U.S. Harm Reduction Services for Indigent Drug Users During COVID-19 (Part 1)
From the beginning, Tarzana Treatment Centers has championedharm reduction services for drug users tosave lives. Still, there is no doubt that many other countries have been more receptive to needle exchange programs and safe injection sites than the United States. However, the COVID-19 pandemic opens the door to harm reduction services in the United States and abroad. The pandemic leads to a true opportunity to overcome policy barriers.
First, check out some harm reduction initiatives taken in the United States reported on in scholarly journals. It seems that even when these harm reduction services took the next step forward, innovations were met with resistance within communities. However, other initiatives manage to avoidneighborhood opposition by embracing mobile options. Indeed, the spread of mobile harm reduction services, which Tarzana Treatment Centers have used for over a decade, is a positive step.
Harm Reduction Services in Repurposed High School Meets Opposition
Understandably, nobody would want homeless drug users occupying their children’s high school. However, when COVID-19 shut down the schools, such a repurposing, side-by-side with harm reduction services became a viable option. During COVID-19, the goal was to get homeless drug users off the streets, even if they continued to abuse drugs. According to an article in the Journal of Urban Health (July 2020), the following sequence of events took place:
“In New Haven, the conversion of a closed high school into a respite facility for homeless PWUD (people who use drugs) upon discharge from the hospital was challenged by local opposition that included a neighborhood-elected official. A resolution allowing its opening required intercession by the newly inaugurated mayor. Thereafter, allowing the facility to operate on harm reduction principles required negotiations with city officials.”
Beyond the back and forth with politicians and the community, the outcome’s long-term impact is more telling. The operating principles of the harm reduction living quartersare now codified. The new operating protocols are a combined effort by physicians from the West Haven VA’s homeless program, Yale’s National Clinical Scholars Program, and the former director of New Haven’s largest shelter. Now championed as a national model by the National Coalition for the Homeless, this harm reduction model hopefully will continue.
Mobile Distribution of Harm Reduction Services in U.S. Rural Areas
Beyond the use of vacant hotels and closed schools for the homeless during COVID-19, there are many challenges regarding harm reduction in the United States. For example, it became harder for many patients to access harm reduction services. When you are a homeless drug user without private transportation, getting around during a pandemic is difficult. Thus, since harm reduction mean saving lives, mobile distribution is a better option.
Moreover, in the U.S. Southern Mountains, where the rural communities are widespread and access is difficult even in normal times, mobile distribution of harm reduction services is necessary. During the pandemic, however, COVID-19 education and recommendations are part of the picture. Thus, we will give you a new needle for a used one and hand sanitizer, and a mask. As reported in the Journal of Rural Health (2020), the following steps are taken. The goal is to ensure homeless drug users’ health.
The recommendations include “increased handwashing; minimizing supply sharing; preparing their own drugs; awareness of the increased likelihood of overdose; avoiding distribution sites if symptomatic; stocking up on supplies and drugs in case of shortages; preparing for withdrawal; and considering getting a prescription for buprenorphine products, even short term, to prevent symptoms of withdrawal or overdose in the case of drug supply disruption.”
The revolutionary perspective is combining substance use disorder harm reduction with COVID-19 behavioral harm reduction. The dual recommendations help to reduce damaging stigma.
Quality of Harm Reduction Services in the United States and Abroad
In the second part of this two-part article, harm reduction directed at indigent drug users abroad will be detailed. Yes, the United States takes steps in the right direction. However, such efforts do not compare to the investment made in harm reduction services in other first-world countries.