“The real war will never get in the books”–Walt Whitman, 1875
On October 31, 1932, Charity Hospital in New Orleans admitted a comatose man, diagnosed with malaria and thought to be an opiate addict. The patient deserted the hospital after being revived. Two days later, he was once again brought to Charity hospital, again in a coma. He died the following day. Over the course of the next month, five more Charity Hospital patients, all injecting drug users, died of malaria. Over the course of the following year, a total of 48 injecting drug users were admitted to the same hospital with diagnoses of malaria, 10 of whom died.
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EDITOR’S NOTE: Today, Points brings you the third in a series of posts on silencing and substance use by Heather Sophia Lee, PhD, LCSW, an Assistant Professor of Family Medicine and Community Health at Rutgers’ Robert Wood Johnson Medical School. You can read the first installment here and the second installment here.
For my dissertation, I conducted a qualitative study of two harm reduction programs. The purpose was to describe the experiences of participants in harm reduction programs given that “outcomes” of such programs were difficult to measure.
At that time evidence existed for the efficacy of harm reduction practices, like needle exchange programs, in reducing the spread of sexually transmitted diseases like HIV and hepatitis C. Less was known about the impact of harm reduction as a model for addiction treatment. Its broad focus made it unclear which “outcomes” were most important to measure. Coupled with political resistance, many agencies often avoided calling their work “harm reduction” to avoid scrutiny which might interfere with meeting the needs of their clients.
As a novice qualitative researcher, I was intuitively curious about how harm reduction was being integrated into twelve step recovery experiences. I was also interested in the extent to which one might be just as likely to come to abstinence through harm reduction as abstinence-only based treatment. Harm reduction and twelve step models were often cast as mutually exclusive, and I knew there was a deeper story to be known though I wasn’t yet sure what it was.
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