The Link Between Harm Reduction, Syringe Access and Addiction Recovery

The Link Between Harm Reduction, Syringe Access and Addiction Recovery

Drug use can devastate individuals, families and communities, yet often the recovery process can be just as long and difficult as the addiction. Sometimes addicts aren’t ready for recovery right away, others may never be ready. For those who aren’t ready, harm reduction programs offer a viable alternative and/or gateway to traditional addiction treatment. Harm reduction refers to a set of practices that reduce the harm of drug use by providing non-judgmental services, such as the provision of sterile injection equipment , safer sex education and overdose prevention services, to people using drugs. Harm reduction programs can act as a gateway to get drug users into treatment and recovery. They emphasize “meeting people where they are at” and providing addicts with the means to protect themselves against HIV, viral hepatitis, and other diseases that spread easily through unsterile drug use, until, if ever, they are ready to enter treatment and recovery. Harm reduction is about believing that lives of people who use drugs are still worth saving.

Mary (alias) is former drug user living in the capital area of North Carolina with a powerful story of how harm reduction can help drug users enter treatment programs.

“I started dabbling in drugs as a teenager,” says Mary, “but things got worse after college. I got into drugs to self-medicate for some mental health issues, exacerbated by traumatic situations in my life at that time. I started shooting up all the time – heroin, crystal meth, and sometimes cocaine. I was lucky because the guys I got high with taught me sterile injection techniques that they learned through harm reduction. They showed me how to clean my needles with bleach if I had to share them. They also taught me how to rotate my veins so I didn’t get collapsed veins or abscesses. I’m grateful for that information because it helped me stay safe from disease.”

One of the functions of harm reduction programs is to protect drug users from blood borne diseases such as HIV and hepatitis C that are passed through sharing needles, crack or meth pipes, cookers, filters, tourniquets, snorting straws or other drug use equipment. HIV can cost over $300,000 to treat over the lifetime of the patient, and hepatitis C costs between $100,000-$400,000 depending on if a liver transplant is required. As many drug users are uninsured, taxpayers often pick up these costs, which add up to $15 to $45 billion of dollar in North Carolina over the lifetime of the patients . Prevention is extremely cost effective, with a sterile needle costing only $0.07 .

In North Carolina (NC), pharmacies are permitted to sell syringes to people without a prescription. However, under NC law an unused syringe can be considered drug paraphernalia and could lead to arrest and conviction of a class A misdemeanor , which also discourages drug users from buying clean needles and leads to more syringe sharing and disease transmission. The North Carolina Harm Reduction Coalition is leading efforts to introduce a bipartisan syringe decriminalization bill in the NC legislature, which would remove syringes from the list of paraphernalia in order to encourage diabetics and drug users to take steps to protect themselves from disease. Syringe decriminalization is proven in multiple studies NOT to encourage drug use or to increase crime in areas where these laws have been adopted .

“I also got syringes sometimes from a harm reduction program where they gave out clean needles,” says Mary. “I was surprised by the people because they didn’t judge me for using drugs. They seemed to care about keeping me safe from disease. I was pretty messed up and so sick I could barely move. The group helped point me towards treatment. I started realizing that I needed to change.”

Harm reduction programs are known for providing nonjudgmental services and frequently serve as a gateway between drug users and treatment. Because of social stigma, many drug users tend to avoid authority figures such as hospital staff, law enforcement, even nonprofits who want to help. Harm reductionists have a unique opportunity to start the conversation about treatment. In fact, studies have shown that drug users who interact with harm reduction programs are five times more likely to enter treatment than those who do not .

“I got into a 12-step program in 2001,” says Mary. “I knew I needed to turn my life around or I wouldn’t go anywhere and I was ready to make change. I’ve been clean from street drugs for 11 years. I try to keep a healthy diet and exercise, and take care of my body.”

SOURCES:
1.) “The Lifetime Cost of Human Immunodeficiency Virus Care in the United States” by Schackman, Bruce, PhD, et al. Medical Care, Vol 44, Num 11, Nov 2006.
2.) The C. Everett Koop Institute of Dartmouth Medical School, “Hepatitis C: Associated Health Costs - United States,” 2011, http://www.epidemic.org/thefacts/theEpidemic/USHealthCareCosts/
3.) Email communication from Susan Thompson, Hepatitis B/C Coordinator, Communicable Disease Branch, North Carolina Division of Public Health, June 29, 2011.
4.) http://www.nasen.org/
5.) North Carolina General Statutes 90-113.22.
6.) Marx MA, et al. Trends in crime and the introduction of a needle exchange program. American Journal of Public Health. 2000;90 (12):1933–6.
7.) Strathdee, et al. Facilitating entry into drug treatment among injection drug users referred from a needle exchange program. Drug and Alcohol Dependence. 2006;83:225-232. Harm Reduction Coalition. Syringe Exchange Programs: Reducing the Risks of Needlestick Injuries. New York: Harm Reduction Coalition; 2006.