In December, GLIDE welcomed its new director of Harm Reduction Services, Juliana DePietro. A native of Davis, California, Juliana comes to GLIDE with years of frontline experience working in harm reduction services and outreach in Portland and elsewhere, and fresh from completing a master’s degree in public health at Harvard University. Last spring and summer, at the outset of the pandemic and while completing her master’s degree online, Juliana returned to the West Coast to operate an emergency social distancing shelter in Portland. She joined this effort, “to be of service to my community” while “approaching that space from as much of a harm reduction lens as I possibly could.” She recalls being driven in that work by an “understanding of all of the overlapping spaces of harm that folks can encounter in emergency shelter systems—as well as in interactions with uprisings against systemic racism and police brutality which occurred over the summer across the country including in Portland.” Juliana recently took a few minutes to let us know how she was settling into her new role.
Juliana, welcome to GLIDE and the Tenderloin! Can you tell us a little bit about what brings you to GLIDE?
Thank you! I come from many years of direct service alongside people experiencing homelessness as well as working directly with people who use and inject and smoke drugs. I began my career also working directly with people with mental health concerns. Working with folks at all of those intersections unfortunately also involves a lot of interaction with law enforcement, with systemic racism, and with other systems of oppression that have significant impacts and traumas on these populations, particularly for folks of color and LGBTQ+ folks. I have done most of my harm reduction work in Portland, Oregon. I worked for a dual diagnosis harm reduction program there and also helped launch the Multnomah County LEAD [Law Enforcement Assisted Diversion] pilot program. I know GLIDE held its own LEAD team for a while. I worked in a few other spots in Portland and then transitioned into graduate school.
I saw the opportunity at GLIDE when I was job hunting this fall, I’d heard about GLIDE from family and friends in the Bay Area as a space of moral grounding in San Francisco, an organization that acts upon deeply rooted values and has a legacy of activism. That, and the chance to be involved in strategic thinking for harm reduction services, really drew me to apply and to join what I’m really getting to know as a citywide and coalition-based set of harm reduction programs. I’m so honored and grateful to be a part of this work.
Can you tell us a little about the graduate school, what drew you there and what you bring back?
I attended the Harvard T.H. Chan School of Public Health—I actually just finished this past week, so I’m feeling very relieved about that!
Making the leap to graduate school was a really difficult decision because my heart is in direct service, in outreach, and in the nontraditional public health programming that GLIDE Harm Reduction Services provides. I found that while I had strengths in the compassionate, person-centric care that undergirds harm reduction services, the strengths that I wanted to tap into were more systems-level and more programmatic and operational. While there was a lot of cognitive dissonances while I was attending graduate school, I had the opportunity to solidify my values and push back on problematic things that I saw in academia and at Harvard in particular, while also trying to bring some of my experience as a provider to folks who were often pushed out of public health systems. Bringing those stories and experiences to that space and interacting with a lot of traditional public health providers, I tried to stretch perspectives on what public health looks like now and needs to look like going forward.
I bring back the results of those conversations, thinking about public health as it is right now and as it could be—a wider, more inclusive social safety net that is well-resourced and well-connected in sustainable ways. I’ve seen the foundations of this public health future in the work that harm reduction teams like the one at GLIDE and other essential nontraditional social service providers have stepped up and just provided that social safety net during this pandemic, regardless of the infrastructure in place. I’m recognizing that we often provide the core and the basics for folks who need it most. How do we build out those systems and make them more sustainable?
How do you see the pandemic impacting both the people GLIDE serves and the work that you’ve been focused on in your career?
On a systems level, and on a public awareness level, it’s really bringing to light how our country lacks a safety net. How people can “fall through the cracks”. In my opinion there shouldn’t be any cracks to begin with, but this pandemic is really exposing the cracks that exist. In my work in emergency sheltering
s over the summer, I met countless people who had never been homeless before, who were not used to living in shelter life, who lost their jobs and lost their housing very rapidly because of the pandemic.
