRIFYING. ARE
THEY GOING TO CALL THE COPS? I WAS AN ADDICT. I WAS ACTIVELY
USING HEROIN. IF I DIDN’T HAVE IT, I MEAN, IN
THE BEGINNING, I DIDN’T NECESSARILY PLAN ON GETTING A
HABIT. ONCE I DID IT FOR A WHILE, I HAD ONE. IF I DIDN’T
HAVE IT, I GOT SICK. I DIDN’T NECESSARILY KNOW HOW TO FUNCTION IN LIFE WITHOUT HEROIN. I BECAME CRIMINALLY DEPENDENT. SO THE TWO ADDICTIONS, THE
CRIMINALITY AND THE CHEMICALS FED OFF ONE ANOTHER. IT WAS A VICIOUS CYCLE AND THE
FEAR OF CHANGE WAS HUGE. I CARRIED FRIENDS IN A FIREMAN’S
CARRY TO A PAY PHONE WHERE I CALLED
911. AND WAITED FOR THE SOUND OF THE AMBULANCE GETTING WITHIN A
COUPLE BLOCKS BEFORE I LEFT BECAUSE WHEN THE POLICE SHOWED
UP, THEY WERE GOING TO ASK ME TO EMPTY MY POCKETS AND FOR SOME
ID. THAT WAS THE WORLD THAT I LIVED
IN. I LOOK AT MYSELF AS A GO-TO
TEAM. I DEFINITELY GOT HIGH WITH PEOPLE. MAN, THAT’S HIS
PROBLEM. SHE WENT OUT, THAT’S HER FAULT. THAT WASN’T A LEVEL I’VE NEVER
WENT TO AND HOPEFULLY NEVER A LEVEL I’LL GO TO. IT’S
DIFFERENT NOW. THE GAME CHANGES. THE GOOD THING IS THERE IS
NALOXONE. AND AMAZING PEOPLE ARE TRAINING
PEOPLE AND PASSING IT OUT. AND EVERY NEW CLIENT THAT WE
HAVE, I DO A QUICK NALOXONE TRAINING. AND WITHIN A FEW DAYS, I GIVE
THEM TWO DOSES. I GET TO DO THAT. I GET TO DO
THAT. I GET TO SUIT UP AND SHOW UP AND
BE AN ADVOCATE AND AN ALLY AND EVERYTHING ELSE THOSE ARE MY
PEEPS OUT THERE. I KEEP WAITING FOR IT LIKE THE
OTHER FOOT TO DROP FOR IT TO REALLY
START MAKING AN APPEARANCE HERE IN PORTLAND. THEY HAVE TEST KITS. LIKE THIS
IS HARM REDUCTION. THEY HAVE TEST KITS THAT YOU TAKE YOUR DOPE IN AND TEST IT ON THE SPOT. THEY HAVE. AS LONG AS TIME HAS
EXISTED AND THERE HAS BEEN HUMAN BEINGS — IF YOU
LOOK IN THE ANIMAL WORLD, ANIMALS USE DRUGS. EVERYBODY WANTS RELIEF FROM THE
HORRIBLE ECONOMY OR THE POLITICAL CLIMATE OR LACK OF
HOUSING. OR THE LOSS OF A JOB OR LOVED
ONE. WHAT ARE THE THINGS WE TURN TO? THAT’S NEVER GOING TO STOP.
