title: 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 150m 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.
authors.affiliation: Division of Global Public Health, School of Medicine, University of California, San Diego, 9500 Gilman Drive, MC 0805, La Jolla, CA 92093-0805, USA. Electronic address: pdavidson@ucsd.edu.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Davidson
authors.affiliation: Homeless Youth Alliance, 1696 Haight Street, San Francisco, CA 94117, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Howe
mesh_terms: D000293:Adolescent; D055030:Drug Users; D018453:Homeless Youth; D006801:Humans; D018671:Needle-Exchange Programs / Q000458:organization & administration*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012495:San Francisco / Q000453:epidemiology; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*
keywords: Homelessness; NIMBY; Needle exchange; Space and place