Tag Archives: heroin

Food and Drug Administration Pulls Opana ER from Shelves

HEAL Blog is the recipient of the ADAP Advocacy Association’s 2015-2016 ADAP Social Media Campaign of the Year Award
By: Marcus J. Hopkins, Blogger

In April 2016, HEAL Blog wrote an entry about the fascinating and heartbreaking first episode of National Public Radio’s (NPR) series, Embedded. Host Kelly McEvers found a group of prescription opioid Injection Drug Users (IDUs) who allowed her to record an audio interview about their lives and how they use their drugs. The drug in question was Endo Pharmaceuticals’ powerful prescription opioid, Opana ER (McEvers, 2016). A little over a year after this broadcast, the Food and Drug Administration (FDA) reached the conclusion that the “…benefits of the drug may no longer outweigh the risks,” and have asked Endo to remove Opana ER from the market (Mandal, 2017).

What’s at stake here isn’t just a 4% increase in prescription opioid overdose deaths in 2016 (n=17,536), nor the 23% increase in heroin-related deaths (n=12,989); it’s not even the 73% increase in synthetic opioid-related deaths (n=9,580) (Stobbe, 2016). What’s at stake, at least for Endo Pharmaceuticals, is the $158 million in sales Opana ER brought in for Endo in 2016 – a 10% decrease from 2015 (Mandal). For Endo, pulling one of their most successful products from the market means a huge hit to their bottom line.

Opana ER pill bottle

Photo Source: Medcitynews.com

Opana ER, first introduced by Endo in 2006, was reformulated in 2012, when the manufacturers began adding a plastic coating to the outside of the pill to make it “abuse deterrent.” This move, while initially praised by the FDA and lawmakers as a great step forward to combating prescription drug abuse and addiction, simply shifted how drug users abused the drug. While the initial formulation could be crushed and easily snorted nasally, the plastic coating prevented this practice. Necessity (read: addiction) being the mother of invention, drug users found a way to abuse the drug by melting the plastic coating off, filtering the coating out through mesh, load the liquefied drug into a syringe, and injecting it straight into their bloodstreams. The McEvers Embedded piece literally goes over a step-by-step “How To” guide that is already known by IDUs.

The bottom line for states, counties, and municipalities who are having to cope with the 40,105 opioid drug-related deaths in 2016 comes down to more than just money – the issue is negatively impacting virtually every arena of daily life. Families are rent asunder, children are left orphaned, and emergency personnel are facing their own increased risk of overdose from inhaling or coming into direct contact with the powerful synthetic opioids, fentanyl and carfentanil, during overdose calls and drug busts. The risk of overdose due to exposure is so great that the Drug Enforcement Agency just this month issued a safety guide for first responders who might come into contact (Chanen, 2017).

Pain advocates who have long pushed for easy access to prescription painkillers argue that increasing restrictions places an undue burden upon patients who properly adhere to treatment regimens, using powerful prescription opioids as prescribed. To their way of thinking, regulations and prescribing limits unfairly limits the ability of those who live with chronic pain to function and/or go about their daily lives. Pain advocacy groups (many of which are conveniently funded by the very pharmaceutical companies whose drugs are at risk) have repeatedly, and in many cases successfully, lobbied state and Federal legislators to prevent the passage of any legislation that might hinder their access to these drugs.

I don’t buy it, and apparently, neither does the FDA. Endo Pharmaceuticals have said they’re “…evaluating the options and reviewing the situation to opt for an appropriate path forward.” Should the company refuse to remove the product voluntarily (as the FDA has asked), the agency intends to take steps to formally require its removal by withdrawing approval (Kean, 2017).

References:

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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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New River Valley Region Reports Sharp Rise in Hepatitis C

HEAL Blog is the recipient of the ADAP Advocacy Association’s 2015-2016 ADAP Social Media Campaign of the Year Award
By: Marcus J. Hopkins, Blogger

The New River is 360 miles long that spans three states – North Carolina, Virginia, and West Virginia – flowing from south to north (one of only a handful of rivers in the world to do so) and serves as one of the most scenic rivers in the eastern United States. It’s known for hosting some of the best white water rafting and kayaking in the U.S., and for having the third-longest single-arch bridge in the world. Nestled along some of the most rural parts of the three states in spans, the New River Valley (NRV) region is also home to a growing Hepatitis C (HCV) epidemic.