IT’S JUST NOT. YOU CAN TRY AND RUN ALL THE LANE
WARS ON DRUGS THAT JUST DESTROY
FAMILIES AND COMMUNITIES. AND IT’S NEVER GOING TO STOP. THE LONGER WE CRIMINALIZE IT,
THE MORE THE CARTELS AND THE PRIVATE PRISONS. THERE. THE MORE FATHERS WE TAKE
AWAY FROM THEIR CHILDREN, THE MORE
COMMUNITIES WE DESTROY WITH THIS. AT SOME POINT IN TIME, WE NEED
TO MOVE FORWARD. AND PRACTICE SOME ACCEPTANCE AND REALIZE THIS IS THE WAY IT IS
AND SO HOW DO WE HELP THESE PEOPLE? OR YOUR MOTHER? HUMAN AND SAFE? MIGHT BE MOST VULNERABLE TO SAY
I REALLY DON’T WANT TO DO THIS ANY MORE. LET’S TAKE A LOOK AT
MY OPTIONS.>>A QUESTION TO YOU, ELONA. THEY DID A GOOD JOB OF SHOWING
THE ENVIRONMENTS THAT PEOPLE SHOOT
UP AND THEY TALKED A LITTLE BIT ABOUT THE INJURIES THAT PEOPLE
GET. WONDERING WHAT YOU ARE SEEING IN
TERMS OF PEOPLE COMING IN WITH INJURIES DUE TO USING DRUGS IN
PUBLIC SPACES.>>YEAH. I’M VERY GRATEFUL FOR MY
POSITION BECAUSE I HAVE A FOOT IN THE COMMUNITY AND A FOOT IN
THE HOSPITAL. AND I GET TO KNOW PEOPLE WHEN
THEY ARE NOT AS SICK. AND WE SEE COMPLICATIONS OF INTRAVENOUS DRUG USE REGULARLY
AS A PART OF OUR IN-PATIENT POPULATION. AND THERE’S A LOT OF UNNECESSARY
SUFFERING THAT I THINK WE COULD PREVENT BY HAVING SAFE PLACES
FOR PEOPLE TO GO. AND IN THE ABSENCE OF THOSE
PLACES , THE VIDEO SPEAKS TO A NUMBER
OF CONTRIBUTING FACTORS. WITHOUT THE INFORMATION AND THE SUPPLIES THAT PEOPLE NEED, WE
SEE BACTERIAL INFECTION OF THE
BLOOD. SOMETIMES RESULTING IN THE NEED
FOR VALVE OR HEART TRANSPLANT. WE ALSO SEE A LOT OF SOFT TISSUE INFECTION S AND THE TREATMENT THAT’S
INDICATED IS 4 TO 6 WEEK COURSE OF ANTIBIOTICS. IT’S CHALLENGING FOR THE
PATIENTS TO ASK SOMEBODY TO BE IN THE HOSPITAL FOR FOUR TO SIX
WEEKS. BUT IF YOU ADD TO THAT THE
REPEATED CYCLES OF TRAUMA BOTH PHYSICAL
TRAUMA EXPERIENCING WITHDRAWAL
EVERYDAY, THE FIRST SEVERAL WEEKS OF THIS COURSE OF TREATMENT ON TOP OF BEING
ACUTELY ILL, I THINK THAT PAIRED WITH THE FORCE
OF STIGMA THAT PEOPLE OFTEN FACE INTERACTING WITH THE MEDICAL
SYSTEM. AND I WILL SAY THERE ARE SOME VERY LOVELY PEOPLE WHO
ARE WORKING REALLY HARD AT IMPROVING SOME OF THE
SYSTEM’S ISSUES IN THE HOSPITAL. THAT ASIDE, I THINK THAT PEOPLE
HAVE UNDERSTANDABLE RELUCTANT OUTSIDE
OF THE HOSPITAL. PEOPLE ARE PRESENTING — THERE’S
A DELAYED PRESENTATION. WHEN PEOPLE COME TO US , THEY
ARE VERY SICK. THE CHALLENGES THAT COME WITH A
