States like New Mexico which ranked 11th in the nation for drug overdose deaths in 2020 significantly expanded access to naloxone and fentanyl test strips after a state harm reduction bill was signed into law in February of 2022. John Swatek, head of the New Mexico Health Department Harm Reduction Program says that the program has proved to be effective, over 3,400 overdose reversals have been reported. “We know just from that data, which we believe is an undercount, that this is an effective program,” said Swatek. “If people use fentanyl test strips, then they’re aware that fentanyl might be in their substances, so they can change their behavior, they can use less. They might not use that batch at all. The goal of harm reduction is to make sure that folks have as low barriers as possible to access lifesaving naloxone and other harm reduction services that our program offers.”
Nate Moellering, a community outreach coordinator at Allendale Treatment and Fort Wayne Recovery knows that some people think that providing people with syringes and naloxone is enabling them but he doesn’t see it that way. “We’re providing a bridge to recovery. We want to keep the person alive and healthy enough so that they can go to treatment,” says Moellering. “You can reduce the harm by the smart implementation of the proper measures.”
Needle and Syringe Programs Prevent Transmittable Diseases
Needle exchange programs and syringe service programs (SSPs) provide the public with access to sterile needles and a secure place to dispose of used needles and syringes. The goal of these programs is to protect the public by preventing outbreaks of transmittable diseases such as HIV, tuberculosis and hepatitis.
What Are Syringe Services Programs (SSPs)?
Syringe service programs (SSPs) are community-based prevention programs that can provide a range of services, including:
Access to sterile syringes and needles
Vaccination, testing and treatment for infectious diseases
Overdose prevention and education on safer injection practices
Abscess and wound care
Referral to substance use disorder treatment
In 2015 Scott County, Indiana become an early adopter of a needle exchange program after it found itself in one of the largest HIV outbreaks in the country. 235 people in Scott County were infected with HIV after they shared needles using drugs. By 2020, that number of newly infected people had dropped to one. Despite the effectiveness of this program, it was discontinued in 2021 due to political pressure.
30 years of research shows that SSPs are safe, effective, and cost-saving; do not increase illegal drug use or crime; and play an important role in reducing the transmission of viral hepatitis, HIV, and other infections. They also play an important role in improving the health of people who inject drugs—People who use syringe services programs are 5 times more likely to enter drug treatment and 3 times more likely to stop injecting drugs, potentially reducing overdose deaths.
Tommy Streeter, a community outreach coordinator for Allendale Treatment and Fort Wayne Recovery says that harm reduction programs like SSAs emphasize the need for humility and compassion for people who use narcotics. “At the end of the day, people are going to continue to use illegal substances and if we can make it a little bit safer for them and try to stop them from contracting diseases so that their path to recovery is easier, it’s a win,” says Streeter. “Just because someone uses drugs doesn’t mean they deserve to contract a disease like HIV or hepatitis from dirty needles or syringes.”
Medication Assisted Therapy Can Lead to Long-Term Recovery
Medication-assisted treatment (MAT) is the use of medications in combination with behavioral health services to treat opioid use disorders (OUD). Currently, there are 3 FDA-approved drugs for the treatment of opioid dependence – buprenorphine, methadone, and naltrexone. A study from the National Institute on Drug Abuse found that 50% of the people in the study who took buprenorphine and naltrexone were drug-free 18 months after they started an MAT. After 3.5 years, that number grew to 61%.
Because maintenance medications (methadone and buprenorphine) are themselves opioids, critics of MATs assume that this treatment substitutes a new substance use disorder for an old one. This belief has unfortunately hindered the adoption of MAT as a part of substance use disorder treatments. While advocates for MATS agree that people taking OATs should be re-evaluated periodically due to the chronic nature of the medications, the stigma around MATs is unwarranted.
Alicia Wells, Director of Public Relations for Fort Wayne Recovery and Allendale Treatment said that she had a negative experience when she went to the hospital in labor and was on an MAT for an OUD. “After I gave birth, I felt an immense amount of stigma from one of my nurses who contacted CPS when she realized I was on medication for my substance use disorder,” says Wells. Part of my work now with Bare Knuckle Recovery is finding medical practitioners who understand what people with substance use disorders are going through so they can provide them with better care through their recovery.”
While the stigma around harm reduction persists, advocates want the public to understand that harm reduction focuses on meeting people with substance use disorders where they’re at. This often entails providing them with resources and support based on their individual needs with the end goal of encouraging them to seek treatment for their substance use disorder so they can achieve a higher quality of life.