harm reduction for & against …& as a last resort

THE DEBATE over harm reduction's role in meth addiction rages on. Here, a physician presents the case for harm minimisation, followed by LIFE OR METH's case against…

"LIKE MANY PEOPLE who have posted to this website, I have had to watch several friends go from consuming crystal to being consumed by crystal. And I've treated more people than I can count who attribute their HIV infection to crystal meth use. Let's face it: Tina's a bitch! But why have the commendable anti-crystal activists decided to demonise the proven philosophies of harm reduction? A scenario: you're in the early phase of crystal use. You use it occasionally and enjoy the ride, not to mention the sex. You have not missed work. You have not spent thousands of dollars you don't have. And you have not had unsafe sex. How are you going to respond to a group of people telling you "meth = death", when clearly you know that it doesn't as you are still alive? The philosophy of harm reduction works exactly because it preaches neither fire nor brimstone, but provides facts for people to do with as they choose. No doubt about it, crystal deserves its reputation. It has destroyed thousands of lives. But the way to reach those at risk is not by telling them facts that do not match their experience, but perhaps by showing them what may happen to them if they continue using. Get people in recovery out into the communities, telling their stories to any who will listen. And arm people with information, not the Eleventh Commandment: Thou shalt not tweak."
~ Dr. Stew, New York City

LIFE OR METH FOUNDER RESPONDS

"HARM REDUCTION accepts and allows the continued and unabated use of harmful substances and the loss of people cannot be recovered. At best, harm reduction is a halfway measure and half-hearted approach that invites deceit."
~ Alison Kogut [Deputy Press Secretary, The US Office of National Drug Control Policy]

IT IS A well-worn myth spread by PC harm reduction advocates – whose science/theory-driven minds cannot grasp or fathom the concept of abstinence through empowerment of the individual, and whose response to crystal meth has instead been to "harm maintain" the user in his habit – that meth abstinence-based strategies must somehow involve a "Just say no!" wagging finger approach, stigmatisation of the target audience and a pious demand to not use.

LIFE OR METH does none of these. What it does do is dispense the hard facts about meth addiction – including, crucially, the underlying reasons why gay men are prone to using in the first place – in a truthful, personable, non-sugar-coated way from which the potential user/abuser can make informed choices 
whether or not to use/continue using. Far from preaching fire and brimstone or casting stern judgements, LIFE OR METH serves to:

• Raise awareness about meth, thereby serving as a resource for prevention;

• Eductate potential users about the risks and the possible consequences of meth dependency (in this category are included those in the so-called "controllable" phase of crystal use);

• Inform the abuser's friends and loved ones so they may better understand what he is experiencing;

• Shine a mirror of clarity and truth at the abuser to awaken a desire within him to rise above his addiction and seek help.

LIFE OR METH shuns all harm reduction modalities because many meth users who claim to have their intake under control are, as we know, on the verge of a very slippery slope, if not already at the stage where they're masking or denying a very serious problem. Most top medical specialists agree that meth is completely controllable only by a minority of people which is why it can never accurately be termed a "recreational" drug, such is its insidiousness and ability to creep up on even the most seemingly responsible of users (separate studies by the University of NSW and the National Drug and Alcohol Research Centre – NDARC – in Australia jointly conclude that two-thirds of Sydney meth users are dependent).

Harm reduction can be useful when targeted only at those able to moderate their usage but, as a generalised, one-size-fits-all approach to tackling the gay meth epidemic, it has proven to be a monumental disaster.

"Crystal has unique pharmacological properties that preclude safe usage. This is what underlies the debate about why harm reduction may be an inappropriate model. Its pharmacological effects on the brain and the body make it impossible to use safely."
~ Paul Galatowitsch [The Centre for HIV/AIDS Educational Studies and Training, New York]

In 2005, an Advocate poll of over 1000 readers, 75% said that meth cannot be used responsibly as an occasional recreational drug; 19% said it could; 6% were undecided. [Click PDF link, left]

Harm reduction, by definition, implies that the average recreational user accessing such information has a degree of control over his usage, at least to the extent that he is able to manage or reduce his intake by will. Yet this is often not the case where meth is concerned, and so a confusing and misleading message is trans-mitted to those in the uncontrollable throes of chronic meth addiction. Such online harm reduction/do-it-your-self resources have included Seven safer slamming techniques and "tips" such as Keep a $10 note rolled up in a safe place in case of emergencies!, but however well-intentioned have served only as a green light and incentive to most meth users controlled by their addiction to continue using. At best, harm reduction is a validation that it is OK and, at worst, cool to use.

"The kind of message we need is: 'You know what? I thought I could use this recreationally and only use it on weekends and only use it when I went to a circuit party, and the fact of the matter is it kicked my ass, and it kicked my lover's ass, and neither one of us have been able to get off it in two years.'"
~ Steve Tierney [San Francisco Department of Health HIV Prevention Director]

Political correctness: a pervasive, socially engineered form of censorship and thought control that prevents people speaking truthfully, discourages engagement and stymyies open and honest debate.