COURSE ARE THEN EXACERBATED. EITHER THEY ARE NOT ABLE TO GET
PLACED IN A FACILITY OUTSIDE OF THE
HOSPITAL. OFTENTIMES BECAUSE THEY ARE DRUG
USERS AND PEOPLE WHO USE DRUGS,
FACILITIES WILL DENY THEM PLACEMENT WHICH
IS A WHOLE ISSUE. AND IT’S A HARD PLACE TO BE. AND I THINK THAT’S TRUE FOR
EVERYONE AND ESPECIALLY FOR PEOPLE WHO USE DRUGS. SO FOR SOME, THAT MEANS LEAVING AGAINST MEDICAL ADVICE AND IT
MEANS THAT THE CONCERN THAT BROUGHT THEM INTO THE HOSPITAL
IS NOT RESOLVED. THAT ALSO MEANS THAT THEY WILL
LIKELY GET SICK AGAIN BECAUSE THEIR INFECTION HAS NOT BEEN CURED, LET’S SAY. THIS HAS BROADER IMPLICATIONS
FOR WHAT WE HAVE COME TO UNDERSTAND ABOUT INCOMPLETE COURSES OF
ANTIBIOTICS AND THE WAY THAT CONTRIBUTES TO
ANTIBIOTIC RESISTANCE. SOMETHING THAT IS WORTHY OF
FURTHER CONSIDERATION. IMPLICATION SIMPLICATIONS WHICH
IF THE HUMAN ARGUMENT ISN’T STRONG ENOUGH, THE COST OF
SOMEBODY OBTAINING A FOUR TO SIX WEEK COURSE OF ANTIBIOTICS IS
PRETTY ASTOUNDING. WHEN YOU ADD TO THAT REPEAT
ADMISSIONS BECAUSE THE COURSE WASN’T
COMPLETED, I THINK THE NUMBERS ARE STRIKING
AND I THINK WE ARE TALKING EARLIER ABOUT HOW WE’RE LOOKING UPWARDS OF $200
MILLION JUST IN THE COSTS RELATED TO
ADMISSIONS DUE TO COMPLICATIONS OF TRAFFIC
VENUS DRUG USE. AND WE’RE SEEING THOSE RATES
INCREASE. THE FACT THAT ALL OF THESE
COMPLICATIONS COULD BE PREVENTED TO HAVE
PLACES FOR PEOPLE TO GO, TO HAVE THE TOOLS THAT
PEOPLE NEED TO INFECT DRUGS MORE SAFELY AND TO HAVE THE POWER OF
PEER S WHO ESPECIALLY WHEN THEORY EQUIPPED WITH THE
KNOWLEDGE AND THE SKILLS, THE POWER OF PEERS PASSING WHAT THEY
UNDERSTAND ON TO EACH OTHER WHICH IS GOING TO HAPPEN ANYWAY ESPECIALLY IN A TIGHT
KNIT COMMUNITY CAN’T BE UNDERSTATED. SO WE SEE PEOPLE WHO ARE VERY,
VERY IT’S HARD TO WATCH. THEY COULD — ALL OF THIS IS
AVOIDABLE. IF NOT ALL OF IT, THEN SO MUCH
OF IT. THERE’S WORK TO BE DONE IN ALL
OF OUR HOSPITALS. AND THE WAY THAT BRIDGES TO THE
WORK WE DO IS MADE SO CLEAR WHERE
PEOPLE CAN COME AND ACCESS THE THINGS THEY
NEED TO AVOID THESE THINGS. SITES ARE A BRILLIANT PREVENTIVE
MEASURE THAT PREVENTS INFECTIONS LIKE A
WHOLE HOST OF HEALTH PROBLEMS, PREVENT
DEATH. AND JUST SAVES MONEY. CONSIDERING THAT, WHY DON’T WE
SEE MORE SAFE CONSUMPTION SITES? FACE IN PORTLAND TO SETTING ONE
UP?>>I THINK WE HAVE 100 YEARS OF
TREATING PEOPLE WHO USE DRUGS AS CRIMINALS. WE HAVE THIS WAR ON DRUG USERS.
