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Harm Reduction to Fight the Opioid Epidemic

By Sam Knight, detoxlocal.com

The opioid addiction and overdose crisis in the United States is getting harder and harder to ignore. In 2016, roughly 64,000 people died as a result of a drug overdose. This is a staggering jump of 22 percent from the previous year, making drug overdose one of the leading causes of death in the United States and the leading cause of preventable death, surpassing automobile accidents.

The overwhelming cause of this overdose crisis can be traced directly to a drug called fentanyl, laid out in detail in a disturbing exposé by The New York Times. Many local communities are feeling swamped by the urgent need of combatants, like increased law enforcement, medical first responders and naloxone, the opioid overdose reversal drug also known by the brand name Narcan. Some politicians are calling for a “tough on crime” approach, but many skeptics are voicing their concerns over this method of dealing with drug addiction. Instead, they recommend methods of harm reduction to fight the opioid epidemic.

Why Treating Addiction as a Crime Backfires

Arresting and jailing drug users has proven to backfire in past decades. Jails offer few resources to drug users, and many of them return to the street worse off than they were before. Many jails are flooded with drugs, so users can continue their addiction while incarcerated. This is why activists and politicians alike are calling for more access to diversion programs, allowing first-time drug offenders to attend rehabilitation as opposed to a jail sentence. This not only shows better results but is often cheaper than traditional jail time. Drug offenders are often repeat offenders, which continues to drain tax money toward court and incarceration costs. Diversion programs limit the number of habitual offenders.

What Is a Harm Reduction Center?

Interlocking handsA newer idea to fight this crisis is the use of harm reduction centers, like syringe exchange programs and supervised injection sites, which have shown impressive success rates in Canada and several European countries. Several cities in the US and Canada have found that, in areas with needle exchange programs, there is up to an 80 percent decrease in risky behavior, including crime.

A common misconception people assume is that needle exchange programs enable drug users. The reality is that 97 percent of all needle exchange programs provide a wide range of public health services, offering avenues to detoxification programs, medication-assisted treatment (MAT) or inpatient rehabilitation. Needle exchange programs have even reduced HIV/AIDS transmission in the US by at least one-third so far.

Another reason harm reduction is gaining the respect it deserves is because a study by the ACLU found that drug users who participate in needle exchange programs are five times more likely to attend an addiction treatment program compared to those who do not. Needle exchange programs are not just a way to prevent the spread of disease. They’re also a vital community support program that opens the door to recovery for many people struggling with addiction. Many drug users live in the shadows of society, hiding from stigma and shame. In a harm reduction center, like a syringe exchange, drug users can meet people in their local community volunteering their time to help them. This gives drug users the opportunity to talk about their drug use with somebody who can help them without judgment. They can also receive the medical care they otherwise would not have access to.

With the recent spike of fentanyl and fentanyl analog drugs, which can be 50-100 times more potent than heroin, some harm reduction programs have begun distributing drug identification kits. These kits can quickly identify if a person is about to use fentanyl as opposed to heroin. There has even been a spike in counterfeit prescription drugs that use fentanyl, so these ID tests can mean life or death for many drug users. Exchange programs also commonly distribute Narcan, which can immediately reverse the effects of an opioid overdose. Narcan can bring a person out of a comatose state to awake and conscious in a matter of seconds. Unfortunately, this drug can be expensive, so many harm reduction centers are constantly seeking grants to continue to provide the lifesaving drug to the public.

Fentanyl deaths are expected to continue to rise this year due to its availability and cost. Fentanyl is synthetically made, often in foreign labs. It can be made at a fraction of the cost of heroin, making it a desirable alternative for drug dealers trying to maximize profit. It also makes the drug seem more potent while creating a powerful dependence on the user, leaving customers helplessly addicted to their product.

To successfully fight this national crisis, more national funding is going to be needed for harm reduction programs. So far, these programs have shown to be the most effective way to get drug users off the streets and into an addiction treatment program. The “tough on crime” stance will continue to exacerbate the problem like it did during the crack epidemic of the 80s and 90s. This is why it is so important to raise awareness and education surrounding harm reduction in order to break the stigma of methods that are proving to work.


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