“We Want a Living Solution”: Views of Harm Reduction Programs in Black U.S. Communities

Abstract

Illicit drug use in the US remains concerning, with injection drug use linked to transmission of blood-borne diseases as HIV/AIDS; persons of color, including Black Americans, experience disproportionately higher transmission rates. Harm reduction programs such as methadone and needle- and syringe-exchange (NEP/SEP) are empirically demonstrated to reduce HIV transmission, yet are believed largely opposed by Black communities. Using interview data from 21 service providers of substance abuse and related service organizations located in and/or serving predominantly populations of color, this study explored perceptions of harm reduction programming for illicit drugs and race in the US. Criticizing each program for unique reasons, respondents deemed them largely inadequate and inappropriate responses to community drug problems. While some believed these programs worsen Black communities, others believed they are becoming more accepted there. Views were informed by racial dynamics surrounding drugs in society, burdens borne by program host communities, and racialized stereotypes of drug use.

KEYWORDS:

• African/Black Americans
• Black community
• methadone
• harm reduction
• needle/syringe exchange
• illicit drugs

Notes

¹Throughout, “Blacks” and “Black community” are used to denote a unique collective of persons in the U.S. who racially identify as “Black,” “African American,” or “of color” yet are distinguished from other persons of color as Latinos/as.