Harm(ful) Reduction: Public Health and Perceptions of Disorder in Orange County, California
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Harm(ful) Reduction: Public Health and Perceptions of Disorder in Orange County, California

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Abstract

Needle exchange programs allow individuals who inject drugs to have access to clean syringes and other harm reduction supplies in an effort to prevent blood borne diseases. Although these programs are supported by public health research and national public health agencies as a way to alleviate the health consequences associated with drug use, several local elected officials throughout the country have actively opposed such operations at the local level. By preventing needle exchange programs from operating, local elected officials may exacerbate rates of HIV/AIDS and overdose deaths at the peak of the opioid epidemic in the United States. For my dissertation, I examine Orange County (OC) as a case of this national phenomenon in which local elected officials work against the operations of the Orange County Needle Exchange Program (OCNEP). I conducted a narrative analysis on public meetings, press release statements, and interviews to examine the rhetoric and political action used by local officials in Orange County, California in response to drug using behavior and OCNEP’s operations. I seek to understand how OC officials use local power to contest state law in an effort to regulate stigmatized behavior. More specifically, I examine the kind of arguments and strategies that are used by local officials to oppose OCNEP and determine how their arguments justify their policy decisions. I conducted my research in three phases. For Phase I, I examined rhetoric used by local officials in OC to oppose OCNEP in city council and county supervisor meetings. For Phase II, I conducted a political narrative analysis on press release and other media statements to analyze how local officials characterized their strategy of litigation against OCNEP and the California Department of Public Health (CDPH). In Phase III, I conducted semi-structured interviews with OCNEP Board members to understand their perspective of the community opposition in OC. My interview data from OCNEP Board members provides insight on the negative consequences OCNEP clients faced from the organization’s forced closure. With my research, I provide insights into local governance and social control by bridging theories on moral panics, political narratives, broken windows, and social movements. More specifically, I examine whether hostility toward OCNEP and opioid drug users in OC can shed light on how local politics attempt to regulate stigmatized behavior and manage perceived social problems.

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This item is under embargo until March 3, 2025.