While federal and state leaders have undertaken efforts to address the ongoing opioid epidemic, there is more work to be done. Arizona health leaders working to address substance use met at the 2024 Arizona State of Reform Health Policy Conference this month to discuss how they are working to tackle the crisis, including addressing stigmas and prioritizing harm reduction in response efforts.
Haley Coles, co-founder and executive director of Sonoran Prevention Works—a statewide harm reduction organization—said people have always used drugs, and always will. In order to advance work aiming to get users connected to the care they need, individuals must accept that people will continue to use drugs, she said. The biggest challenge with that is addressing related stigmas, Coles said.
“People still hate people who use drugs,” Coles said. “In general, our society really just hates people who use drugs. We view them as criminals, we view them as helpless, we view them as sick.”
Coles said those struggling with substance use deserve dignity, to live, and to receive adequate healthcare. Sonoran Prevention Works operates a syringe service program—a needle exchange program—which distributes unused syringes, smoking supplies, naloxone, and fentanyl test strips.
“We also give out women’s care supplies (and) hygiene items. We provide on-site HIV and Hepatitis C rapid testing and connection to treatment. We also provide a lot of referrals to care. We are seeing people that do not engage with any other system, so when they come to us, we’re able to build a relationship,” Coles said. “We can then help them slowly move towards positive change; whatever that positive change is for them.”
The program is working with other Arizona organizations to scale up the capacity of its harm reduction work by providing training and education. Since the federal government doesn’t provide funding for the needle exchange program or smoking supplies, community relationships are crucial, Coles said. Sonoran Prevention Works has distributed over one million naloxone doses since 2017, which resulted in the reversal of about 30,000 overdoses.
Jeremy Bloom, CEO of Northsight Recovery, a treatment facility for mental health concerns and substance use, emphasized the need to address an individual’s social needs. He noted that more attention needs to be given to loneliness, which is more abundant in individuals with complex cases who have numerous health-related needs.
“The thing that really is the turning point in their treatment is human connection, so we put a lot of focus and energy into building that community, and the place for that connection with our workforce as well,” Bloom said.
At Northsight Recovery, over 90 percent of individuals living with moderate-to-severe opioid use disorders have co-occurring mental health issues, which can contribute to feelings of isolation and loneliness, Bloom said.
“The one thing technology won’t replace is connection and relationships with somebody, so being focused on allowing that space for our team to build that connection with our members (is important), as well as building that connection for our workforce,” Bloom added.
Harm-reduction options like drug-checking machines—which identify the different substances in a sample of drugs—are now available to needle exchange programs, Coles noted.
“People are going to use drugs anyway. Wouldn’t you want to know if that cocaine you’re going to do for New Year’s has fentanyl in it or not?” Coles asked.
Coles hopes to see a federal paraphernalia law implemented, as the methods of substance consumption continue to change, and legal exceptions for using certain types of paraphernalia cannot be made due to federal constraints.
Coles also hopes to see methadone deregulated at the federal level, as the requirements for providers to administer the medication are burdensome to patients and their families. Some federal restrictions around methadone use have been loosened, she noted. Methadone is a daily medication used by individuals with opioid dependency, which reduces their cravings and symptoms of withdrawal.
“If we want people to stop using, we need to make sure there’s available treatment for them. It’s hard to quit cold-turkey, and this treatment is the gold standard when it comes to treating opioid use disorders,” Coles said.