HEAL Blog has covered the exploding rates of HCV in West Virginia many times since our inception in 2013, as well as having covered those rates in the rest of the Appalachian Mountain Region (AMR). What frustrates many advocates and healthcare workers who live and work in the NRV is that the sharp increase in new HCV infections is largely a product of pharmaceutical companies’ – and healthcare providers’ – making.

Map showing the New River Valley area

Photo Source: Snipview

During the early-1990s, Perdue Pharma using rural towns and counties in the NRV as testing grounds for OxyContin, one of the most widely prescribed opioid drugs of the late-90s and early-00s. HEAL Blog has previously reported on this issue (Cassandra in the Coal Mines), and I stand by the assessment that this region and its population have been systematically targeted by the manufacturers and wholesalers of prescription opioid drugs; wholesalers have, in fact, spent several tens-of-millions of dollars settling cases in West Virginia related to oversupplying the drugs and creating “pill mills” in the state.

There is a direct link between the opioid and heroin epidemics in this region and the vast increase in new HCV infections. In December 2016, Dr. Marissa Levine warned during a meeting of the Virginia Board of Health that the state should expect a “tidal wave” of HCV and HIV primarily related to Injection Drug Use (IDU). The state saw a 21.212% increase in new HCV infections in 2015, from 6,600 in 2014 to 8,000 in 2015 (Demeria, 2016). Dr. Levine also argued that the lack of a dedicated funding stream greatly hinders the ability of the Health Department to accurately capture and track the data accurately, an argument shared by virtually every state in the U.S.

Beyond just opioid drug injection, New River Health District Health Director, Noelle Bissell, M.D., has seen a spike in acute HCV infections (as opposed to chronic conditions) linked to tattoo parlors, the use of homemade tattoo guns at parties, and in people who report more than 10 sexual partners, as well as a trend in cases associated with IDU involving methamphetamine, and in pregnant women and women of childbearing age (SWVA Today, 2017). It should be noted, however, that the Centers for Disease Control and Prevention (CDC) specifically states that the transmission of HCV via sexual activity is “not common” (CDC, 2015). The virus is inefficiently transmitted in this manner, and while it is possible in the manner Dr. Bissell describes, much of the data provided during screening is self-reported by patients – self-reporting may lead patients to purposely omit or skew their answers in an effort to avoid embarrassment or mask other behavioral risk factors.

The rural areas along the NRV are very likely to be hit with a greater explosion of HCV and HIV, and HEAL Blog will be monitoring the situation in the coming months.

References:

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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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Heroin and Hepatitis Go Hand in Hand

HEAL Blog is the recipient of the ADAP Advocacy Association’s 2015-2016 ADAP Social Media Campaign of the Year Award
By: Marcus J. Hopkins, Blogger

Over the past year, HEAL Blog has paid a lot of attention to heroin, particularly in relation to the massive increase in heroin and prescription opioid overdoses in Appalachia, the Midwest, and the Northeast. While the purpose of HEAL – “HEAL” standing for “Hepatitis: Education, Advocacy, and Leadership” – is to specifically address issues related to Viral Hepatitis, and particularly Hepatitis C (HCV), when we cover issues related to prescription opioid abuse and heroin, we sometimes fail to connect the dots between the two topics. There is, in fact, a very high correlation between Injection Drug Use (IDU), People Who Inject Drugs (PWIDs), and the transmission of HCV: most new HCV infections in the three previously listed regions are related to IDU.

Sources of Infection for Persons with Hepatitis C

Photo Source: Pinterest

HCV and HCV-related co-morbidities (e.g. – Cirrhosis, Advanced Liver Disease) kill more Americans each year than any other infectious disease (Centers for Disease Control and Prevention, 2016). It is also one of the most expensive diseases to treat, with Direct Acting Agent (DAA) drug Wholesale Acquisition Costs (WACs) ranging between $50,000 and $100,000 for twelve weeks of treatment. This makes preventing the spread of HCV not only a matter of physical health, but one of fiscal health.

