August 31 is International Overdose Awareness Day. People across the globe have organized community events to fight, to build and to grieve for those who are no longer with us. Harm Reduction Coalition fights, builds and grieves with them. We have all lost too many parents, children, siblings, friends and neighbors.
Overdose is the leading cause of death for people in the U.S. under 50 years old, which represents the highest rate of drug-related mortality in the world. Overdose deaths are preventable, and today we also celebrate the lives and resilience of each person who got another day when their overdoses were reversed by naloxone and other prevention programs.
Ending the overdose crisis will take all of us
We may not see a year with no overdoses in our lifetimes, but reducing harm and healing from the multi-generational harms of the drug war will require collective action. In the last few years, we’ve seen harm reduction as a movement grow. There is more awareness and support for naloxone. And yet, so many barriers remain to getting overdose prevention resources to the people who need them. We need universal access to naloxone and harm reduction services, on demand access to evidence-based treatment, and everything in our toolkit that we know works. But that won’t be enough if we don’t also stand together to fight against racialized drug policies, heal from stigma and shame, and challenge the systemic harms faced by people who use drugs and their families. It will take all of us.
For 25 years, Harm Reduction Coalition has been uplifting community-led initiatives from grassroots programs to political and structural advocacy campaigns to reduce overdose and improve safety and wellbeing for people who use drugs. Our overdose prevention work is centered in expanding effective treatment and care, increasing access to naloxone, and changing the narrative of people who use drugs.
Increasing access to naloxone
In San Francisco, Kristen Marshall directs The DOPE Project, the largest single-city naloxone distribution program in the country that focuses on getting resources into the hands of people who use drugs. The DOPE Project has trained people responsible for reversing more than 1,600 overdoses last year, and another 1,100 so far in 2019. People who use drugs and their communities in San Francisco use naloxone provided by The DOPE Project to reverse more overdoses each year than any group of first responders.
“This is about people who use drugs saving each other. If your community is wondering what you can do to reduce overdose, get naloxone into the hands of people who use drugs. Once you’ve done that, look at the systemic issues that are impacting people who are at risk of overdose – including policing, homelessness, and systemic racism – to change the conditions that make overdose happen to begin with.” — Kristen Marshall
Targeting regional initiatives to expand harm reduction services
The HepConnect initiative will expand access to harm reduction services and education through funding and technical assistance in five states experiencing the highest increases in injection-related Hepatitis C. While the initiative primarily focuses on reducing new cases of injection-related infection, more than $6 million of funding will go into these states to expand harm reduction services, including naloxone distribution and overdose prevention programs. In addition, our staff have launched a statewide initiative to expand harm reduction access points for people in the frontier state of Wyoming.
Improving capacity and structural competency of healthcare providers: Harm Reduction Coalition’s Medical Director Dr. Kim Sue works with health care providers across the country to elevate best practices and expand low-threshold access to evidence-based buprenorphine treatment. Dr. Sue works with practitioners to challenge stigma, educating on access points to treatment and promoting evidence-based care to providers who work with people who use drugs. In addition to this work, we’ve worked with our partners at RTI International to offer implementation resources to expand access to naloxone in correctional and closed settings.
“As long as it’s easier to get heroin or fentanyl than it is to get medication treatment for heroin or fentanyl, we will continue to see unrelenting numbers of overdose deaths. Getting kicked out of treatment programs for smoking, for example, or being tapered off medication for ongoing heroin use or cocaine use, means we as providers might have the wrong goals. The goal is not to dictate exactly what people do with and put into their bodies but to help them stay alive and engaged, make more healthy choices and achieve other life goals.” — Dr. Kim Sue
Changing the narrative of people who use drugs
Expanding access to treatment and harm reduction services is critical to addressing the overdose crisis, but at the core of disparities in access to quality care is stigma towards people who use drugs. Stigma and shame play a detrimental role in racialized U.S. drug policy and access to harm reduction programs that reduce risk, prevent fatal overdoses and improve health outcomes for people who use drugs. This week, our staff participated in direct action and events to raise awareness and demand change from political leadership to address the overdose crisis through evidence-based programs like safer consumption sites, overdose prevention programs, and challenging policies centered in stigma that harm people who use drugs and their communities.
Uplifting community initiatives
There’s no one-size-fits-all program that works for every community. We are inspired by the way people and organizations across the country have designed their own campaigns, programs and initiatives to address this crisis in their own communities:
- The Urban Survivors Union (USU) launched the Reframe the Blame campaign to take a stand against drug-induced homicide laws. The campaign is led by people targeted and directly impacted by racist and classist drug war policy and insists that prohibition is responsible for untimely drug-related death, not individual dealers.
- In Baltimore, Bmore Power launched the Go Slow initiative to educate the local community to save lives, reduce harm and address risk to Hepatitis C and HIV/AIDS in the community.
- In Seattle and California, Yes to SCS calls on people who use drugs, their families, neighbors and community members to support safer consumption spaces (SCSs) to prevent fatal overdoses through evidence-based alternatives. Around the world, SCSs have been saving lives for more than 30 years, impacting drug-related deaths, public drug use and discarded needles, and the spread of diseases like HIV and Hepatitis C. Other cities, including New York, Denver, Portland and Philadelphia are leading similar local campaigns and initiatives.
- Queering Harm Reduction (QHR) is a collective project focused on making radical, LGBTQ-oriented harm reduction information available and accessible to all. QHR maintains a library of resources at the intersection of substance use, sex, queerness, race and disability.
- Chicago Recovery Alliance is working toward “any positive change” with a collaborative, real-time drug-checking project and other mobile harm reduction services that reduce risk and improve access to resources for people who use drugs. Other services include syringe access, harm reduction counseling and referrals into evidence-based treatment programs.
We are inspired by the work of our partners and colleagues across the country and are committed to continuing to support and uplift their work. If you want to share how you or your organization participated in a community event or action, please tag us on Twitter (@HarmReduction), Facebook or Instagram and we will repost and share to our pages.
Through the weekend, Harm Reduction Coalition staff will be with our families, friends and communities to honor International Overdose Awareness Day in our own ways. We encourage everyone whose lives and communities have been affected by fatal overdoses to do the same. Find a way to observe International Overdose Awareness Day in your community at www.overdoseday.com.