Syringe Exchange Strategies Produce Real World Results

By: Marcus J. Hopkins, Blogger

We face a growing epidemic of prescription opiate and heroin addiction, in this nation, in large part fueled by overprescribing of powerful pain relievers to patients who become addicted to their effects, but find that heroin can be both cheaper and, depending upon the batch, more potent. Sadly, this explosion in opioid addiction isn’t something that just came out of nowhere – it has been clearly and vocally predicted by medical and social researchers since 1996, when OxyContin received FDA approval and began being prescribed not to those patients whose pain levels were the most severe, but to virtually any patient who could pay for the drugs.

HEAL Blog has covered the history of OxyContin and other prescription opioids in previous 2015 editions, as well as their effects on rural Appalachia and other suburban areas, and beginning in April of 2016, the HIV/HCV Co-Infection Watch Report will be expanding its coverage of Harm Reduction efforts in the United States. The decision to expand our reporting into the world of Harm Reduction arose from the reality that, with rare exception, reports of new Chronic Hepatitis C (HCV) infections are overwhelming coming from injection drug users (IDUs), as well as a recent uptick in the number of new HIV infections as a result of injection drug use for the first time since the 1980s (Smith, 2016).

Photo of opioid prescription drugs and an IU needle spread across money.

Photo Source: ReinventingAging.org

This increase in new HIV and HCV infections amongst IDUs was brought most sharply into focus with last year’s largely preventable (Smith) outbreak in Scott County, Indiana. As of February 01, 2016, 188 people in the area were diagnosed with HIV in only fifteen months, which overlapped 312 cases of acute HCV infection, 25% of which were co-infected (Smith). In response to this outbreak, Indiana’s largely Conservative legislature, along with Republican governor Mike Pence, overcame its decades-long rejection of syringe exchange programs (SEPs) in order to deal with the burgeoning HIV crisis (Harper, 2015). Similar actions were taken in surrounding states, as Federal, state, and local governments took notice of HCV and HIV infection reports reflective of the Indiana tragedy.

What has yet to take hold in America, however, is the reality that SEPs work. To date, many Americans (as well as citizens around the world) continue to cling to the decades-old illusion of a drug-free world (McLean, 2016), as well as to the punitive approach taken in the long-since-lost “War on Drugs.” This opposition to SEPs comes despite literally volumes of research showing that epidemics can be, and have been, averted or reduced, as evidenced in settings as diverse as Australia, China, Malaysia, Mauritius, Portugal, Switzerland, Vietnam, and Ukraine (Smith).

But, as with all things “foreign,” the concept of following in the footsteps of other nations in dealing with any crisis strikes Americans as being un-American; the mere mention that another nation is doing something right, much less “better” than America smacks of Communism and prompts accusations of trying to “inflict” Socialism upon the American public. We largely are, and have been increasingly becoming, a nation whose drug laws are based not upon research and facts, but upon fear, emotion, and a “Not In My Backyard” mentality.

There are, however, efforts to change this mentality. As evidenced by the sudden change of heart (albeit temporary) by the Indiana legislature, occasionally actual wisdom (and research) will prevail, and real Harm Reduction strategies can be put into place. Hopefully, the expansion into coverage of this topic will help to lead that charge within the HIV and HCV communities, regardless of whether people are mono- or co-infected. The whole purpose of the HIV/HCV Co-Infection Watch – nay, the very reason it exists – is to empower patients to better advocate for themselves in the healthcare debates. By tracking Federal-, state-, and local-level Harm Reduction measures, we hope to provide an invaluable tool that will allow both patients and advocates to confront and demand action from their representatives in the Legislative Branches to enact the evidence-based measures that will actually make a difference in the fight against HIV and HCV.

References:

Harper, J. (2015, June 02). Indiana’s HIV Outbreak Leads To Reversal On Needle Exchanges. Indianapolis, IN: National Public Radio (NPR): 90.1 WFYI Public Radio: Public Health: Shots. Retrieved from: http://www.npr.org/sections/health-shots/2015/06/02/411231157/indianas-hiv-outbreak-leads-to-reversal-on-needle-exchanges

McLean, S. (2016, March 21). To end HIV in drug users, stop chasing the dream of a drug-free world – Why does ‘harm reduction’ continue to be such a problem for global drug policy when it’s a proven way of reducing cases of HIV?. New York, NY: The Guardian: Global Development. Retrieved from: http://www.theguardian.com/global-development/2016/mar/21/end-hiv-drug-users-drug-free-world-harm-reduction

Smith, M. (2016, February 26). Drug-Fueled Indiana HIV Outbreak Was ‘Preventable’ – But other poor rural communities face similar risks. New York, NY: MedPage Today, LLC. Retrieved from: http://www.medpagetoday.com/MeetingCoverage/CROI/56416
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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

 

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