Despite pharmaceutical manufacturers’ arguments that the one-time cost of a regimen to achieve a Sustained Virologic Response (SVR – “cure”) is far cheaper than the long-term costs of other diseases, not to mention the long-term costs that arise if HCV goes untreated, state and Federal healthcare budget departments remain unconvinced. Budgeting processes generally focus on a single year, rather than accounting for multi-year spending, so arguing that long-term expenditures “cost” more hasn’t been an effective argument. Even with the clandestine pricing agreements and rebates – clandestine, because they are not made public due to “trade secrets” laws – states have yet to begin treating every HCV-infected client on their government-funded rosters. To do so would blow through entire pharmacy budgets several times over, in many states.

With PWIDs representing the highest number of new HCV infections between the ages of 18-35, state legislatures are starting to come around to the realization that the best way to avoid spending that money on expensive treatments is to put into place Harm Reduction measures that are shown to prevent the spread of blood borne illnesses. As it is very difficult and unfeasible to stop IDU, syringe exchanges can be put into place that allow PWIDs to inject using clean needles, rather than sharing them.

Syringe exchanges have, for much of the past forty years, been largely reviled by politically conservative politicians and states; many Republican politicians have repeatedly argued that state-sponsored syringe exchanges will only encourage bad behavior, serving as a tacit endorsement of IDU. Now that prescription opioid and heroin abuse has moved outside of the urban areas and into the suburban and rural areas that serve as bastions of the Conservative ideal, suddenly, these politicians are coming around to the idea.

Medical technician counting needles.

Photo Source: Daily Beast

In the past two years, several considerably conservative states have passed laws allowing syringe exchanges to be established – Indiana, North Carolina, Ohio, and Virginia, to name a few – largely in response to a relative explosion of new HIV and HCV infections related to IDU. The problems that politicians and their constituents once relegated to the big cities have come to their quiet towns, and have done so right under their noses. The lessons out of Scott County, Indiana, where nearly 200 people tested positive for HIV near the end of 2015 and into 2016, are still reverberating throughout the region, and people are starting to look at ways to prevent the spread of disease, rather than punish the behavior.

It is clear that the opioid and heroin abuse epidemic is not going away, anytime soon. Since we aren’t likely to stop currently addicted people from injecting drugs, the smartest path forward is to at least make certain they can do so safely.

References:

  • Centers for Disease Control and Prevention (CDC). (2016, May 04). Hepatitis C Kills More Americans than Any Other Infectious Disease. Atlanta, GA: Centers for Disease Control and Prevention: Newsroom Home: Press Materials: CDC Newsroom Releases. Retrieved from: https://www.cdc.gov/media/releases/2016/p0504-hepc-mortality.html

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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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West Virginia’s Rx Crisis

HEAL Blog is the recipient of the ADAP Advocacy Association’s 2015-2016 ADAP Social Media Campaign of the Year Award
By: Marcus J. Hopkins, Blogger

Over the past two years, HEAL Blog has paid much attention to the prescription opioid and heroin epidemic sweeping America’s suburban and rural areas, particularly in the 13-state Appalachian Mountain region. Nowhere is this truer than in those counties and states where coal mining is the predominant industry. Mining coal can be brutal work, and miners have historically led the pack in terms of health issues. From Black Lung Disease to various types of cancer related to the inhalation of coal dust and exposure to chemicals used by the mining industry, it is a long-standing reality that the hard life coal miners face to make a living will likely result in long-term illness, pain, and/or disability.

Compounding the myriad health issues related to mining coal is how physicians, pain advocates, and pharmaceutical companies have capitalized upon these issues in the pursuit profits. In the late 1990s, prescription opioid painkillers that were once reserved for only the sickest, most desperately hurting patients gained acceptance as an acceptable treatment for even the most minor injuries, and Purdue Pharma, maker of OxyContin, one of the most widely abused prescription opioid drugs, was key in ensuring that their products were made available to as many people as possible, despite knowing (and withholding information about) the highly addictive nature of these pills. Purdue even went so far as to provide physicians with tens-of-thousands of coupons offering free 30-day trials of OxyContin to give their patients. And, with its work- and lifestyle-related injuries causing their patients pain, coal mining regions quickly became a pipeline for overprescribed opioid drugs.

