COMMENTARY: Harm reduction treads close to enabling

by Jan 11, 2019OPINIONS





Addiction has plagued our Tribe for decades. Alcoholism has been one of our oldest battles, but certain drugs have arrived on the scene, and that has made for new and probably uglier battles. While the drugs and the impacts on the users themselves are damage enough, it’s the collateral damage that makes addiction so heartbreaking.

Addiction doesn’t just hurt the user. It hurts the user’s family, children in particular. It also hurts neighbors and others around the users who have to cope with their behavior. So, it should seem that helping addicts recover would be a top priority, and it is. However, among the collateral damage, particularly with drugs that are injected, like methamphetamine and heroin, is the spread of bloodborne diseases like HIV and hepatitis C.

This is where the Eastern Band of Cherokee Indians’ syringe service program comes in. Programs like this have been around since the 1980s. Where many drug users will share needles, and therefore end up spreading bloodborne pathogens to other users, the practice of providing unused, clean syringes to users to reduce the spread of disease came into practice.

With hepatitis C being widespread among the Tribe, and HIV infections still being problematic, it’s been shown to reduce these infections. The program offers unused syringes, alcohol wipes, a bottle of water, biohazard containers for disposal, a card that provides immunity from paraphernalia charges, and supplies that include cooking tins and tourniquets. They also offer referrals for drug treatment, medical care and community resources when requested.

The Tribe is in a catch 22 here. Does it work toward harm reduction through reducing disease transmission? Or, does it take a strong, no-tolerance stance, particularly necessary with the opioid trade? No one wants to see an increase in hepatitis or HIV, but no one wants to see growing numbers of addicts either.

I’m willing to place a wager that there isn’t a single family on the roll who hasn’t been touched by addiction, and I mean opioids or methamphetamine. In my family’s case, it’s both. That’s on top of past family members’ addictions that have included cocaine on top of alcohol. I know three things about addiction based on what I’ve dealt with. One is the addict has to want to quit and change. It can’t be forced.

Two is that most addicts don’t reach that point until they’ve hit rock bottom, and that’s different things for different people. For some, it’s getting arrested, and/or seeing their mugshots on TV or in the papers. For some, it’s a near overdose. For others, it’s the look of shame in a child’s eye. Tragically for some, rock bottom is death, and my family has been through that too.

The third thing is, the worst thing you can do for an addict is enable and coddle.

Some of my opinion is from having to cope with the behavior of addicts and users around me. Call me cold-hearted, but I don’t care whether the man I caught attempting to break in my car, at the house where my children were sleeping, is struggling with addiction. I want him to face the consequences. His being obviously high is not an excuse. It certainly doesn’t bring out any feelings of sympathy, and I have every right to prohibit that element from being around my children. Given my experience, it should also be understandable that I feel we are coddling and enabling addicts, and I don’t just mean the Tribe. Refer addicts to treatment and work with them sincerely to get clean and sober, but don’t let them off the hook or hand out cushy punishments for criminal behavior.

I also find it incredibly sad that we have gotten to the point where we hand out clean needles to drug addicts to combat what could be a greater scourge in HIV and hepatitis C. When local resident and grandfather David Jumper stood before Tribal Council on Wednesday, Jan. 9 and demonstrated how his grandchildren play, which mimicked the use of a tourniquet and injecting drugs, it now appears as though addiction has become normalized. This can’t be the new normal. Jumper, being a tribal detention center employee, has seen the ravages of addiction first hand. While the needle exchange is a necessary evil, emotionally for me it doesn’t sit well. It feels a lot like enabling. In fact, I could argue that it is enabling.

Yes, I support the exchange program’s efforts to reduce the spread of disease, but I don’t feel good about it. I also feel far too many drug offenders (including dealers and traffickers) get off way too easy on a justice system conveyer belt. We need to change something, because what we’ve been doing isn’t working, and the problem is getting worse.