Beyond NIMBYism: Understanding community antipathy toward needle distribution services

Abstract

In late 2007 the Homeless Youth Alliance (HYA), a small non-profit serving homeless youth in the Haight-Ashbury neighbourhood of San Francisco, USA, attempted to move its needle exchange service from a site on the Haight street commercial strip to a community centre approximately 150 m away. The reaction of the housed community in the area was vocal and organized, and attracted considerable regional media attention. Ultimately, the plan to move the service had to be cancelled. The authors were, respectively, board chair and executive director of HYA at the time, and collected extensive field notes and media records as events unfolded. In this paper, we re-examine these events through literatures on contested spaces and on ‘Not In My Backyard’ (NIMBY) resistance to social services. We found that opposition to the service relocation had little to do with opposition to needle exchange itself, but rather was symptomatic of broader contestation over the identity and character of the neighbourhood. On the one hand, the neighbourhood had experienced skyrocketing housing prices over the past 40 years, making home ownership almost exclusively the province of the wealthy. On the other, the neighbourhood retains historic connections to the 1968 ‘Summer of Love’, and the main commercial strip forms the centre of an active injecting drug use scene. As a consequence, many home owners who felt they had made considerable sacrifices to afford to live in the area expressed a sense of being “under siege” from drug users, and also believed that the City government pursues a deliberate policy of “keeping the Haight weird” by supporting ongoing service provision to drug users in the area. Housed residents responded to this situation in a variety of ways. One response was to engage in what we term ‘defensive place making’, in which a small part of a broader neighbourhood is reimagined as “a different neighbourhood”. HYA’s attempt to move from its current location to this ‘different neighbourhood’ was thus perceived as an “invasion” which threatened to break down a tentatively established separate identity. We conclude with a discussion of the relevance of these events for understanding and mitigating community opposition to services for drug users elsewhere.

Integrating place into research on drug use, drug users’ health, and drug policy

“…Research by Davidson and Howe (2014) deepens our understanding of how characteristics of “place” affect whether particular areas adopt harm reduction services or other unpopular services. This study highlights how different experiences and meanings ascribed to a “place” shape local debates about the location of harm reduction services.…”

Community attitudes towards harm reduction services and a newly established needle and syringe automatic dispensing machine in an inner-city area of Sydney, Australia

“…The community response to this announcement was reported in the local print and state-wide radio and television media (Channel 10 News, 2013;Day et al, 2014;Fordham, 2013aFordham, , 2013bFordham, , 2013cFordham, , 2013dWhite et al, 2014). Media attention was largely focused on perceptions of a "honey-pot" effect, a perceived increased in crime, reduced public amenity and a poor understanding of the aims of harm reduction imbued with a sense of NIMBYism ('not in my back yard'), remarkably similar to that described by Davidson and Howe (2014). Although there were multiple objections from both residents and business groups, it appeared at least some of the negative community sentiment arose from one particularly well-organised group.…”

“…Despite being a key harm reduction initiative, NSPs remain controversial and vulnerable to localised community opposition, which in some instances has resulted in service closures (Körner & Treloar, 2003;Southgate et al, 2000). Concern regarding NSP services include public amenity and discarded syringes, perceived drug-related and other crime, attracting drug users from outside the area into the neighbourhood and concern that children might access needles from the machine (Davidson & Howe, 2014;Körner & Treloar, 2003). While there is no published evidence to support these concerns, such misconceptions can undermine public confidence in this important public health intervention.…”

Not in My Back Yard: A Comparative Analysis of Crime Around Publicly Funded Drug Treatment Centers, Liquor Stores, Convenience Stores, and Corner Stores in One Mid-Atlantic City

“…NIMBY syndrome has been repeatedly observed in the placement of drug treatment centers (DTCs)-such as methadone clinics-as many believe that people in recovery are objectionable (Boyd et al, 2012;Polcin et al, 2012). Residents are particularly concerned about violence increasing in their neighborhoods subsequent to the establishment of behavioral health or housing initiatives for people with substance use disorders in their neighborhoods (Boyd et al, 2012;Davidson & Howe, 2014;Polcin et al, 2012;Takahashi, 1997).…”

“…Although many residents may support these initiatives in theory, they are against having them located in their neighborhood (Davidson & Howe, 2014;Krause et al, 2014;Piat, 2000;Polcin et al, 2012;Takahashi, 1997). Polcin and colleagues (2012) examined community concerns about "sober living houses" (i.e., alcohol-and other drug-free living environments aimed to help residents maintain sobriety) and found that concerns centered on issues such as noise, traffi c, violent crime, and unpleasant resident behavior.…”