A New Push Towards Reducing Overdose Deaths in Kentucky
Harm reduction is getting more attention as the opioid crisis evolves into more of an overdose crisis. Typically viewed as a product of the late ‘80s according to the National Institutes of Health, it didn’t reach Kentucky until the mid-2010s when the state legislature passed a measure that established harm reduction services in many local health departments statewide. Now, it’s prevalent enough in the community to meet the fentanyl overdose crisis with fentanyl test strips.
What’s Harm Reduction?
The state of Kentucky defines harm reduction as “a set of ideas aimed at reducing negative consequences associated with substance misuse for individuals, their families and communities by meeting people where they are.” This being as broad a definition as it is, harm reduction efforts in Kentucky have seen syringe exchange practices and safer use practices, among other things. They’ve even involved attempts to provide those with a substance use disorder to food, healthcare and insurance.
Harm reduction, however, is about more than drug use. It applies more broadly to any manner in which people detrimentally harm themselves unintentionally. Shreeta Waldon, executive director at Kentucky Harm Reduction Coalition (KyHRC), compared harm reduction to booster seats for children to explain that it’s more about general prevention of harm than about drugs.
“People said, ‘We need [kids] to be in a seat, not a car seat because they’re not a baby.’ They need to be in a seat that adequately supports them the way normal seating supports adults in the event of an accident,” Waldon said. “Well, that’s prevention, right?”
The Substance Abuse and Mental Health Services Administration defines harm reduction as a service pipeline that engages directly with people who use drugs and aims to “improve the physical, mental and social wellbeing of those served.”
The Fentanyl Focus for Harm Reduction
Despite the miscellany of concerns that fall under harm reduction’s purview, the fentanyl overdose epidemic is a major focus for KyHRC. Fentanyl contributed to 71% of the fatal overdoses in 2020. Based in Louisville, KyHRC launched a program to distribute fentanyl test strips by mail. It’s a particularly unique effort aimed at upending the fentanyl trend, which demonstrates how serious the situation is but also how seriously the organization takes it.
Many people struggling with substance abuse nationwide are overdosing, not because they necessarily took more than they could handle of the substance they typically use. Rather, they are overdosing because the drugs they used were laced with fentanyl, usually unknown to the user. That’s the point for KyHRC. They want people to be equipped with what they need to use safely by first testing it to see if fentanyl is detected.
“It is more important now because they have adulterated all of the substances, all drugs, marijuana, cocaine, meth,” said Erica Williams-Archie, executive administrator at KyHRC. “If you don’t know that there’s fentanyl in the drug supply, then it could kill you instantly.”
Getting Fentanyl Test Strips from KyHRC
Kentuckians are able to access an online form to request not only strips but also naloxone. Naloxone is a synthetic drug mirroring morphine that blocks opiate receptors in the nervous system. The hope, according to Williams-Archie, is that residents will actually take the strips and use them rather than scoffing at the need to do so. It doesn’t even necessarily mean for some that knowing fentanyl is present is even expected to stop users.
“But with knowing that there’s fentanyl in it, then you can cater your use toward that, so you can possibly not use as much,” Williams-Archie added.
Advocacy and Opposition
Back when harm reduction services were established by law in the state, the fentanyl trend was barely getting started at a rate so imperceptible that no one had noticed yet. That’s when Linda Squire was working hard to find resources like KyHRC to assist her in getting help for her son, Johnny. We covered his story here, but part of the desperation his mother experienced was because there was genuinely less effort being made back then to provide the necessary resources.
That’s why the state legislature passed the bill the very same year Johnny died. He was one of the only four people whom Louisville lost to fentanyl in 2015. His mother has since become a warrior for harm reduction, albeit not as part of KyHRC’s staff. She now runs the local chapter of G.R.A.S.P. — Grief Recovery After a Substance Passing.
The Biden Administration has presented a $30 million plan to use harm reduction services like KyHRC all over the country to mitigate drug overdose deaths. This comes in response to over 107,000 fatal overdoses nationwide last year. It was delivered as part of the $1.9 trillion doled out by the American Rescue Plan Act. Critics point to harm reduction programs, however, as legally fringe. In some cases, they accuse such organizations as aiding and abetting criminal substance abuse. These arguments make harm reduction a controversial service market in the public sector.
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