IT’S A WAR ON DRUG USERS. WE HAVE A WAR ON DRUG USERS THAT
WAS DESIGNED TO PUT BLACK AND BROWN PEOPLE IN PRISON. IT WAS DESIGNED TO LOCK PEOPLE
AWAY. WHICH IS THE EXACT OPPOSITE TO HELP PEOPLE WHO USE
DRUGS. AND SOCIETY IS SHIFTING IN SOME
OF ITS THINKING AROUND DRUG USE. IN PART BECAUSE OF RACISM. THE FACT THE OPIOID CRISIS WE
ARE LOOKING AT TODAY IS THE
WHITEFACES HAVE BROUGHT POLITICAL WILL AND POLITICAL
ACCEPTANCE THAN THE BLACK AND BROWN FACES ASSOCIATED WITH THE
CRACK EPIDEMIC. AND SO I THINK IT’S IMPORTANT TO
SAY THAT THAT DRUG USERS ARE TREATED
LIKE SHIT EVERYWHERE THEY GO. AND AS POLICY GO, DUDE REMEMBERS A
TIME WHERE YOU COULDN’T USE THE TERM HARM >>I DON’T KNOW ABOUT THIS
BUILDING. YEAH, THERE WAS A TIME WE COULDN’T USE HARM
REDUCTION IN CDC LANGUAGE. AND I THINK ANOTHER TIME WE
COULDN’T SAY THAT COMMONS PREVENTED HIV.>>I THINK A LOT OF IT HAD TO DO
WITH POLITICAL WILL. WE TALK ABOUT THE OPIOID
EPIDEMIC AND A CRISIS BUT WE’RE NOT FUNDING IT LIKE A CRISIS AT
ALL. NOT ON A STATE, LOCAL AND
FEDERAL LEVEL. IT’S NOT BEING ORGANIZED LIKE A
CRISIS. WE WANTED TO ACKNOWLEDGE THIS WAS AN OPIOID
CRISIS, WE WOULD BE PULLING TOGETHER WEEKLY MEETINGS OF ALL
OF THE FACTIONS. THE SUBSTANCE USE PEOPLE WOULD
BE TALKING TO THE HEPATITIS C PEOPLE. I THINK THERE’S A LACK OF WILL
TO ACTUALLY ADDRESS THIS. I THINK IT’S MUCH EASIER TO WRITE POLICIES ABOUT — FOR
DOCTORS TO CONTROL THE PROTOCOLS OR REQUIRE THEM TO BE ON THE
PDMP. SO MUCH EASIER TO TALK TO DOCTORS ABOUT WHAT THEY CAN DO
TO FIX THIS PROBLEM THAN IT IS TO ACTUALLY SIT WITH DRUG USERS. NOT ALL OF THEM ARE REAL NICE.
BUT NOT ANYONE IS REAL NICE EITHER. I PROMISE I’VE SAT THROUGH
CLASSES AND MEETING WITH DOCTORS THAT IS WAY
WORSE. AND REALLY ACKNOWLEDGING THAT WE
NEED TO START THINKING OUTSIDE THIS BOX. I’VE BEEN DOING THIS WORK SINCE
2002. I’VE NEVER SEEN ANYTHING LIKE THIS. I HAVE FRIENDS WHO HAVE BEEN
DOING THIS WORK SINCE THE 70s AND THE
80s WHO LIVE THROUGH THE MASS DEATH OF
HIV NOW — AND OVERDOSE DEATH ALL COMING TOGETHER AT THE SAME
TIME. IT IS REALLY — LIKE THOSE
NUMBERS INCLUDE PEOPLE DYING IN ALONE
CARE IN THE HOSPITAL. WE’RE LOOKING AT IT AS MORE
PEOPLE DIE FROM METH IN OREGON THAN OPIOIDS DO. SOME OF THAT
IS THE SAME BECAUSE OF THE WAY WE COUNT DEATH NUMBERS.SOME OF
THOSE METH USERS ALSO WERE HEROIN USERS. THAT’S A WHOLE OTHER
CONVERSATION. BUT THESE ARE THINGS THAT WE
NEED TO TAKE ACTION TOWARDS. AND WE NEED PEOPLE TO BE BRAVE. WE NEED CHAMPIONS IN OUR
