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Helping Drug Users Survive: ‘Harm Reduction’ Gets Federal Support

GREENSBORO, NC — A slim young man quietly enters the room as he waits for free supplies to help him avoid death: sterile water and rice cookers to dissolve illegal drugs. clean syringe Alcohol wipes to prevent infection; and naloxone, a drug that can reverse drug overdose. The sign on the wall – “We stand for drug users who love them the way they are” – feels wrapped up. hug

It’s the first day a drop-in center in its residential neighborhood has opened its doors since the coronavirus forced it to close in spring 2020. “I’m so glad you all reopened,” the man whose real name is Jordan, told Volunteer. Apply for the person who handed him a paper bag full of paper. As heavy metal music echoed through the speakers in the background, he asked for extra naloxone for his rural friends. which is an hour away which he said was rare throughout the pandemic.

Overdose deaths rose nearly 30 percent in the 12 months ending in November to more than 90,000, according to preliminary federal data released this month. This indicates that 2020 has broken past death records. The alarming increase during the pandemic has been a number of contributing factors. This included widespread unemployment and dismissal from work. Access to drug addiction treatment and medical care is declining. and an even more dangerous supply of illegal drugs after the country was shut down.

But being forced to isolate for people with addiction and other mental health problems Probably one of the biggest problems now is reopening the country. Biden’s management is providing support behind the controversial approach the center operates. which is called harm reduction Instead of helping drug users succeed in quitting smoking. The main goal is to reduce the risk of death or communicable diseases such as HIV by keeping the equipment sterile. Fentanyl and other dangerous substances detection tool or even a safe area to nap .

The project has long been under attack to allow drug use. But President Biden has expanded its harm reduction efforts. One of his drug policy priorities which was the first president to do so. The American Rescue Act covered $30 million specifically for evidence-based harm reduction services. This is the first time Congress has allocated funds specifically for that purpose. Funding, though modest But it was a victory for the project. both in symbolic and practical terms. Because they often use a limited budget.

Daliah Heller, director of the drug abuse initiatives at Vital Strategies, a global public health organization, said: “This is a big sign. Realizing that not everyone who takes medication is ready for treatment. “The harm reduction program says, ‘Okay, you’re on drugs. How can we help you stay safe, healthy and alive first?’”

Although some programs of this nature Run by the North Carolina Survivors Union. Some supplies were able to be provided throughout the pandemic — through the window. Pick it up by the roadside or even send it in the mail — almost everyone has stopped inviting drug users inside. Many customers, such as Jordan, have stopped coming, losing their trusted security network.

Some former servicemen at the Greensboro Center have died or disappeared. Many have lost their homes or jobs. at the same time The center was flooded with new customers. And now there is a problem in sourcing enough raw materials.

“The number of battles that people have during this time both unknown and unanswered It’s really difficult,” said Louis Vincent, executive director of the Survivors’ Union.

Still, many elected officials and communities remain against the provision of drug supplies. This includes the recent addition of test strips to detect illegally produced fentanyl. This has been shown in most drug overdose deaths. Some also say that syringes from harm reduction projects end up littering nearby neighborhoods. Or such projects cause more crime? Researchers dispute both claims.

West Virginia recently passed a law making it harder for the syringe service program to operate. Although there has been a significant increase in HIV cases from intravenous drug use. The North Carolina legislature weighed a similar proposal this spring. and select officials in Scott County. India The syringe exchange helped curb the massive HIV epidemic six years ago voted to shut it down this month. Dispensing syringes may have contributed to death from overdose.

“I know people who are alcoholics. And I don’t buy them a bottle of whiskey,” he said. “And I know people who want to kill themselves. And I don’t buy ammunition for their guns.”

Many harm reduction programs are run by people who have used the drug in the past, or sometimes still do. and the fight against addiction mental illness or other health problems Their own erupted during the epidemic as well. In Baltimore, Boston, New York and elsewhere, beloved movement leaders have died from drug overdose. chronic health problems and other reasons during the past year Their deaths left a gap in their efforts to continue their service.