Purdue Pharma logo

Photo Source: Purdue Pharma

Recent investigations and lawsuits in West Virginia have revealed astonishing levels of overprescribing, abuse, and overdoses in the state. Drug shipping sales records from drug companies (which those companies fought to keep confidential) indicate that, between 2007 and 2012, 780,069,272 prescription opioid drugs were shipped into state, amounting to 433 pills for every man, woman, and child in the state of West Virginia (Eyre, 2016a). A single pharmacy in the town of Kermit, WV (population 392) received nearly 9 million hydrocodone pills in a period of two years. In Wyoming County, a mom-and-pop pharmacy in Oceana, WV received 600 times as many oxycodone pills than the corporate Rite Aid pharmacy just eight blocks away. This essentially unfettered flooding of prescription opioids into the state has resulted West Virginia having the top four counties – Wyoming, McDowell, Boone, and Mingo – in the United States for fatal overdoses related to prescription opioid drugs, with two more – Mercer and Raleigh – also in the top ten. Logan, Lincoln, Fayette, and Monroe counties sit in the top twenty counties for opioid-related fatal overdoses.

West Virginia map of opioid overdoses, by county

Photo Source: Gazette-Mail

To make matters worse, state regulations have required wholesale distributors to set up systems to identify “suspicious” orders for highly addictive narcotics, and to report those questionable orders to the state’s pharmacy board, a regulation that drug companies ignored. Between 2001 and June 2012, the pharmacy board received just two reports – both from Cardinal Health; since June 2012, 7,200 reports about suspicious orders have been faxed in to the pharmacy board. This sudden flow of reports only came after former Attorney General Darrell McGraw filed lawsuits against fourteen drug wholesalers. Despite these reports, the pharmacy board did nothing with them, even failing to investigate or forward the reports on to law enforcement authorities (Eyre, 2016b). The state recently reached a $3.5M settlement with drug wholesaler, H.D. Smith Wholesale Drug Company over its role in the problem (Associated Press, 2017).

The state has since made receiving these drugs more difficult, which has led many patients addicted to them to turn to cheaper, more readily available heroin, and as such has resulted in a sharp increase in the number of heroin-related overdoses, deaths, and disease transmissions (primarily Hepatitis B and C). The state’s first syringe exchange programs opened in the Fall of 2015, which will hopefully stem the spread of disease, but they are located only in the state’s major cities. Additionally, treatment facilities for addition are vastly overcrowded, underfunded, and unaffordable for those whose meager resources are already stretched past the point of breaking.

West Virginia continues to be a state to monitor, along with Indiana, Kentucky, Ohio, and Pennsylvania, where opioid addiction can often lead to the rampant spread of blood borne diseases that were once rare in the region. It is difficult to overstate the severity of the epidemic, and HEAL Blog will do its best to report on the situation.

References:

 
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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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Ohio’s Opioid Nightmare Continues

HEAL Blog is the recipient of the ADAP Advocacy Association’s 2015-2016 ADAP Social Media Campaign of the Year Award
By: Marcus J. Hopkins, Blogger

Yet again, Ohio’s drug users and first responders are being overwhelmed by heroin laced with a stronger opioid drugs. Seven fatal overdoses occurred in one day in Cleveland on Saturday, September 24 (Kaufman, 2016). The following Tuesday saw 27 heroin overdoses in a 24-hour period in Columbus, including two fatalities. One patient had been released from the hospital after being treated for an earlier overdose just thirty minutes prior to being picked up for a second overdose; there were two such overdose victims that first responders treated twice in the same day for being overdosed (Sullivan, 2016).

With the introduction of the powerful opioids, fentanyl and carfentanil, not only those who are addicted to prescription opioid drugs and heroin face increased risks; first responders, emergency personnel, and law enforcement officers also face increased risks of being sickened by exposure to these drugs during raids and rescue situations. So great are the risks to first responders and SWAT teams that the Drug Enforcement Agency (DEA) released a warning about the dangers of handling these powerful opioids without extreme caution (Jones, 2016).

