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Some Needle-Exchange Counselors Fall Victim to Heroin Use
January 14, 2009

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News Summary

Needle-exchange programs have been credited with saving many lives by preventing the spread of HIV/AIDS among injection-drug users, but some counselors at the harm-reduction programs have been fatally tempted by easy availability of heroin, the Wall Street Journal reported Jan. 9.

At least five workers at harm-reduction programs in New York and San Francisco have died of overdoses, including the founders of two needle-exchange programs. The victims included Pete Morse, 36, a 10-year veteran counselor who died in 2007 of an overdose of heroin, alcohol and cocaine, and John Watters, a researcher and advocate who fatally overdosed in 1995.

Jon Zibbell, a Skidmore College assistant professor and founder of a drug-users coalition in Massachusetts, called staff overdoses a "huge problem."

"We prevent [overdoses] among our clients," he said. "So we should try to prevent them among our workers." Program staff typically get paid little money to work in harsh environments. Training can be minimal, and some programs hire active or former drug users. Other workers may learn about drug use on the job.

Morse's family said he learned to shoot heroin only after working in harm reduction, but said he was depressed and that his workplace was not to blame for the fatal overdose. Needle-exchange supporters note that only a small percentage of workers overdose, and that overdoses also occur in abstinence-oriented programs.

Still, Kirk Read, a coworker of Morse's, said his friend's death "punctured the illusion that knowledge can protect you."

Some see the overdoses as an argument against harm reduction, while others say the cases show why more money should be put into training and supporting addiction workers.

COMMENTS ON THIS ARTICLE:
(Comments now appear first to last)

Posted by garypoyssick on 15 Jan 09 08:31 AM EST
I personally don't think that 'harm reduction' programs reduce anything. Junkies need to wake up to get sober; they don't wake up having access to clean needles. They wake up whether they have clean needles or dirty needles. Or not. Help them wake up, don't help they stay asleep. That's what these seemingly well-meaning programs do. This comes from somebody that's only been awake for five years. gary

Posted by Allan Clear on 15 Jan 09 08:39 AM EST
This is an annoyingly frustrating article that was written by someone who knew Pete Morse at one point and has seen an opportunity to further his career in journalism. It could have raised and focused on the dangers of drug overdose and how we can respond to the problem. Most of the 200 or so needle exchange programs in the US use volunteers and have done so for 20 years. Not surprisingly the field of harm reduction, like that of drug treatment, is driven by people with histories of drug use. Considering the 1000s of people that have worked in syringe exchange, accidental drug overdose is low. I suspect the field of journalism has a more difficult time with alcoholic writers. This was a sadly wasted opportunity.

Posted by sumdood on 15 Jan 09 08:42 AM EST
Needle exchange programs save lives by protecting the sex partners of addicts from HIV. Exchange programs also limit the spread of other diseases such as Hepatitis B and C. I have seen health care volunteers succumb to drug addiction as a result of exposure to addicts. It is the exposure to addicts that is the main risk and is not limited to needle exchange counselors

Posted by george on 15 Jan 09 09:10 AM EST
It is a sad event when a helper becomes a victem. This seems to happen with mental health workers becomming depressed related to the nature of their work, prison staff crossing the line, or health care workers becomming ill. For helpers it is important to identify risks. Harm reduction still reduces harm even if it is less than perfict or close to the solution.

Posted by deb.b on 15 Jan 09 10:10 AM EST
The argument that exposure to addicts and needles causes someone to use, ranks right up there with trying to keep gay teachers out of our schools lest they, "turn" our children gay. Anyone who works with people that have long-standing heroin/ methadone addiction will tell you that they witness profound misery and hopelessness in their clients every day. Addiction at this level is not pretty. Consider addressing instead the pervasive and exploitive practice of hiring newly recovering individuals, throwing them into clinics and tx. centers(many times at low pay under the table--or for room and board--working ungodly hours. These are frequently people with NO other options. In the name of, "helping" we hire,and then expose recovering people daily to their triggers, exhausted with no time to attend support groups, watch them relapse, and then re-enter them into our tx. program....and around and around again. This is a CHRONIC problem that does a great disservice(and often kills) individuals with the true desire to get and stay clean. Long term recovering people like myself(and others that have a working moral compass) working within the system need to step forward and ADVOCATE.

Posted by ElizabethO on 15 Jan 09 12:15 PM EST
Having worked in both abstinence based drug treatment and harm reduction centers, I can say that I saw an about equivalent rate of "return to use" among people. Could it be that relapse and its harsher consequences does not discriminate according to workplace? And to those who doubt, there is evidence that harm reduction does reduce disease among active drug users, who also happen to be citizens and thus have a right to the full range of services that are made accessible to them (at least in free societies; fascism is a different story). Its pretty simple. Treating all persons with dignity and respect for their life, regardless of our personal feelings about their choices, is not only ethical but the sinequanon of service delivery. And good service delivery does not usurp free will, so there will always be those who do what they will anyway. Its no one's "fault". It is life.

