Syringe exchanges and other harm-reduction strategies can prevent drug overdose deaths, but some places reject them

Ainsley Bryce runs Holler Harm Reduction. (Yonder photo by Stacy Kranitz)

Seatbelts, helmets and vehicle airbags are about reducing harm, and so are teams that work on prevention of drug abuse and overdoses, with measures such as syringe exchanges to prevent disease and steer intravenous drug users into treatment. But such measures often face pushback, reports Taylor Sisk of The Daily Yonder reports from her home region: "Central Appalachia has suffered disproportionately from our crisis of addiction. But over the past five years, politicians throughout the region have put policies in place that counter the research in addiction science, limiting communities from implementing proven policies."

In the mountains of western North Carolina is Sisk's key example: "In the back parking lot of the Dollar General, a litany of interactions is conducted with the utmost discretion. . . . . Ainsley Bryce is here each Saturday morning to distribute life-saving assets. . . . The free items she offers are numerous: syringes, naloxone, fentanyl test strips, Covid-19 test kits, saline, vitamin C, Band-Aids. Bryce can also provide information, referrals, a smile, a hug, non-judgment, and kindness. . . . She is the director of Holler Harm Reduction . . . Though these interactions are entirely legal, discretion is wise."

While the number of American overdose deaths is staggering, equaling over 100,000 in 2021 alone, politicians have sought to prevent help from being given, even to the sickest people. Many localities with high risk of disease outbreaks among IV drug users have refused to allow local health departments to have syringe exchanges, and "In 2022, Sen. Joe Manchin, Democrat from West Virginia, the state with the nation’s highest rate, by far, of fatal overdoses – joined with  Sen. Marco Rubio (R-Fla.) to introduce a bill prohibiting the use of federal funds for syringe and other exchange services," Sisk reports. "Americans are now more likely to die of an accidental opioid overdose than a car accident. But cars would kill 15,000 more people a year were it not for seatbelts – something required by the federal government to be placed in every new car since 1968. . . . For decades, drug-policy experts have recommended that we embrace the seatbelts of drug use."

"Harm reduction doesn't abet drug use, Judith Feinberg, a professor of infectious diseases and behavioral medicine at West Virginia University, told Sisk. "It's about reducing the attendant harms of drug use, supporting people in the community and trying to keep them alive and healthy."

Sisk reports, "Research shows that naloxone access laws have resulted in a 14% decrease in opioid overdose deaths nationwide. And a Seattle study of people who used injection drugs found that new participants in a syringe exchange program were five times more likely to enter treatment than those who weren’t in the program. . . . In Tennessee, legislation went into effect in July 2022, that allows health care providers and community groups to distribute naloxone under standing orders. The hope is that this will make naloxone much more accessible in rural communities." Still, humanity must fight to stay human. "Feinberg is 'terrified that we won’t have the humanity and the generosity of spirit and the political will to see that this is somebody’s mother, somebody’s brother, somebody’s uncle, somebody’s son and daughter.'”