Alaska health care professionals discussed the importance of using harm reduction services in treating substance use disorders on Wednesday.
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Dr. Sarah Spencer, a family medicine specialist at Ninilchik Traditional Council Community Clinic, discussed harm reduction during the Alaska Division of Behavioral Health’s Project ECHO meeting. The ECHO series educates residents on substance use disorders and treatment. Spencer said funding for harm reduction is incredibly limited, as it mostly comes from donations and other charitable sources.
“There are federal limitations on what you can spend money on for harm reduction,” Spencer said. “Harm reduction saves society a huge amount of money, but the government is not funding it. [Harm reduction] encourages people to get treatment because they’re in a nonjudgmental environment. Treatment can also be harm reduction.”
Venus Woods, Director of HIV Prevention and Education at Alaskan Aids Assistance Association (Four A’s), discussed some harm reduction services the organization provides.
Four A’s operates a syringe access program out of a mobile unit. It serves Anchorage, the Matanuska-Susitna Valley and Juneau. The program provides sterile syringes and supplies to people who inject drugs. It also provides clients with Narcan kits, fentanyl test strips, overdose educational materials, and general information about helpful community services.
“They might need to know where the food banks are, they might be ready to talk about going to detox, or [want to] know about treatment,” Woods said. “It’s a lot of hands-on case management with our clients.”
The program distributed 1 million syringes throughout the state in 2019, taking another 1 million used syringes out of the hands of clients.
“In 2020, our numbers went down because of COVID,” Woods said. “We had to modify the way we served clients. We gave out about 700,000 in 2021. You match someone’s used syringes with new syringes. The benefit to that model is its more cost effective, and encourages our clients to turn in their used syringes.”
Woods uses harm reduction methods to minimize negative health, social, and legal impacts associated with drug use and policies.
“Harm reduction ensures that drug users and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to serve them,” Woods said. “I’m someone in recovery, and I think it’s important we incorporate the voices of drug users in our programs. There’s a lot of different ways we can ensure our clients are engaged with the policies in the programs designed to serve them. Harm reduction programs do not encourage drug use. We know people are going to continue using drugs despite the consequences and whether they have access to supplies.”
For example, syringe access programs decrease improper needle disposal, which helps prevent accidental needle sticks, Woods said.
“If an individual is using injection drugs they should be provided with information about safer injection practices and connected to resources and safe injection equipment,” Woods said. “Syringe access programs are safe environments for open discussion, everyone is welcome and their health is important. They decrease rates of injection drug use, decrease overdose rates, increase community safety, and most are cost effective.”
Brenda Henze-Nelson, Clinical Director of Interior Aids Association (IAA), discussed IAA’s syringe services program.
“We have a comprehensive assisted medication treatment program,” Henze-Nelson said. “The focus of the program is to reduce harm. We really are just wanting to support positive change. Our syringe services, that’s the most positive change a person can make to protect themselves and others.”
IAA also distributes condoms, safer smoking/snorting kits, sterile water, first-aid kits, Naloxone kits, and fentanyl test strips, Henze-Nelson said.
“We know from supervised injection sites in Canada, the research shows people eventually enter treatment,” Henze-Nelson said. “Here, we feel so lucky to meet folks where they’re at. They’ve encountered so much stigma, and felt unsafe in so many places. They can come here and access the services they need. They may come in to take an HIV test, but then decide to fill out an application for treatment.”
Christina Love, Senior Specialist at Alaska Network on Domestic Violence & Sexual Assault, said recovery is self-defined.
“For people who are deciding they no longer want to use meth, but still want to drink, that’s recovery,” Love said.“As a person who has experienced substance use disorders, the way I thought about addiction changed so much. There’s so much misinformation. Science helps us get to the heart of what stigma is. Part of harm reduction is when you’re sitting with a person who is struggling, you have no agenda.”
Christine Furey shared a personal story about addiction. She said she was a drug addict by the time she was 14, and later became a drug dealer. But she went through a 12-step program to overcome her addiction.
“I went to that program every day like my life depended on it, because it did,” Furey said. “I had not lived my life without drugs for many years. I was done.”