Claudia Figallo, MPH: Harm Reduction Advocate

Claudia“From the time I was maybe five years old, I knew I would end up in a profession where I cared for people,” Claudia Figallo, AHP Counselor and Case Manager, recounted. After growing up in Caracas, Venezuela and getting a BA in special education, Figallo moved to London in 1991, switching her focus to substance abuse counseling. “I haven’t used my undergraduate degree in all my years as a counselor and case manager, because substance use and harm reduction were my sole interests almost from the start.”

Figallo first became familiar with the concept of harm reduction therapy while working with incarcerated women. Harm reduction, now applied to many behaviors that can lead to health complications, initially referred specifically to the programs, policies, and practices that focus on reducing the potential harm of drugs for individuals who cannot or choose not to stop using them. The movement was, and remains, revolutionary in that “abstinence,” becomes just one possible approach, not the only approach, to preventing harm.

“For a long time, drug-users were the villains,” Figallo said. “Helping them was about confrontation and punishment.” Now it has become an exploration of the “factors in their lives [that have] led them to drug use and how to address environmental influences.”

Old pamphlets Claudia keeps around her office paint a grim picture of drug detox, complete with garish bloodshot eyes, yellowing skin, and broken teeth. And popular television shows like Intervention capitalize on the perception of the non-functioning user, someone whose life has been completely derailed by their inability to kick a habit. Although harm reduction’s goal doesn’t seek cessation as its primary purpose, there is value in abstinence for some people and, Figallo said, scare tactics have had a big hand in making traditional rehab unattractive to someone who wants to kick a habit.

A harm reduction philosophy is attractive to Figallo not only because of its client-centered, compassionate approach but also because it goes hand-in-hand with her interest in drama and creative arts therapy. Figallo began introducing images, structure, stories, and drama games into her community drug and residential treatment work in 2000. San Francisco has always been at the top of the wave of harm reduction, and AHP was one of the first to humanize drug-users and recovery, which explains why Figallo, who had been splitting her time between London and San Francisco throughout the 1990s, moved to the city full time in 2003.

Figallo explained that although substance abuse counseling and therapy have come a long way, there’s still much to be done to create a truly supportive environment, “The biggest social issues we have to tackle are stigma and loneliness.” Stigma, shame, and isolation affect both patient and provider in all aspects of the health care system. We cannot provide effective treatment unless we address the lack of connection and purpose in people’s lives. As President of the Board of Directors for the Harm Reduction Therapy Center, Figallo believes that tailored drug treatment for individuals and communities is key to successful treatment; whether it be through needle exchange programs or programs which provide incentives or counseling. She concludes; “the biggest issue is policy itself.

“. . . our drug laws are ineffective because we are not honest about the level of drug use taking place all over the country.” Policy reform could mean the difference between a vibrant San Francisco community and a failing one that doesn’t prioritize drug user health.

It’s not all work for Claudia. She likes to spend time in her garden and explore the outdoors with her partner and kids or head out to San Francisco’s street festivals and music venues. When asked what the rest of us should do in our spare time, she laughs, “It’s such a cheesy answer, but, seriously, laugh, dance, sleep-in, and go bananas, if you want; but do it safely. Just do whatever makes you happy!” Now, that sounds like harm reduction!