Health care professionals in Alaska discussed the importance of using harm reduction services in the treatment of substance use disorders Wednesday.
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Dr. Sarah Spencer, a family medicine specialist at the Ninilchik Traditional Council Community Clinic, discussed harm reduction during the Alaska Division of Behavioral Health The ECHO project meeting The ECHO series educates residents about substance use disorders and treatment. Spencer said funding for harm reduction is extremely limited, coming mostly from donations and other charitable sources.
“There are federal limits on what you can spend harm reduction money on,” 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 are in a non-judgmental environment. Treatment can also be harm reduction.”
Venus Woods, Director of HIV Prevention and Education at the Alaskan AIDS Relief Society (Four A’s), discussed some of the harm reduction services the organization offers.
Four A’s operate a syringe access program out of a mobile unit. Serving 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 education 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 statewide in 2019, removing another 1 million used syringes from the hands of clients.
“In 2020, our numbers were down because of COVID,” Woods said. “We had to modify the way we served customers. We gave out about 700,000 in 2021. You match someone’s used syringes with new syringes. The benefit of this model is its more cost effective and encourages our customers to hand in their used syringes.”
Woods uses harm reduction methods to minimize the 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 to include the voices of drug users in our programs. There are many different ways we can ensure that our customers are engaged with the policies in the programs designed to serve them. Harm reduction programs do not encourage drug use. We know that people will continue to use drugs regardless of the consequences and whether they have access to supplies.”
For example, syringe access programs reduce needle misdisposal, which helps prevent accidental needle sticks, Woods said.
“If an individual is using injection drugs, they should be given information about safer injection practices and connected to safe injection resources and 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 the Internal Assistance Association (IAA), discussed the IAA’s syringe services program.
“We have a comprehensive medication-assisted treatment program,” Henze-Nelson said. “The focus of the program is to reduce harm. We really just want to support positive change. Our syringe services are the most positive change a person can make to protect themselves and others.”
The 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 the supervised injection sites in Canada, survey it shows that people eventually get into treatment,” Henze-Nelson said. “Here, we feel very fortunate to meet people where they are. They’ve faced so much stigma and felt unsafe in so many places. They can come here and access the services they need. They may come in for an HIV test, but then decide to fill out an application for treatment.”
Christina Love, Senior Specialist at the Alaska Domestic Violence and Sexual Assault Network, said recovery is self-determined.
“For people who are deciding they don’t want to use meth anymore but still want to drink, this is healing,” Love said. “As someone who has experienced substance use disorders, the way I thought about addiction changed so much. There is so much misinformation. Science helps us understand the core of the stigma. Part of harm reduction is when you sit down with a person who is in trouble, 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 I did,” Furey said. “I had not lived my life without drugs for many years. I was done.”