This present argument reminds me of the book The Pastoral Clinic by Angela Garcia, published in 2010. It looks at an area within the US that has/had the highest heroin addiction and fatal overdoses, the Espanola Valley in New Mexico.
The author, an anthropologist, goes into the region, and realizes that it's not just simply providing healthcare, jailing the people for possession of drugs, that'll help. In fact, it just perpetuates the cycle, a cycle of getting addicted, shooting up, getting in trouble/being sent to the hospital, trying to get clean, and then starting from the beginning. The saddest part though is when she realized that all of the drug abuse is heavily embedded in historical and cultural narratives and systems that are hard to break; the cycle affects families and friends, neighbors and even strangers, for even at the graves of those who died of OD people shoot the needles into the ground, a symbol of how deeply rooted the area is to this drug, how interwoven the drug is in the narrative of their lives.
Parents rope in their children, and vice versa. Friends get other friends involved, and those who aren't try their best, but are powerless to do anything. It's a literal and figurative familial and social paradigm that towards the end the author tries to figure out how to deal with it, meeting with physicians, government officials, the various peoples involved in public health. It's not an easy situation to fix she notes; it's complex and cannot be solved with just a bandaid. And when she gave a talk a couple of years back to give an update, she commented on how those questions are still there, and how the intersections of medicine, public health, and anthropology need to figure out how to address these problems not only in New Mexico, but other areas of the US that have similar struggles.
So upon reading this book, hearing her talk, and doing some research, I'd rather have the Clean Needles Program than not. I understand the other side's argument about how having this program is aiding and abetting drug users to continue using, but at the same time, I would be lying to myself and denying the accounts of others who've noted that having clean needles is better than nothing.
Because when you're sharing needles not just with random strangers, but with your family, your friends, people you love and shouldn't be harming, things get messed up. When you share a needle with your daughter, and you later learn that you not only gave her HIV, but possibly her newborn baby, that's serious. The needle you shared possibly led someone else to their death. Yeah, it's their fault, they're responsible and should live with the consequences, but at the same time, how is someone to rise above that when there is little opportunity to do so?
Garcia talks about how this sharing is an intimate experience, one of sharing the suffering and euphoria of the circumstances of life. It's poetically depressing, and it's something that she notes obviously shouldn't be occurring. Granted, I believe and want better treatment programs and have the funds go towards more aggressive, effective solutions, but I don't think we have a comprehensive plan yet for that.
nope nope nope.
I died
