[HARMRED] 1:1 Syringe exchange versus distribution

[sue purchase]

Hi Chris,
I am happy to hear Baltimore is looking at making changes. My experience is
similar to Dan's
in that it is need based which generally is determined through friendly
conversation.
It is a wonderful opportunity to provide education on why one clean shot is
important to safer
injecting practices.

peace sue

sue purchase

"disturb the comfortable and comfort the disturbed"



On Fri, Oct 15, 2010 at 8:41 AM, Dan Bigg <cra at attglobal.net> wrote:

>  Chris -
>
> CRA does need-based -- what need?  The need for the person we see and
> everyone they will see to have enough syringes for one shot-one sterile
> syringe (in fact, some need more than 1 for each shot and this is OK too).
>
> The essential way you get there is NEGOTIATE UP..."How many do you need for
> yourself and those around you to have a new one each shot?"  (Answer -- they
> say for instance 100)... you say "How about 200?...They say OK..you say "How
> about 300?...They say, "No, 200 is fine!"  This is the number you give them.
>
> Please keep in mind that changing to a need based system -- where I feel
> the best science of safer injection, improved health, clean streets, etc lay
> -- may take a long time and such strict negotiating up will take time to
> sink in as the new standard!
>
> Be ready for a few to leave with a bunch, maybe in the thousands, and you
> need to be OK with this as people test you and pass the word!  Without such
> a clear and present change more generous syringe usage and providing AND
> Collecting may never develop!
>
> I saw the Vancouver Program DEYAS switch from a strict 1 - 4 - 1, with a
> limit of 4, to no limit (after they saw a massive spread of HCV) and three
> years later almost everyone who came in only took four -- even in
> discussions with participants people felt that taking more than 4 somehow
> 'violated' the program and evaded the shame/control/condemnation all 'good'
> drug users should always feel towards themselves and others...
>
> It is somewhat counter intuitive but in a three year study with Yale/Robert
> Heimer we saw that such a respectful system results in MORE of what I would
> call community altruism -- kinda the "you catch more flies with honey than
> vinegar" approach.  We saw an 88% return rate at our program -- much less
> circulation time critical to lessening disease spread -- versus three 1 - 4
> -1's around the country who averaged in the 50%'s .
>
> Meeting with your participants, paying them for their expertise, having a
> nice meal and asking these questions would also help - we have had such
> meetings, we call Community Advisory Groups for years and our participants
> have been great with suggesting and navigating all such positive changes...
>
> Call me to clarify if needed.
>
> Peace, Dan
>
> At 9:16 AM -0400 10/15/10, Serio-Chapman, Chris wrote:
>
> Content-class: urn:content-classes:message
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>
>
>
> Hello from Baltimore!
>
>
>
> Currently we are exploring the possibility that our syringe exchange
> services may go the way of distribution-finally.  Just curious how many SEPs
> actually still do 1:1 and how many do distribution.  Is there someplace I
> can find this information?  If not, if individuals from SEPs could respond
> to let me know what they are doing I would be grateful.
>
>
>
> Chris
>
>
>
>
>
> Chris Serio-Chapman
>
> Baltimore City health Department
>
>
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>
>
> --
>
> Dan Bigg, Director                      cra at attglobal.net
> Chicago Recovery Alliance              (312) 953-3797
>
> 3110 West Taylor                  fax (773) 489-7448
> Chicago IL  60612-3944                http://www.anypositivechange.org
>  "A new scientific truth does not triumph by convincing its opponents and
> making them see the light, but rather because its opponents eventually die,
> and a new generation grows up that is familiar with it." --* Max Planck
> 1858 - 1947*
>
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