Political correctness stands in the way of many gay men's sexual health/AIDS agencies targeting directly those most vulnerable to health risks like HIV and crystal through a perceived fear of offending or stigmatising HIVers and meth users. Umbrella options like harm reduction and generic AIDS campaigns aimed at HIV- and HIV+ men alike are often the preferred methods of those mandated to safeguard sexual health, because they allow them to be seen to be addressing everyone while really benefitting only a few.

In reality, only knowledge and truth – the antitheses of political correctness – can enable the meth abuser to understand his situation clearly, thereby serving to empower him to confront and release the fear, or demons, that keep his mind imprisoned in addiction. Like applying a Band Aid to a gaping wound or prescribing boxes of matches to an arsonist, PC strategies fail to target the symptoms at the heart of the problem and so they, the addiction itself and the escalating cost to society persist. An analysis of methamphetamine-related costs for treatment, health care, social services, crime and lost productivity in the United States in 2005 alone reached $23.4 billion.

Defending politically correct umbrella strategies, Russell Westacott, former associate director at New York's Gay Men's Health Crisis, wrote in The Sydney Star Observer in 2006: "While meth use is problematic for some, the majority of users do not view their use as equating to death. Regardless of what some may think meth users should believe, any effective health promotion message needs to be reflective of realistic experiences." Is Westacott implying that those who face addiction should be sacrificed to those who are able to mange their intake?

"While abstinence is anathema to the advocacy groups, they can at least preach restraint and responsibility. But no: better to stay silent then to be seen as prudish or even — eek! — socially conservative… It would behoove the advocacy groups to catch up with the rest of society and put a stigma, as scary as it might be for them, on the irresponsible behavior that leads to HIV/AIDS, other diseases, and broken lives. Such a stigma would lower the risk of another 1980s-style outbreak. Even the sexy would approve."
~ Katherine Ernst [City Journal]

LIFE OR METH approaches crystal from the perspective that it is a drug too psychologically and physically addictive for most to be able to control consistently, and so encourages abstinence via empowerment of the meth victim above all else, firstly by focusing on the consequences of meth addiction, and secondly by addressing the underlying issues around low self-esteem and lack of self-worth that disempower so many gay men into fearful lives characterised and defined by victimhood; a mindset that invariably leads on to hard drug use.

"Certainly there’s validity in trying to not make crystal glamorous, but we need to look at some of the underlying issues driving this crisis rather than just staying in a crisis mode mentally… Why are we persistently trying to kill ourselves in the gay community? That’s the larger discussion that’s not happening around crystal meth."
~ Patrick Moore [Author of Tweaked]

The PC harm reduction approach ignores the underlying reasons why people use meth, preferring instead to maintain the user in victim mode. Yet while those reasons exist, then meth addiction and social degeneration will persist.

Harm reduction, or "harm maintenance" as it should more accurately be termed, at least in relation to crystal, effectively serves to validate, sustain and perpetuate meth's hold on communities where its use is rampant. As such, harm reduction is a symptom of the ongoing problem itself; a resigned acceptance by its PC-indoctrinated advocates that the user cannot be encouraged, influenced nor empowered to refrain by self-will and determination alone. LIFE OR METH is proof that they can: around 70% of meth users accessing this site are inspired or empowered by its truthful message – or "shock tactics" as the harm reduction lobby prefers to describe our approach – to quit using.

Yes, there are those able to manage their intake of meth to a degree, and for whom harm reduction can play a useful role. However, while they continue to use then meth will always be nearby to entice and entrap those more vulnerable and less strong-willed, while also acting as a seductive trigger for recovering addicts. Indeed, most of the harm that is being caused in gay communities is by those who act as catalysts for others being introduced to drugs like meth who might otherwise not come into contact with the drug.

Isn't the scenario we should all be working towards, therefore, one in which the demand for crystal is stymied to such a degree that its life-force is severed, putting it out of reach to all and stopping it dead in its tracks? Meth's hold on society could be terminated instantly with a concerted effort to intervene and expose the sources of supply; the cooks, suppliers and dealers who brazenly ply their trade with virtual impunity, delivering door to door or from their gloomy, whte smoke-filled dens.

Now, that would be harm reduction in action, but do we possess the will to break the few who sustain the chain of supply in order to save the lives and souls of many? Or do we persist in our vain excuses, of which harm reduction is but one, and continue using meth while making apologies for those who deal in small quantities to fund their own habit, lest they be victimised or intimitated by efforts to instigate such a zero-tolerance approach? [See New York]

Each person introduced to meth is another potentially obliterated soul, but those who supply and deal meth do so to fulfill a demand. While that demand remains then there will always be others eager and willing to fill their shoes. Each individual who scores even the occasional gram of meth, therefore, must recognise their complicity in fueling an epidemic that is destroying the world around us, and decide for themself whether their need is greater than the harm reducing role they could play by abstaining and, in turn, helping to destroy the demand… • 

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