All over the state of Ohio, first responders and crime labs are taxed to the breaking point responding to opioid and heroin overdoses. Jamie Landrum, a Cincinnati police officer, is quoted: “We were literally going from one heroin overdose, and then being on that one, and hearing someone come over [the radio] and say, ‘I have no more officers left,’” Landrum said. Three more people overdosed soon after that (Harper, 2016). At one overdose scene, a patient required at least four doses of Naloxone to be revived; after the fourth dose, he was still not responding.

Beyond the primary concerns of overdose is the reality that these drugs were never meant for use in humans, and therefore, has no human testing data from which to extrapolate even the most basic information: the lethal dose per kilogram of body weight, or how long carfentanil stays in someone’s system. This makes responding to overdoses more difficult.

Naloxone rescue kit

Photo Source: Yourblogondrugs.com

What this means for local, state, and Federal governments is more: more overdoses, more Naloxone, more time spent on each call, and ultimately more money in areas already strapped for resources. And while there’s great outcry for more resources, there seems to be little appetite for holding the pharmaceutical companies that produce these opioids financially liable for the havoc their products have wreaked upon the populace.

At this point, penalties and criminal charges have been largely reserved for prescribing physicians and individual pharmacists; holding anyone higher up the food chain responsible for the opioid epidemic has proven difficult, as the industry is very active in combating any efforts to either curb prescribing habits or to hold anyone in the industry accountable. What we really need are a few brave politicians who are willing to forego the promises of the industry that supports their reelection campaigns, and who will do what’s best for their constituents.
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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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President Obama Proposes $1.1 Billion in New Funding for Prescription Opioid & Heroin Epidemic

By: Marcus J. Hopkins, Blogger

Last week, the Obama Administration announced that the President is proposing $1.1 billion in new funding to address the prescription opioid abuse and heroin use epidemic that is currently sweeping our nation’s rural and suburban areas. The funds are earmarked to spend $920 million to expand access to medication-assisted treatment efforts, $50 million in National Health Service Corps funding to expand access to substance use treatment providers, and $30 million to evaluate the effectiveness of medication-assisted treatment programs under real-world conditions.

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President Barack Obama and others listen to Charleston Police Chief Brent Webster, foreground, during an event at Charleston, W.Va., where Obama hosted a community discussion on prescription drug and heroin abuse, Oct. 21, 2015. Photo Source: VOA News

If I sound dismissive of this effort, it’s because there are some strings attached to this proposal that makes it yet another example of how little people understand the severity of the issue and the difficulties associated with trying to address it in a rural setting. The $920 million will be allocated to states based on the “…severity of the epidemic and on the strength of their strategy to respond to it.”

The last part of that is the kicker – really, How Do You Solve a Problem Like Maria? One of the most difficult barriers to overcome in the hard-hit Appalachian Mountain Region is one of access; there simply are too few places for people with any health condition to turn.

For the past few years, the state of West Virginia has been besieged by budgetary, economic, and employment woes. In a state where the per capita income is $22,966, it’s hardly surprising that financial issues abound. Those issues are further compounded by a dearth of private and public services available across the state. We have food deserts (areas where there are no grocers or markets providing fresh foods), healthcare deserts, utility deserts – if a map of all the available services were created of West Virginia, it would resemble an actual desert, replete with a handful of oases where these services are available.

Despite the state’s efforts to combat a nearly two-decade-long opioid abuse and heroin use epidemic in the state, the fact of the matter is that there just aren’t enough physical resources – literally, buildings in place – with the capacity to serve as treatment hubs. More troubling is a proposal by the current Republican legislature to combine county health departments into nine multi-county districts, essentially forcing residents from dozens of already underserved counties to have to travel even further to get to a single health department facility. The report suggests potential savings of $12.5 million or more to the state…but doesn’t bother to take into account issues of accessibility, affordability, or the impact that this would have on one of the least healthy states in the nation.

