Contemporary Harm Reduction Practices in Minneapolis

Working with Southside Harm Reduction

by Louise Bequeaith

Background

Harm Reduction (HR), at its core, is a radical concept that aims to give the autonomy of health back into the hands of the community. It is a philosophy of community care that works to mitigate the harm of drug use without criminalizing the act of drug use. Harm reduction (HR) has always been fueled by demanding autonomy and self-determination, it is work that began by people who used drugs, for themselves and for others who use drugs, outside of state control or institutional supervision.¹ The foundation of the organized HR movement began at a time when the US War on Drugs, and thus the criminalization and stigmatization of people who use drugs was escalating.² It is important to note that the War on Drugs primarily functioned to target Black and other racially marginalized communities, making HR work positioned to fight medical discrimination, specifically medical racism.³ The movement of HR challenged these racist assertions of medical authority by locating stigmatized persons and communities as the key actors in their own health, allowing them to fight back against medicine influenced by social authority and to do what was best for their own health. HR work situates people who use drugs as valuable community members who can intervene in health crises; a process that is typically only allowed to credentialed authority figures.

Image from The Idaho Harm Reduction Project (https://www.idahoharmreductionproject.org/)

Harm Reduction in Minneapolis and Southside Harm Reduction Services

As of October of 2022, Hennepin County, Minnesota, a county that includes South Minneapolis, is experiencing an HIV outbreak.⁴ In 2021, there were a reported 340 deaths caused by drug related overdoses in Hennepin County.⁵ Preliminary data for January-early August 2022 shows that at least 108 people have died from drug overdoses in Hennepin County, and in the first seven days of October 2022, there have been 55 drug overdose deaths in Minneapolis.⁶ This data, which is most likely underestimated due to lack of city attention to the houseless population, is an important context for why harm reduction (HR) work is so necessary in South Minneapolis. Beyond this, according to research done by the Drug Policy Alliance, “Despite using drugs at roughly the same rate, Black people are 5x more likely to be arrested for drugs than white people. Arrests of Black individuals account for 24% of total US arrests despite Black people being 13% of the US population.”⁷ I bring this up to center the fact that drug criminalization and stigma continues to affect Black communities at disproportionate rates, that marginalized communities face the harshest effects of the state's reaction to drug use. The health system and their treatment of drug addiction need to be understood as part of the criminalization process. It is not just the criminal justice system’s racist history that continues the disproportionate effects of drug criminalization, the health industry is also part of this process.

In the fall of 2022, I worked as an intern for South Side Harm Reduction Services (SHRS), a nonprofit operating in South Minneapolis. SHRS began in 2017 providing education and resources directly to people who use drugs. In 2017, SHRS was a small, mutual aid based collective, run out of the trunks of a few people’s cars. It was during the summer of 2020, during the uprising that followed the murder of George Floyd, that the intense need for harm reduction was recognized and that mutual aid groups in Minneapolis, and all over the country, started to operate and organize in a more resourced way. More funding and attention have been pouring into mutual aid; a pattern that has allowed SHRS to expand its operation with a focus on sustaining the work they do to provide resources for people who use drugs within Minneapolis. SHRS operates with two main objectives: limit the spread of infectious diseases in the community and reduce deaths caused by drug overdose. SHRS goals are generally aligned with the goals of professional public health organizations. However, SHRS addresses these problems in a way that operates outside of medical authority and aims to confront the root of the problem. To do so, SHRS provides a range of services: deliveries, outreach, training, HIV testing and street clean-up (see table 1).

For my internship, I mostly worked doing deliveries. Twice a week, I would spend four hours meeting with people who use drugs to deliver syringes and other products used for safe drug use. I would drive directly to these people, meet with them one-on-one, discuss what products they needed, and direct them to other health resources if necessary. Beyond deliveries, I worked to keep the offices of Southside Harm Reduction Services (SHRS) stocked, prepping supplies to be delivered. I also helped in the creation of educational material, focused specifically on a zine being made that discussed how to safely use drugs alone.

Image from Southside Harm Reduction Services (https://southsideharmreduction.org/)

Lessons Learned

The most critical lesson I learned from my time with Southside Harm Reduction Services (SHRS) was the benefit of working in a health environment that is non-hierarchical. One of the main points of harm reduction work is to center the people who use drugs as the ones with control over their own health. Thus, working at SHRS it became clear that our role was support, not to dictate or tell others what to do. I think that this contradicts the traditional medical system, where health care providers hold all the information and power. This approach to autonomous health work also leads us to recognize and prioritize the ways in which social factors impact health. Although SHRS aims to curtail harm from drug use, from talking to the participants, it became clear that most of their health problems stemmed from poverty. Thus, our work was centered around poverty and houselessness. I believe this lens, where health is understood as a result of social factors, pushes health care providers to work in a more holistic way, which is a necessary lens within the field of public health.

Louise Bequeaith

My name is Louise Bequeaith (she/they) and I am originally from Des Moines, Iowa. I have an American Studies major and Biology minor in edition to the Community and Global Health Concentration. After graduation, I plan to pursue a career in community health work. I am interested in learning more and working more within the field of autonomous health care work. I believe health is a critical part of liberation and healthcare is a critical part of liberation work.

References

Braine, Naomi, Autonomous Health Movements: Criminalization, De-Medicalization, and Community-Based Direct Action, 89.
Braine, Naomi, Autonomous Health Movements: Criminalization, De-Medicalization, and Community-Based Direct Action, 88.
Woods, Bringing Harm Reduction to the Black Community: There’s a Fire in My House and You're Telling Me to Rearrange My Furniture, 305.
MN Department of Health, HIV Outbreak Response and Case Counts.
Hennepin Public Health Data, Opioid Epidemic.
Minneapolis Health Department, City Sees Spike in Drug Overdoses.
Drug Policy Alliance, Drug War Statistics.
Cover Photo from Southside Harm Reduction Services (https://southsideharmreduction.org/)

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