Behavioral health is also gaining a lot of attention because more and more folks are finding they need help with the stresses of the pandemic. Not always, but often, people use drugs to cope with trauma and stressors, and we’re going through a collective trauma right now. Hopefully, a wider spectrum of people are gaining empathy for their neighbors and community members use drugs and who have serious and persistent mental health issues.
In terms of the people GLIDE serves, so much of our traditional health infrastructure is closed or the barriers to accessing it are higher. That has real and immediate impacts on the people we serve. It makes me extremely grateful for our frontline healthcare workers and our frontline harm reduction specialists, experts who are every single day showing up and providing services as safely as they can. It doesn’t surprise me, but it terrifies me the extent of the impact on the populations that we work with, how much has shut down and how many opportunities have closed because of the lack of preparedness and the lack of response to this pandemic.
I know also that people who use drugs and people who live outside and people who engage in sex work, and all other folks that we serve in harm reduction, are incredibly resilient and survivors and will continue to figure out ways to get their needs met even if our systems take some time to catch up. I’m just grateful to be a part of the bridge to getting those needs met for folks and to bolster the systems that are in place to have that happen.
What will your role entail, now that you’re at GLIDE?
I have big dreams for harm reduction in general. I’m really excited to learn about and from the work that is already being done in San Francisco. There are a bunch of really talented, creative, hard-working folks who make up the harm reduction community. So, though I have my own big dreams, my goal for GLIDE’s harm reduction program is to integrate within the sector of harm reduction services with our partners and figure out the best ways to collaborate with one another and continue to build the strongest coalition we can to spread harm reduction as far and wide as we’re able. There’s a lot of learning from and building relationship with our community partners.
I also really recognize how hard my team has been working and how much trauma we’ve experienced in terms of being on the frontlines of this pandemic as harm reduction providers. One of my priorities is making sure that our team has everything that we need to continue the work in a safe, healthy, sustainable, and joyous manner. Because I know how much my team cares about GLIDE’s work in our community and I want to make sure that we’re able to continue that.
And then I think about where we want to go. What that looks like for me is getting an understanding from our team about both the gaps that we see that need to be filled and then also the work that we’re already doing or end up doing that isn’t sufficiently resourced and trying to figure out the best ways to formalize that. I’m focused on striking a balance between being a harm reduction innovator and a collaborator and a nurturing support system.
Speaking of collaborations, SB 57, as a piece of proposed state legislation, recently returned the issue of safe consumption services to the political agenda. Can you speak about the significance of this legislation? What’s the opportunity you see here?
SB 57 is the latest attempt to legalize safe spaces for overdose prevention resources via the safe consumption of substances that are currently illicit, making sure those spaces are hygienic and safe and monitored to reduce the negative impacts that substance use can
s have, including overdose. In our context, this can feel very progressive but safe consumption sites exist all over the world, in Europe and in Canada. It’s a very exciting opportunity that has been raised by bringing this bill into the legislature. I know a similar bill was brought a couple of years back [but was vetoed by then-Governor Jerry Brown]. I know that dealt a huge blow to the harm reduction community. At this point, within the pandemic context in San Francisco and all over California, we’ve seen a really tragic rise in overdose deaths. A space like this, while not curing the problems that lead to overdose, would absolutely provide a safer venue for folks to be able to use inside, and without the threat of incarceration, without the threat of criminal legal system intervention. That’s a huge part. I know San Francisco is already pursuing and acting on calls from the community to decouple the police and law enforcement intervention from other spaces of a behavioral health crisis. This just feels like an extension of that, and one that is particularly important when we think about the larger context of the racist war on drugs in our country—how people using drugs who are Black, who are Latinx,
With the passage of SB 57 and the opening of multiple different modalities of safe consumption sites, we could start to respond to the impact of the racist war on drugs. This bill is an incredible opportunity for our harm reduction community of providers and advocates to work together to figure out what different safe consumption sites could look like.
Really, for me, it’s also about acknowledging that people use drugs—something which is harder to deny the longer we go without safe consumption sites, without affordable housing, without robust healthcare systems. [SB 57] is just an extension of that recognition, acknowledging the humanity of those folks, that they deserve to continue to live their lives as they are able to with the respect and support of our community and without the surveillance of law enforcement.