Mr. Vincent, who became addicted to opium from his long battle with bipolar disorder. Back in illicit drugs again this spring She was nervous not withdrawing from her body, she said, after trying to switch from methadone to another appetite-suppressing drug like methadone. But without success, she later learned that a small amount of fentanyl she used was mixed with xylazine. This is an animal sedative that can cause skin lesions. she arrived at the hospital Her hemoglobin level was very low. She needs a blood transfusion.

At the beginning of the pandemic, Ms Vincent said street drug prices had skyrocketed. Then drugs sold as heroin, amphetamine or cocaine began to be cut with unfamiliar flavorings. Fentanyl was always available – including counterfeit drugs sold as prescription painkillers or anti-anxiety drugs. But so are substances such as xylazine, which appear in illicit drugs from Philadelphia to Saskatchewan.

“It’s just poison,” said Vincent, who returned to treatment with methadone. “The drug supply is unlike anything we’ve seen before.”

In the afternoon of the reopening of the center A young woman asked to review the method of injecting naloxone. And if Vincent can explain what an overdose looks like? An old man asked if there was any food to eat with a clean syringe. Volunteers stick snacks in the microwave for him.

In addition to the project here Vincent also supports the Nationwide Harm Reduction Service as executive director of the National Urban Survivors Union, a large non-profit organization. In 2016, her 19-year-old daughter died of a heroin overdose while she At an inpatient treatment center without naloxone on hand, she said.

Naloxone is more prevalent now, but Vincent wants to see another life-saving tool become commonplace: a drug-detection program that will help people find out what substances are in illegal drugs before they are. he will take them Such projects exist in other countries such as Canada, the Netherlands and New Zealand. Another type of harm reduction program used in other countries where people use illegal drugs under medical supervision in case of overdose remains illegal here after the group tried to open a project in Philadelphia. Philadelphia has lost in court so far.

“we cThere should be a real-time surveillance system instead of waiting for the coroner’s death to be reported,” Ms Vincent said. “Will it change the game?”

She found out about xylazine in a drug she was taking recently. This was done with a device called a Fourier transform infrared spectrometer. which donors gave to her group this year. Street drug samples can be identified in minutes.

Jordan, 23, is traveling from Stokes County. near the Virginia border The pre-epidemic drug overdose death rate is nearly twice the state average. He said his cousin was hospitalized weeks ago after an overdose of fentanyl. The test results showed that there were heavy metals remaining.

“At least 50 people in my area were rescued by Narcan from here,” he said, accepting several boxes. Each box contains 10 vials of the injectable antidote. “Even my grandmother knows how to handle it.”

Many harm reduction programs including this program Help connect people with drug therapy. or even sometimes provided But Jordan counts himself among the many drug users who ignore that route. at least for now The closest programs are in Greensboro or Winston-Salem. each strong distance from his home and treatment with appetite suppressants such as buprenorphine or methadone. While it has been proven to save lives. “It really didn’t work for me,” he said.

County which includes Greensboro which is the third largest city in North Carolina. There were 140 drug overdose deaths last year, up from 111 the previous year. This figure does not include deaths from infections caused by injectable drugs. including the woman’s fiancé who walked into the center on the evening of the day it reopened. by calling Ms. Vincent that “Where is Louis?”

She met Vincent when they were both patients at a methadone clinic six years ago. and come to the center regularly to have syringes and naloxone checked. She and her fiance tried to stop using drugs during the pandemic. By feeling uneasy from new foreign objects. that appeared in the supplies But her fiancé developed a high fever last December. and was admitted to the intensive care unit of the hospital who is seriously ill with endocarditis from infection Heart valve infection resulting from injections He died before Christmas.

“Is everyone having a meeting tonight?” the woman asked Miss Vincent. It cited support groups at the center several times a week before the pandemic.

“They will start over soon,” Vincent assured her. “Connection is more important than we think.”

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