November 8, 2020. The Daily Reflector. 2d. By Joshua Park.
According to the National Institute on Drug Abuse, 619 people died from heroin and synthetic opioid-related overdoses in North Carolina in 2018. The overdoses seem never-ending as people lose family and friends every week to opioids. In 2020, COVID-19-related stay-at-home orders and physical distancing measures have reduced access to clean supplies and treatment, exacerbating the opioid crisis in our country.
As an Albert Schweitzer Fellow and ECU Brody School of Medicine student, I have seen first-hand that harm reduction programs reduce adverse effects of injection drug use. Harm reduction refers to the policies and procedures that support and protect the wellness of individuals who use drugs. Instead of ignoring the impact of drug use, harm reduction strategies actively work to minimize the substance abuses’ harmful effects.
My community mentor, Diannee Carden-Glenn, lost her son, Michael Carden, from an overdose in 2012. Michael committed his life to helping others with substance use disorders and led the way for harm reduction in New York while he was alive. In dedication to Michael’s life, Diannee now directs the only syringe service program, formerly called syringe exchange, in Pitt County. Diannee named the program “ekiM for Change Syringe Service Program,” to honor Mike, as “ekiM” is a palindrome of “Mike.” In addition to serving as a safe disposal site for used needles, ekiM provides clean needles, syringes, naloxone (the opioid-reversal drug), hygiene products, condoms, vitamins, bus passes, and meals to the participants.
The goal of harm reduction is not to force people into treatment, but to rely on consistent and friendly interactions to which can develop into reliable relationships to segue into recovery when the participant is ready. One woman had been a participant of ekiM since it opened in 2017. Diannee kindly greeted her every week at ekiM and they built a trusting relationship. When the participant was ready, Diannee connected her with a treatment center and she was able to end her injection drug use. She gave birth to a healthy baby boy in September 2020 and periodically returns to ekiM to visit with Diannee.
Substance use disorders and overdoses affect everyone, not just those directly involved. The Recovery Centers of America estimates the economic loss and societal harm of substance use in the United States to be $1.45 trillion annually. Hospital systems absorb the majority of the costs of opioid overdose visits and treatment of skin and soft tissue infections from missed injections, resulting in higher healthcare prices for everyone. Syringe service programs, like ekiM, educate participants on proper injection techniques to avoid skin and soft tissue infections, reducing lengthy and expensive hospital visits.
Blaming people who inject drugs for lacking the ability to break the cycle of addiction is misguided and counterproductive. Poverty, housing insecurity, past trauma, and lack of health insurance all threaten access to quality healthcare and reinforce addiction. Addiction is a racial justice issue, a health system issue, and a community issue. Recognizing the realities of these social inequalities on effectively managing drug-related harm is an important step in addressing the opioid crisis.
We all have a responsibility to make our communities safe and welcoming for everyone. Supporting laws that improve access to health insurance, affordable housing, and substance use treatment are necessary to promote such an environment. While we eagerly wait for policy change, consider examining substance use disorders through the humanistic lens of harm reduction that respects life, pursues equity, and benefits all people.
Joshua Parke, 2020-21 NC Albert Schweitzer Fellow and ECU Brody School of Medicine student.