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Modeling Harm Reduction


In yesterday’s NY Times Giving section (yes, a whole section devoted to charitable giving and public service organizations), the paper published an article about a San Francisco organization that should serve as a model of a harm reduction approach to pregnancy, homelessness and drug addiction. A nice alternative to the pervasive “lock up the ‘bad’ mothers” perspective.

The Homeless Prenatal Program provides a wide range of services, including yoga and parenting classes, to Bay Area pregnant women who are homeless, pregnant, and – quite often – addicted to drugs, in need of proper nutrition, and lacking prenatal care. The program, which was started 19 years ago by Martha Ryan, sees over 3,000 people (90% of them women) each year, and employs a staff of 53, half of whom have been homeless. It’s a model of a non-punitive approach to substance abuse that should be exported to other communities and that should (but won’t be) embraced by our government.

Sadly, but not surprisingly, the women who turn to the Homeless Prenatal Program have more in common than homelessness or drug dependence: abuse and poverty.

Ms. Ryan said the real common denominator was poverty and abuse as a child. More shocking than the sheer numbers, she added, was that the cycle keeps going. Children of women she treated 18 years ago are now clients, pregnant or with children and living in poverty like their mothers….

The center reports that among homeless women under age 50, 8 percent reported being pregnant at the time that they were homeless. Ninety-two percent of homeless women say they had been physically or sexually abused severely either in childhood or adulthood.

Supporting women who battle drug addictions instead of throwing them in jail seems to me a good – and vital – first step in stopping this cycle of abuse, poverty, homelessness, and drug addiction. But this is only one organization — and they can’t even get state or federal funding (Ms. Ryan, the program’s founder, seems surprised by this, but I’m not). Harm reduction programs, especially ones that also provide services, aren’t popular in this country. Some say they “condone” or even “encourage” drug use. Maybe that’s true. But maybe that’s not so bad, especially when the option is to turn our backs on people or to jail them (which might be one and the same).

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