COMMUNITY TO SAY WE’RE DONE. MY HEART CAN’T TAKE MUCH MORE. PUBLIC HEALTH WEEK TO TALK ABOUT
IT, TO HAVE THESE CONVERSATIONS AND REALLY MOVE PAST THE I’M
AFRAID DRUG USERS ARE GOING TO USE IN MY YARD. TO SILOED THINKING. AND SILOED THINKING LEADS TO
SILOED ACTION WHICH DOESN’T GET US OUT
OF OUR PROBLEM. SO WE KEEP GOING AROUND IN THIS
CIRCLE AND UNTIL SOMEBODY IS BRAVE ENOUGH TO STEP OUT OF THE SILO THINKING
AND THE SILO FUNDING AND THEN WE’LL GET
SOMETHING THAT’S MORE OF A RESULT. AND I WOULD HAVE TO SAY I THINK
THE LAST TWO MONTHS I STARTED
HEARING THE FEDERAL GOVERNMENT USE THE WORD
— AND IT TELLS ME IT’S NOT USED VERY
OFTEN ABOUT INFECTIOUS DISEASE AND
OPIOID AND METH AND DRUG USERS. AND IF WE DON’T TALK ABOUT THEM
AT THE SAME TIME, WE ALSO HAVE A
SYPHILIS PROBLEM AND IT’S RELATED TO DRUG
USE. IF WE DON’T START TALKING ABOUT METH IN OREGON AND WAIT UNTIL METH
GETS TO ATLANTA OR THE EAST COAST, THERE’S GOING >>CAN YOU DEFINE EPIDEMIC? BUT IN CASE PEOPLE DON’T KNOW
WHAT >>YOU WERE SAYING WE HAVE THIS
OPIOID WE CLEARLY HAVE A HEPATITIS C
EPIDEMIC IN OREGON. IT’S ALL OF THESE ARE INTER RELATED. THEY
FEED OFF EACH OTHER AND WE’RE NOT GOING TO GET OUT OF ONE IF
WE DON’T AND SO IT KIND OF FEELS LIKE, TO
ME, MONKEYS IN A BARREL. THE SECOND YOU KIND OF GET OUT, YOU >>YOU TALKED ABOUT SEVERAL
DIFFERENT TOPICS. THE FILM YOU SHOWED IS FABULOUS. THE PRESENCE OF THIS TOWN IS
IMPORTANT. IF YOU WANT TO FOCUS ON GETTING
IN PORTLAND, THE ANSWER IS DO DOZENS OF THESE FAMILIES AROUND THE CITY,
[INAUDIBLE].>>WE’RE NOT SEATTLE AND NOT SAN
FRANCISCO. BUT THEY HAVE AN OPPORTUNITY HERE IF THE PEOPLE DOING THIS WORK TO
FOCUS ON IF THIS IS IMPORTANT, SOMETHING THAT WE THINK IS AN
IMPORTANT POINT. TO SEE WHETHER HOSPITALS ON A
FREE BASIS WOULD OFFER AN EMPTY SPACE
IN PORTLAND. AND I’LL JUST SAY THAT I’M
SPEAKING FOR MYSELF AND NOT AS A
REPRESENTATIVEREPRESENTATIVE FROM MY INSTITUTION. I DO THINK THAT HOSPITALS
ESPECIALLY AND REALLY ANY PLACE THAT PEOPLE
ENCOUNTER THE HEALTHCARE SYSTEM HAS AN OPPORTUNITY TO EXPAND ITS
SERVICES TO OUR COMMUNITY WHICH INCLUDES PEOPLE WHO USE DRUGS AND THAT IN EVERY AREA
OF HEALTHCARE SERVICES, THAT PART
OF THE EDUCATIONAL AND HEALTH PROMOTION THAT WE HAVE THE OPPORTUNITY TO ENGAGE
IN INCLUDES THINGS LIKE SAFER INJECTION PRACTICES, LIKE TALKING ABOUT
PEOPLE’S OPTIONS AS THOUGH THERE’S A RANGE. WHICH IS TRUE AND JUST LIKE WE
PROVIDE PEOPLE WITH EDUCATION TO INJECT INSULIN MORE SAFELY, WE CAN DO THAT WITH
PEOPLE. I’LL SAY THE MEDICINES PEOPLE USE TO STAY WELL.
