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Knox Drug Coalition Director Pits Prevention against Harm Reduction

by Landmark Recovery

February 10, 2023
A class of high school students who would benefit from primary prevention (or early prevention) programs more than from harm reduction initiatives according to the Metro Drug Coalition. Unfortunately, one's more costly than the other.

The Metro Drug Coalition (MDC) in Knoxville, Tenn. works with community organizations to fight addiction and overdose. They do this in many ways from hosting pill takebacks to advocating for treatment-friendly policies and lobbying for prevention measures. MDC Executive Director Karen Pershing has provided new insights on early addiction prevention through Education Week magazine

Early Prevention of Addiction 

Education Week, which covers national education news, recently published a piece about old and new drug prevention tactics. The article focused on how new research has debunked and replaced tactics from the Nancy Reagan “Just Say No” era.  

To explore the more modern, data-driven strategies, they solicited the expert contributions of Exec. Dir. Pershing. Since high school- and college-age kids were commonly found to be experimenting with drugs and alcohol in the ‘80s as they do now, prevention programs have traditionally targeted adolescents. Contemporary data shows prevention is more effective if it targets children much younger.  

“You’ve got to talk early and often,” according to Pershing. She added that lessons ingrained in children early “are stepping stones. You’re not necessarily talking about drugs to young children. You’re teaching them how to have respect for your mind and your body.” 

In some cases, this may even be at odds with what harm reduction advocates propose.  

Primary Prevention vs. Harm Reduction 

Primary prevention, or early prevention, is actually a distinct set of programs aimed at preempting substance abuse initiation in kids. The idea is that, in order to curb overdose deaths and other adverse outcomes, we have to intervene before kids can even try these substances. This would involve targeting so-called gateway drugs and educating kids about their effects. It’s also about, as Pershing pointed out, teaching kids how valuable their minds and bodies really are.Once kids start abusing substances, primary prevention (or early prevention) may be too little too late. At this point, the Metro Drug Coalition agrees that you need to take harm reduction measures.

Harm reduction is about what we do for those who have already developed self-destructive habits with drugs or alcohol. When they develop addictions, they endanger themselves with each use. Harm reduction tactics aim to encourage treatment and recovery but allowing them to make those decisions at their own pace. To accomplish that, they have to be able to safely use until the moment they actually take the necessary steps toward recovery. Reducing the harm they do to themselves in the meantime has become the more popular alternative to primary prevention.

Lots of institutions are responding to harm reduction advocacy amid the opioid crisis. A reported 40% of schools nationwide now have Narcan on hand. The embrace of early prevention tactics, alternatively called primary prevention, hasn’t been as universal or obvious. 

A wealth of primary prevention programs are available, numbering 200 commercial programs as of 2014 according to the National Institutes of Health. Prevention experts like Pershing, however, say they’re severely underutilized and under-resourced. She was vocal about that in Jan. 2023, too. 

“I’ve been in this position for 12 years. Our focus has always been primary prevention; now we’re doing harm reduction,” Pershing said. 

Pershing claimed prevention-based education has always been a hard sell. “You don’t necessarily see the impact of primary prevention,” she said. “People want a quick fix.” 

It’s easier to prepare for what’s considered an inevitable overdose than to proactively preempt it. Narcan is easy to acquire. Reorganizing education to comply with drug prevention programs, however, requires more time and personnel.  

MDC’s Harm Reduction Tactics 

Pershing’s point, of course, isn’t that harm reduction is bad. She advocates, however, that it supplement early prevention, which would be more effective. Whoever overdoses but is saved with Narcan is lightyears behind the peer who never used in the first place.  

MDC has shifted its focus toward harm reduction as the opioid epidemic has worsened. WBIR 10 News reported on Jan. 5, 2023 that MDC began disseminating fentanyl test strips. It’s an increasingly popular harm reduction strategy. Kentucky Harm Reduction Coalition rolled this out in 2022. Las Vegas has also seen similar efforts arise from a grassroots level to combat a sharp overdose uptick. 

The point of distributing fentanyl test strips is to help those using other drugs. It theoretically helps those abusing any of a variety of substances know for sure whether or not the Xanax or heroin (or whatever else) they’re using contains fentanyl. If it does, they can moderate their dosage accordingly since fentanyl’s high mortality rate is largely attributable to people not knowing it’s there. 

Does Harm Reduction Stop Overdose? 

While harm reduction efforts will not stop overdose, they have proven to keep more people alive. There’s no cure-all for the opioid epidemic. Overdose is fairly inevitable. Nevertheless, fentanyl test strips have proven effective at getting some to avoid fentanyl in Tennessee. A pilot program in the state recently showed that 81% of people who used the test strips actually changed their behavior. 

“It was interesting because it wasn’t just, ‘We use less.’ No, it was, ‘I decided not to use,’” said Anthony Jackson, Jr., director of prevention and early intervention services for the Tennessee Department of Mental Health and Substance Abuse Services. 

This gives state officials hope for the effectiveness of harm reduction tactics. As such, MDC is one of many cogs in the machine expected to comply with this strategy.  

If you’re up for cutting your losses like those who tested their purchase and chose life over detrimental risk, call our addiction specialists at 865.448.5714. If you want to make arrangements for a loved one to receive addiction treatment for drugs or alcohol, go to Landmark Recovery of Knoxville.  

Our staff can even arrange for your transportation to the nearest facility. Don’t wait until after your next high because there’s a chance you won’t survive it. Don’t keep testing the odds. Seek help ASAP! 

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About the Author

Landmark Recovery

Landmark Recovery

Landmark Recovery was founded with a determination to make addiction treatment accessible for all. Through our integrated treatment programs, we've helped thousands of people choose recovery over addiction and get back to life on their own terms. We're on a mission to save one million lives over the next century. We encourage all those struggling with substance use to seek professional help.