 in the harm reduction conference. What does harm reduction mean to you? And why do you think it's important to be here? Well, harm reduction to me is a philosophy, a strategy, and a movement. And the philosophy is you just take people where they're at in terms of their drug use, and try not to make any judgments good or bad about that. And then the strategy is all of those things, needle exchange, methadone, crack kit distribution, providing counseling, referrals, all of those things are kind of the strategies of harm reduction. And the movement, I think, is a larger social movement towards drug policy changes, drug law changes, looking at drug use as a health issue rather than a criminal one. We do HIV testing, hepatitis C testing, abscess wound care, showers. We provide people with clothing and food and referrals and syringe exchange. We have two sites that are fixed sites in the streets and the rest of the time we do backpack exchange. What harm reduction means to me is that we come up with a solution on how to keep people safe while they're using drugs. And at some point, maybe they'll change their mind and stop using drugs, which, of course, is the ultimate reduction in harm. Harm reduction also pushes back on the system, the bureaucratic system, to create greater access in terms of housing, health care for people that are using and to really talk about the stigma that active users face in this country or in the world, actually. Harm reduction to me means a way of life. You actually begin to internalize harm reduction and think about how you can reduce the harm or in different aspects of your life. We do medical case management. We do syringe access. We do substitution therapy. We do drug treatment. We do a lot of work in the court system, in particular working with individuals in the sex trade that they would like to incarcerate. We advocate to keep them out of the penal system and move them into a different direction where they can access the health care systems that they need. I'm someone who's been in the recovery process, believe highly in abstinence, and I think what people hear when they hear harm reduction is that we don't believe in abstinence. We believe that drug users should be able to just go out and use and do whatever they want. That's not what harm reduction is about. Harm reduction is about connecting with people that are actively using, helping them improve their life. Based on some of the information that they already have, giving them the materials that they need to stay safer and feel better about themselves, and most people, when given that opportunity, will start to move towards a continuum of healthier decisions and a lot of times abstinence. Why is it that the government still rejects the term harm reduction? What the government can sort of accept are services based on a harm reduction model. So they can accept needle exchange works, but they don't want to use the term harm reduction because they're nervous about what they think it means. They hear various interpretations, such as that it's a Trojan horse for drug legalization. If you look at the political debates, it's prohibition here, and then their conception of legalization, which is some sort of free-for-all legalization, and that's where the U.S. debate at least is largely trapped, but within that range are a lot of different policies. And so they associate with legalization even a harm reduction is something you'd want, you know, whether a drug is legal or illegal. That's why people talk about alcohol harm reduction, for instance, even though alcohol is legal. We dig our feet into the ground in a belief system, and even with proof to the negative consequences of that, we have a tendency to not humble ourselves enough to make a decision to start changing that. Is there any effective way to convince people about the benefits of harm reduction? Well, I think we're doing it. I think that we're starting to show the benefits of harm reduction in this country in a number of ways. Certainly the scientific stuff early on around syringe exchange with all the scientific data from the GAO that has shown us for many years, curbs of spread HIV, reduces drug use, connects people to services. I mean, that's what you want when you develop an intervention, and yet it's taken us 20 years to even have them lift the federal ban around this incredibly effective intervention. People look at drug using and drug users as being bad people, and it doesn't matter how much scientific data that they have, like all the scientific data that we have that syringe exchanges save lives and help prevent people from getting HIV wasn't enough because of the puritanical sense that this country has about people using drugs. If it's not scientific data and pure logics, what will convince the people about the benefits of harm reduction? I think some of it is cost analysis. A lot of times it's about money, and if you can prove and show that if you are able to provide harm reduction service at far less cost to the county, then you'll have some attention from people. We may not convince people about harm reduction, but if we can convince people about one small piece of it, it starts opening up their minds. So we get allies who wouldn't describe themselves as harm reductionists, but can agree with us on the need to prevent overdoses, can agree with us that syringe exchange is a good way to prevent HIV and hepatitis. So it's still a struggle for us, but over time I think we just become part of the landscape and we seem less threatening.