Surveying RGV Residents on Harm Reduction

Recently, we created a survey for individuals to whom we distribute harm reduction materials. Creating a QR code was one way to expediate gathering information because it allows the participant to access our survey online. With printed surveys, we found that potential participants were hesitant to fill out the document and then hand it back out of concern over being identified. Online surveys make it easier to maintain privacy, while also allowing us to gather the information necessary to better respond to our communities' needs.

One of the challenges of measuring the impact of our services is the fear that any information collected will be used to prosecute the people who uses drugs (PWUD). Due to the harmful rhetoric around drugs, that many of us were raised in, there is a stigma surrounding even collecting harm reduction items. This stigma extends to even opioid reversal medication like naloxone. Though it was challenging to find sponsors for harm reduction materials initially, it was far more difficult to distribute these items. After a few months of regularly engaging our community, we now have individuals that will not only come forward to gather our safer use items but also complete our harm reduction survey. This data is vital to our growth. Based on the information we obtain from these endeavors; we can decide where to invest our resources to better serve the community. It became clear that many of our participants lack not only vital safer use materials, but also access to the knowledge of how to reduce their risk with these items. It truly is necessary to meet people where they are, we have found success in designing our efforts around the community we hope to serve.

Though we face many challenges when surveying our community, we are not alone in this struggle. Harm reduction organizations throughout the U.S.A., have reported similar experiences. Non-profits and community organizations traditionally rely on the data produced to justify requests for funding. If an organization distributes a hundred harm reduction items to numerous clients, it is common to receive only one completed survey for these distribution efforts. Initially, the lack of data resulted in harm reduction organizations restricting distribution if completed questionnaires were not received. This restriction resulted in safer use materials sitting in storage, the change in the distribution rule did nothing to change the fear of handing over information regarding drug use. Seeing the effect these restrictive regulations had on distribution, many organizations decided to distribute harm reduction material to individuals even if they chose to not complete questionnaires regarding use. People still wary of harm reduction theory point to these artificially small numbers to prove that safer use items are not needed. Not taking a moment to appreciate the challenges in surveying communities of PWUD can lead to rushed conclusions that do not match the lived experiences of organizers within the harm reduction community.

In creating our survey, there was an effort to guarantee that it was inclusive to the First Nations community. In the survey, there is the marker of Two Spirit which “refers to a person who identifies as having both a masculine and a feminine spirit, and is used by some Indigenous people to describe their sexual, gender and/or spiritual identity.” (Fewster, Two Spirit Community) We also include a survey portion for all First Nation members, regardless of enrollment. Unfortunately, at this time it is not standard practice for inidiqueer identities to be included when harm reduction organizations are collecting surveys. By not including this vital category, an already underrepresented community is further erased. If you do not ask the question, you will not be able to gather data. Without the data, there will be no services for said community. With this in mind, RGVHR has made it part of our mission to encourage our partners within Texas and throughout the United States to survey forward with First Nation communities in mind.

One of our best practices for addressing the obstacles surrounding obtaining completed surveys, has been our approach of recruiting community organizers who have experience working alongside PWUD or who they themselves are part of that demographic. These team members have allowed us to see an increase in the number of surveys we can complete while distributing harm reduction materials. Moving forward, we will continue to rely on the model of respecting that PWUD are best able to understand and respond to their own communities' needs.

If you would like to participate, here is a link to the survey. All responses are private and we do not collect identifiable information.

Fewster, Peter H. “Two-Spirit Community.” Researching for LGBTQ Health, https://lgbtqhealth.ca/community/two-spirit.php.