A day in the life of a harm reduction volunteer
When people think of syringe services programs, they might have a specific image in mind, cultivated by years of negative news coverage and media misrepresentation: a dingy building or van, a line down the block, and needle waste. Me? I think of the neatly organized storefront where I volunteer each week.
I show up for my volunteer shifts on Saturday mornings and I’m immediately greeted by the staff. Some of them have been working in harm reduction for years, like Lynell, who started as a volunteer. (Lynell has the distinction of being one of the few people convicted for “syringe distribution” in California in 2001—over the protests of the county’s then-public health officer, who rightly feared that it would lead to an increase in HIV rates at a time when the disease remained prevalent.) The walls are decorated with photos and banners accumulated over years of work. Another major design feature? Boxes. The walls are stacked with crates of water, bags of pet food, and cardboard boxes of naloxone, fentanyl test strips, hygiene supplies like deodorant, and other supplies waiting for distribution.
My responsibilities over my three-hour volunteer shift can vary, but most often, I’m working on bagging supplies. Injectable naloxone, which is often preferred by people who use opioids because it allows people to customize the dose used and avoid precipitating withdrawal when they reverse an overdose, is bagged with an instruction manual and syringes. Safer smoking supplies, whose use can reduce overdose rates and disease risk, are packed with information about accessing low-barrier treatment and recovery resources.
In fact, the organization itself provides on-site, low-barrier initiation of buprenorphine to treat opioid use disorder. Staff work to ensure that people interested in buprenorphine are connected to care as soon as possible—preserving their momentum toward change. After an initial in-person appointment, doctors are able to schedule telemedicine follow-ups, increasing accessibility for people who may not be able to travel for a weekday appointment.
Importantly, the staff is predominantly made up of people who have lived experience of substance use, homelessness, and incarceration. Staff treat program participants with dignity and respect, earning long-term trust—a valuable currency given that many participants have had negative experiences with the medical field that keep them from seeking care when they need it. Here, they can be tested for HIV, hepatitis C virus (HCV), and syphilis, and immediately be connected to treatment by on-staff doctors. Participants with injection-related or other injuries can attend a weekly wound care clinic and receive supplies to heal, regardless of their circumstances. And staff are always ready with referrals and resources for people who seek higher-level care or housing.
This organization is one of dozens across California that serve people who use drugs and protect public health, often with little funding and even less positive recognition. These interventions are critical to ensuring that all Californians, regardless of their substance use, receive high-quality services that meet them where they are. As a volunteer, I’m proud to be able to contribute to harm reduction efforts that promote #HealthNotHarm.