People of Color and Syringe Exchange Programs

1. People of Color and Syringe Exchange Programs An Overlooked Resource

2. Slavery; Tuskegee experiment; Jim Crow; War On Drugs; disproportionate unemployment; imprisonment of minority offenders; Hurricane Katrina Historical Mistrust of Government

3. "Nothing has contributed more to the systematic mass incarceration of people of color in the United States than the War on Drugs." - Michelle Alexander, The New Jim Crow (2010)

4. War on Drugs

5. The Drug War Drives Mass Incarceration and Racial Disparities in U.S. Judicial Systems There were more than 1.5 million drug arrests in the U.S. in 2016. The vast majority – more than 80% – were for possession only.

6. The Drug War Drives Mass Incarceration and Racial Disparities in U.S. Judicial Systems People of color experience discrimination at every stage of the judicial system and are more likely to be stopped, searched, arrested, convicted, harshly sentenced and saddled with a lifelong criminal record. This is particularly the case for drug law violations.

7. The Drug War Drives Mass Incarceration and Racial Disparities in U.S. Judicial Systems Research shows that prosecutors are twice as likely to pursue a mandatory minimum sentence for black people as for white people charged with the same offense. Among people who received a mandatory minimum sentence in 2011, 38% were Latino and 31% were black.

8. Mass Incarceration Destroys Families 2.7 million children are growing up in U.S. households in which one or more parent is incarcerated. Two-thirds of these parents are incarcerated for nonviolent offenses.

9. Mass Incarceration Destroys Families One in nine black children has an incarcerated parent, compared to one in 28 for Latino children and one in 57 forwhite children.

10. Mass Incarceration Destroys Families Punishment for a drug law violation is not only meted out by the criminal justice system, but is also perpetuated by policies denying child custody, voting rights, employment, business loans, licensing, student aid, public housing and other public assistance to people with criminal convictions.

11. Mass Incarceration Destroys Families • Such exclusions permanently relegate millions of Americans to second-class status, disproportionately among people of color. • One in 13 black people of voting age are denied the right to vote because of laws that disenfranchise people with felony convictions. • www.drugpolicy.org

13. Can I TRUST THE SAME PEOPLE WHO HURT ME TO HELP ME?

14. Continued Mistrust Local Government Medical Mistrust Surgical Experiments on Enslaved People  Tuskegee Syphilis Study African American women are more likely to die in child birth • African Americans are the least likely to trust their “local” governments, compared with all other racial and economic groups, political scientist Shayla Nunnally shows in her recent book Trust in Black America: • Reasons for this could be because of aggressive police surveillance of black communities. • Programs like stop and frisk” policy in New York (more than 684,000 were recorded in 2011 alone) • Also by the history of local and state governments’ denial of and resistance to blacks’ civil and human rights. 

15. Building trust in these communities

16. Understanding the resistance • Facebook response to harm reduction programs • “Where was all this compassion when it was the crack era and you was locking up the black and brown people. No one was the angel of compassion for our community” • SEP Clients response to why other black people do not come to the SEP • “They are afraid, I have shown them my card and everything but they don’t believe that they won’t get arrested”

17. Breaking down barriers • Meeting POC where they are - • Locations • Non Judgmental staff • Gate Keepers

18. Locations • Louisville SEP has 7 locations: • Main Health Department • Lake Dreamland Fire Station • Dixie Government center (No Data Yet New site) • Middletown Government Center • Portland Health Clinic • Redeemer Lutheran Church • Bicknell (Abandoned Parking area) • Most of these locations are Government Ran Locations.

19. Breakdown by Race Lake Dreamland FS Middletown Gov Center Main HD Asian, NH 8 Black, NH 261 Hispanic 133 Islander, NH 9 Multiracial, NH 338 Native American, NH 40 Other, NH 83 Unknown 101 White 4,632 Total Non White 872 Asian, NH 4 Black, NH 19 Hispanic 18 Islander, NH 0 Multiracial, NH 24 Native American, NH 5 Other, NH 8 Unknown 17 White 625 Total Non White 78 Asian, NH 0 Black, NH 1 Hispanic 0 Islander, NH 0 Multiracial, NH 1 Native American, NH 0 Other, NH 0 Unknown 0 White 29 Total Non White 2

20. Breakdown by race Redeemer Church Bicknell Portland Asian, NH 0 Black, NH 22 Hispanic 13 Islander, NH 1 Multiracial, NH 21 Native American, NH 3 Other, NH 6 Unknown 61 White 603 Total Non White 63 Asian, NH 0 Black, NH 12 Hispanic 5 Islander, NH 0 Multiracial, NH 16 Native American, NH 4 Other, NH 7 Unknown 1 White 227 Total Non White 44 Asian, NH 4 Black, NH 43 Hispanic 13 Islander, NH 1 Multiracial, NH 32 Native American, NH 4 Other, NH 9 Unknown 20 White 905 Total Non White 106

21. Louisville Demographics • White: 74.8% (non-Hispanic: 71.7%) • Black: 22.2% • American Indian: 0.6% • Asian: 2.0% • Hawaiian or Pacific Islander: 0.1% • Other race: 1.4% • Two or more races: 1.6% • Hispanic or Latino of any race: 2.9%

22. PWID By Race

23. Overdose Death Rates

24. Breaking Down barriers Variety of Services Locations Staff Changes Diversity of staff when possible Not only race but by social status as well Peers/vested staff/ volunteers That can do outreach That can relate What other items are people using to use drugs that can also spread disease? Ask them what else is needed. Crack kits - People who smoke crack cocaine are at risk of acquiring HIV, hepatitis C and hepatitis B from the physical injuries caused by smoking crack, and also through condom less sex associated with the drug use. Education for Safer snorting- Microscopic amounts of blood can pass from one irritated, or raw, nose to another when equipment is shared, spreading hepatitis C. Developing more community partners that: Are willing to give space in more discrete locations Can advocate Not only offer SEP but other services that can increase trust Advanced student nurses that can do wound care Safer injection education Narcan Treatment info (if requested)

25. We don’t have all the answers!