While additional funds are always appreciated, if past precedent is indicative of anything in West Virginia, it’s that Federally-allocated, but state-administered funds for state improvements rarely go very far in a state beset by geographic and economic hardships that have been allowed to go unaddressed for decades, intransigence and failure to adapt being the name of the game in the state. How is West Virginia – the state with the highest rate of opioid overdoses in the nation – supposed to compete for these funds when the state’s legislators are actively attempting to cut healthcare costs at the expense of healthcare access? If we are to receive funds based on the strength of our plans to confront this healthcare crisis, how will it look when, rather than expanding access, we are going about shrinking it?

This additional funding proposal has the potential to be a game changer…in states with legislatures who actively seek to expand access. To be honest, I am somewhat concerned by the caveat that these funds are designed to support medication-assisted treatment efforts. Even if they are effective in reducing dependency on opioid drugs, it seems ironic that addiction to one type of drug should be addressed by the use of another type of drug. Perhaps this proposal needs a bit more work, and a lot more focus on proven harm reduction efforts, such a accessible and legal syringe exchange programs, accessible treatment and rehabilitation centers, and more attention paid on the prescribing side of the issue.

Overall, I thank the President for his consideration, and welcome him to expand his thinking to include other types of treatment.
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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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Appalachian Syringe

By: Marcus J. Hopkins, Blogger

If the heroin epidemic of the 1970s taught us anything, it’s that heroin use mostly affects the inner city minority communities, so white people who live outside of those cities don’t have anything to worry about, right?

Wrong. Much to the chagrin of anti-drug propagandists, this narrative was then, and is now, entirely false. One of the biggest fallacies of America’s drug policy is the fact that most of the prevention-based legislative efforts have been based off of similar false narratives, shoddy “science (most of which is relegated to stereotyping drug users), and a desire to punish, rather than prevent.

The latter – punishment over prevention – is a recurring theme in American drug politics, and that is arguably best reflected in how our states approach the issue of syringe exchanges. Despite the Appalachian Region (including AL, GA, KY, MD, MS, NY, NC, OH, PA, SC, TN, VA, & WV) having some of the highest rates of opioid prescriptions per 100 people, the highest rates of Hepatitis B and C, and some of the highest opioid-related overdoses in the nation, there has been little political will to enter into the scientifically uncontroversial, but politically controversial, business of syringe exchanges.

droppedimage

Photo Source: Bathroom Sketch

The premise behind syringe exchanges is this – we understand that people are going to use injection drugs; providing them with a safe way and place to exchange used needles for clean ones helps to stem the spread of virulent diseases that often run rampant within these communities. Sadly, the punishment-based approach to dealing with drug abuse operates off the premise that drug abusers know the risks of their bad habits, and if they’re stupid enough to use injection drugs, they deserve whatever health consequences come their way. Not only is that premise callous, it is also costly.

In the past few years, some states have begun to learn this lesson the hard way – Scott County, Indiana’s 2015 epidemic of IDU-related HIV and HCV, for example – and have begun to recognize that the conventional approach to dealing with the opioid and heroin epidemics has been largely unsuccessful. Rather than quelling the epidemic, the punitive approach to coping with addiction has simply driven it underground where it cannot be effectively monitored, diagnosed, or treated. This has helped to create a dangerous breeding ground for the spread of disease as a result of IDU that was largely thought to have ended in the 1990s.

Thankfully, several states’ law enforcement communities and local governments have recognized that the punitive approach to this problem has not brought about satisfactory results, and have come to be some of the most ardent supporters of both syringe exchange programs and rehabilitative and recovery services – two measures that research indicates as being the most effective tools in stemming the spread of preventable IDU-related disease exposure. These programs also offer support staff who are there to engage participants in confronting their problems with addiction, as well as helping to provide linkage to other important social services, such as housing and healthcare.

While we clearly have a long way to go in providing addiction and recovery services to the underserved communities in Appalachia, there are positive strides being made and steps being taken, although this is happening mostly on the local level. The best way to extend these programs to hard to reach communities is to advocate for their inclusion in state-level legislative initiatives, and doing that will require advocates to demonstrate how these programs help to save states money in these times of economic uncertainty. When faced with empirical and quantitative evidence, even the most fiscally conservative debt hawk can’t deny that these measure save not only lives, but precious resources.
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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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