Posted by Finding Normal on 16 Jan 09 12:57 AM EST
Needle exchange programs provide the opportunity (or should) for the workers to pass along a little education during the brief encounter. People had the same reaction to handing out condemns stating it sent the wrong message and encouraged sex. When in fact those who obtain condemns are going to have sex whether they get the free condemns or not but with anonymous, safe programs available they are much more likely to use protection. Just as handing out condoms meant a chance to send brochures about STD'S and unwanted pregnancy needle exchanges mean a chance to give educational material on related disease like HIV, in addition to local rehab facilities, NA meetings, etc. I never met a Heroin addict who was sick in withdrawal who would let lack of a clean needle stop them from pulling them out of the physical hell they were in at the time. They are gonna use clean needle or not. Why not let them go ahead and catch HIV or Hep-C because they deserve it? Doesn't this come from the same people who complain about their tax dollars going for welfare programs? Guess who pays the enormous health care costs for them after they contract HIV or HCV? You guessed it.

Posted by Anonymous on 20 Jan 09 02:17 AM EST
As someone who knew Pete all too well, many of the 'facts' of his life and choices to use are missing or misrepresented here. There is no cut and dry connection to working at needle exchange and using, and there wasn't for Pete. I don't believe he would have appreciated the bias in this article and the use of his life/death for such an effort.

Posted by frjimt on 20 Jan 09 10:03 AM EST
"more money should be put into training and supporting addiction workers"..........Amen to that! We're burning from btw. $15-25,000 @ student for a public education that is, for the most part, failing. Much more needs to be spent on recovery!

Posted by Jonathan on 02 Feb 09 04:28 PM EST
I could not disagree more vehemently with the above post, by Garypoyssick. It's a travesty, with the depth of knowledge we now have regarding IV drug use, that we still have individuals of the mind that treatment is the only issue. Haven't you heard about co-occurring diseases? If we continue to foster partisan believes and drive wedges between the disparate, but collective groups, then we'll never actually address the entire problem. We will simply have roosters shouting in their respective hen houses, which doesn't help much when we're trying to establish and sense of harmony.

Posted by frontline on 02 Feb 09 07:31 PM EST
I want to say that i think this whole thing is very sad, the field is sad and getting sadder. and more useless, Once upon a time, one could get help, and be helped now ou have to have x amount of time clean you cannot have a menatl illness to hold a mental health license, I mean really what are we coming to the whole world is mentally ill in some respect. most of them run our country. Some our institutions some do it well, some dont, we are all people, just trying to get by, trying to fight the same battle. I say, make sure that there is equality for everyone, help for everyone without discrimination and ridicule, and labeling, and judegement, and then perhaps, just perhpas, peole may find the hero within and get better, instead of opt for suicide or drugs and alcohol. Read Barry Duncans And Scott Millers Work.

Posted by jonnyz on 03 Feb 09 02:22 PM EST
I was contacted by the author and asked to provide an insider's viewpoint on illegal drug use among workers in needle exchange programs. On three occasions I provided a nuanced reflection on the practice of drug use by needle exchange workers, stressing the fact that the percentage of active drug users employed in needle exchange programs paralleled the percentage of people who used drugs in both abstinence-based treatment programs and across the health care industry at large. The author then contacted me some time thereafter to confirm what I had said. I immediately told him that I did not make that claim he attributed to me nor did I believe it was accurate. I proceeded to restate that drug abuse among harm reduction workers seems to occur at the same rate as drug abuse outside of the harm reduction industry. but that drug abuse appears to be more pronounced among needle exchange workers because due to the morally contentious nature of needle exchange programs and the dominance of the abstinence-based model in the US. Needless to say, I was extremely disappointed to learn that the author proceeded to use the exact quote that I told him was inaccurate.

Posted by garypoyssick on 23 Apr 09 10:03 AM EDT
"I could not disagree more vehemently with the above post, by Garypoyssick. It's a travesty, with the depth of knowledge we now have regarding IV drug use, that we still have individuals of the mind that treatment is the only issue. Haven't you heard about co-occurring diseases? If we continue to foster partisan believes and drive wedges between the disparate, but collective groups, then we'll never actually address the entire problem. We will simply have roosters shouting in their respective hen houses, which doesn't help much when we're trying to establish and sense of harmony." SHUT THE HELL UP.

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