ESPECIALLY, WHEN WE’RE LOOKING AT CHEMICAL DEPENDENCY, OFTENTIMES
PEOPLE WHO HAVE — I’M GOING TO DIGRESS. I WANT TO FOCUS ON
YOUR QUESTION. YES. YES, WE DO. WE HAVE A NUMBER OF EXISTING
PHYSICAL STRUCTURES THAT COULD PROVIDE ADDITIONAL SUPPORT
SERVICES WHICH COULD FUNCTION AS SAFER >>I WOULD ALSO LIKE TO NOT GET
CARTS BEFORE THE HORSES ON THIS. SAN FRANCISCO BUT IT WAS REALLY
ABOUT COMMUNITY ORGANIZING AND REALLY
ABOUT GETTING ENOUGH PEOPLE AT THE TABLE AND I’M EXCITED TO SEE THE TABLE
AROUND DRUG USER’S HEALTH IS GROWING. I CAN TELL YOU IT’S
BEEN TAKING A LONG TIME TO BUILD THAT UP AND GET
THE RIGHT STAKEHOLDERS TO PAY ATTENTION TO THIS IS A THING. AND SO DIRECT TO YOUR QUESTION,
IT IS STILL ILLEGAL TO DO. IN OREGON, SYRINGE EXCHANGE IS
STILL ILLEGAL.>>THE WAY CONSERVATIVES WORK IN
THIS STATE IS THEY PASS A STATE LEVEL THAT SAYS THE COUNTY CANNOT MAKE A
LAW.>>GOT IT. NOW I UNDERSTAND
WHAT YOU ARE SAYING.>>WE’RE RUNNING OUT OF TIME. I LIKE
THIS AND I WOULD LIKE TO TALK TO YOU ABOUT THIS. REALLY. AND I WANT TO KNOW IT. THERE IS A GROUP HERE LOCALLY
WORKING ON ADVOCACY. SAFER SPACES PORTLAND. I WILL TELL
YOU THERE ARE TWO OF US AND WE’RE VOLUNTEERS. AND WE’RE
DOING AS MUCH AS WE CAN. I AM ON THE NATIONAL NETWORK FOR
SAFE CONSUMPTION SPACES. CLOSE TO 40 CITIES NATIONALLY. AND NEED EVERY YEAR TO SIT DOWN
AND TALK ABOUT WHERE WE’RE AT AND
TALK TO EACH OTHER REGULARLY CAUSE WE’RE FRIENDS. IT’S A
SMALL NETWORK.I THINK THE CONVERSATION IS JUST STARTING. BUT I ALSO THINK IT’S GOT TO
START SOMEWHERE.>>I WAS GOING TO ADD I THINK A
LOT OF THINGS THAT WE’RE SEEING ARE
COMMUNITY MEMBERS EDUCATING THEMSELF WANTING TO BRING THE INJECTION ROOM MODEL. DOING A LOT OF COMMUNITY
BUILDING SO WHEN THE IDEA MOVES FORWARD THERE’S NOT AS BIG AS AN AVALANCHE BACK. AND I DON’T TEXT BACK THERE
WON’T BE SOME PUSH BACK.>>I THINK TOO JUST TO TAG ON TO
WHAT YOU ARE SAYING, WE NEED DIVERSITY. WE NEED TO BE IN
DIVERSE SPACES. WE NEED TO BE TALKING ABOUT THIS
IN AS MANY NEIGHBORHOODS AND COMMUNITIES AS POSSIBLE. WE NEED THERE TO BE ACTIVE USERS
AT THE TABLE. I THINK HAVING A RANGE OF DRUGS AND METHODS OF
ADMINISTRATION PRESENT BECAUSE IT’S NOT JUST
ABOUT OPIOIDS. AND IT’S REAL. AND PEOPLE ARE DYING. AND
THAT’S TERRIFYING. AND IT’S GETTING WORSE. AND THERE ARE
ALL KINDS OF SUBSTANCES PEOPLE ARE USING. AND ALL KINDS OF PEOPLE WHO ARE
USING AND THEY THINK THE MORE THESE CONVERSATIONS CAN HAPPEN WITH
RESPECT TO DIVERSITY , BROADER HOUR STRATEGIES CAN BE
ADDRESSING A VERY COMPLEX ISSUE WITH SO >>QUICK CONTACT. I KNOW IT’S
3:30. THERE’S PLENTY MORE TO TALK ABOUT. IF OUR PANELISTS
ARE WILLING TO STICK AROUND AND FOLKS WANT TO STAY
AND IF

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