Syringe Exchange and the State: A Case of Insurgency in the Bureaucratic Field

• In Event: 477 - Section on Crime, Law, and Deviance Roundtable Session
  In Refereed Roundtable: Table 14. Substance Use

Abstract

In November 1988, a group of AIDS activists in San Francisco, calling itself Prevention Point, began illegally exchanging drug users' dirty syringes for clean ones in an effort to slow the spread of HIV. In response, the city's public health authorities immediately endorsed syringe exchange while the police began arresting exchangers, but within two years, Prevention Point had attained de facto legal status. This article employs Pierre Bourdieu's conceptualization of the state as a "bureaucratic field" in order to make sense of these divergent actions by governmental authorities and explain Prevention Point's surprisingly rapid success. Using archival data from the San Francisco Department of Public Health and community-based AIDS organizations throughout the Bay Area, I demonstrate that Prevention Point's entrance into the ranks of publicly supported institutions depended on both the existing structure of the bureaucratic field, as well as the group's symbolically oriented direct action. First, San Francisco's experience of the AIDS epidemic weakened support among local officials for restrictive state-level syringe laws. Second, Prevention Point's social marginality and political radicalism proved useful to the task of outreach to isolated drug users. Finally, the group's rhetoric and political practice successfully challenged the principles of legitimacy that excluded drug users from "society" in the first place. The case of Prevention Point, along with comparisons to other Bay Area communities, demonstrates how marginalized and even criminalized groups can redefine the boundaries of legitimate state activity.

Author

• David Showalter, University of California-Berkeley