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Scholarly Works (3 results)

  • Thesis
  • Peer Reviewed
UC Irvine Electronic Theses and Dissertations (2022)

As nonprofit syringe services programs (SSPs) and the harm reduction social justice movement gain broader mainstream acceptance, they receive more funding opportunities from the government and private foundations. On one hand, funding can be seen as a net positive because it is necessary for programs to operate. However, scholars have pointed out how this funding can also be detrimental to SSPs and the broader harm reduction movement. In this dissertation, I discuss how funding is a double-edged sword: a necessity for programs, yet an opportunity for funders to exert control over services and social movements. I do this by examining funding streams made available to SSPs in California, and how SSP staff navigate their funding constraints. I also explore how the social movement continues to pursue radical social change, despite its involvement in what scholars have termed the nonprofit industrial complex (NPIC). My findings highlight how the harm reduction movement is able to resist the neoliberal ideology of the NPIC through intentional choices and actions. These findings provide nuance to our understanding of the dynamics between social services, social movements, and the NPIC. This research can be used by scholars, service providers, and activists alike, to understand how to build a a social justice movement while continuing to participate in the NPIC.

    Cover page: Reducing the Harm of the Nonprofit Industrial Complex: How SSPs and the Harm Reduction Movement Resist Neoliberal Ideology
    • Article
    • Peer Reviewed
    UC Irvine Previously Published Works (2020)
    In the current study we use a synthetic control group design to estimate the causal effect of a medical marijuana initiative on suicide risk. In 1996, California legalized marijuana use for medical purposes. Implementation was abrupt and uniform, presenting a "natural experiment." Utilizing a panel dataset containing annual frequencies of Total, gun, and non-gun suicides aggregated by state for the years 1970-2004, we construct a control time series for California as a weighted combination of the 41 states that did not legalize marijuana during the analysis period. Post-intervention differences for California and its constructed control time series can be interpreted as the effects of the medical marijuana law on suicide. Significance of the effects were assessed with permutation tests. Our findings suggest that California's 1996 legalization resulted in statistically significant (p<.05) reductions in suicides and gun suicides, but only a non-significant reduction in non-gun suicides (p≥.488). Since the effect for non-gun suicides was indistinguishable from chance, we infer that the overall causal effect was realized through gun suicides. The mechanism could not be determined, however. Participation in the medical marijuana program legally disqualifies participants from purchasing guns. But since most suicides involve guns, it is possible that the effect on total suicide is driven by gun suicide alone.
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    Cover page: Medical Marijuana Laws and SuicideCreative Commons 'BY' version 4.0 license
    • Article
    • Peer Reviewed
    UC Irvine Previously Published Works (2021)

    Background

    For over 30 years, syringe services programs (SSPs) have served as an efficacious intervention for the prevention of HIV and Hepatitis C transmission among persons who use drugs. Despite a strong body of evidence for the effectiveness of SSPs as a preventative public health measure, numerous local and state governments in the United States continue to resist the establishment of new SSPs and aggressively pursue the closure of those already in operation.

    Commentary

    In Orange County, California, local officials have repeatedly mobilized in opposition of the establishment of syringe access - thereby hindering access to healthcare for thousands of predominantly unhoused individuals. The county was previously served by the Orange County Needle Exchange Program from 2016 until 2018 when a civil suit brought by the Orange County Board of Supervisors resulted in the closure of the program. For more than 2 years, persons who inject drugs in Orange County lacked reliable access to clean syringes, placing them at increased risk for contracting HIV and Hepatitis C. Here, we comment on the ongoing effort to restore syringe access in Orange County. This collaborative physician-directed endeavor has brought together students and community volunteers to provide vital harm reduction services to a remarkably underserved population. Since the reestablishment of syringe access in Orange County by the Harm Reduction Institute, new legal barriers have arisen including the passage of new municipal legislation banning the operation of syringe exchanges. We are well-equipped to overcome these obstacles. This work serves as an affirmation of assertions made by previous authors regarding the unique qualifications of medical & graduate students as effective harm reductionists.

    Conclusion

    Harm reduction services are vital to the health and well-being of people who use drugs. The provision of these services should not be impeded by legislative interference by municipal, county, or state governments.
      Cover page: Shifting the paradigm: physician-authorized, student-led efforts to provide harm reduction services amidst legislative opposition
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