I vividly remember the day I first stepped foot into my local Needle/Syringe Exchange Program. I was utterly terrified of what might happen once I walked through that door. It would be the very first time I had ever admitted out loud to anyone other than my fellow addict husband and our dealer, that I was in fact, an intravenous drug user with an out of control habit.
My mind immediately raced to the most extreme and ugly scenarios I could possibly think of. At the time, I knew next to nothing about this type of service, aside from the bare minimum and the usual stereotypes. Would they look upon me with total shame and disgust? Would they somehow end up getting in touch with my Physician or my family members, divulging my dirty little secret? Force some unwanted treatment program down my throat? Or would they just turn me away altogether? No longer able to afford to purchase sterile supplies and syringes from the pharmacy for both my husband and myself, I knew full well that if I wanted access to sterile supplies, I would have to get myself through that door. Accompanied by my husband, I took a deep breath, lifted my hand to the small doorbell located to the right of the door frame, closed my eyes, and rang the bell…
We were greeted by a young nurse who quickly confirmed that I was looking for the exchange, and then herded us both through the doorway. She proceeded to explain the process, which to my extreme relief, was completely anonymous and free of charge. She assured me that there would be no pressure to engage in unwanted treatment programs, or any judgements whatsoever. The nurse then pointed towards a small room located off to my right hand side, nodded her head and said “help yourself, Hun.” I followed her directive, and timidly entered the small room. My eyes were immediately drawn to the back wall, which was lined with boxes stacked up taller than me.
Oh my…. This was HARM REDUCTION HEAVEN! Why, oh why, had I waited so long?
Sterile syringes, tourniquets, single use disposable cookers, sterile water for injection, alcohol swabs, and cotton filters galore. But it didn’t stop there. There were snort kits, packets of ascorbic acid, stems, screens, condoms and plenty of easy to understand booklets/literature on safe injection, drug use and safe sex. Absolutely everything a user needs in order to stay as safe as possible and avoid the possibility of contracting communicable diseases or dangerous infections. I could be safe while I struggled to find my path to recovery. On top of it all, there was no stigma, no stereotypes and no pressure. No one to give me that glaring look of disapproval or disgust. Just acceptance.
Good ol’ Harm Reduction. Every day, the policies and principles implemented through Harm Reduction initiatives are working to ensure people who use drugs are able to do so safely. But Harm Reduction is so much more than just passing out a few clean needles to intravenous drug users. ‘Harm Reduction’ covers a wide range of services and community supports such as Maintenance Treatments (Methadone, Suboxone, etc.), Naloxone distribution, supervised consumption sites (such as InSite Vancouver, where not a single overdose death has ever occurred), peer support and outreach programs, as well as communicable disease testing and education; all free of stigma. Since drug use and addiction are public health issues, not criminal, this movement also works to reform drug policies and protect the rights of users. Harm Reduction recognizes and “accepts that many people who use drugs are unable or unwilling to stop using drugs at any given time.” It helps users to remain safe and as healthy as possible while using, so when and if the time comes that they are ready to pursue treatment options, they are able to do so.
While many dispute the effectiveness of Harm Reduction initiatives, the amazing impact these programs have is well documented in study after study. One major benefit of these initiatives is the reduction in communicable diseases and infections. “International evidence demonstrates that effective communicable disease prevention programming for people who use drugs can reduce the transmission of HIV, HCV, HBV, and other harms related to drug use.” Providing users with the proper education regarding disease and infection, as well as the sterile supplies needed to implement safe injection practices not only benefits the user, but the entire community as a whole.
Speaking of benefitting the community as a whole, Harm Reduction initiatives have also been shown to help reduce high risk behaviors such as criminal activity to fund addiction, drug use and discarded needles/supplies in public places, as well as preventing death and overdose. Not only does Harm Reduction offer all of these amazing benefits, but the initiatives are also cost effective! An Australian study found that for every dollar invested in needle exchange programs, four dollars will be returned. It showed the programs result in substantial savings in healthcare related costs, as well as averting new HIV and HCV infections and costs to treat it.
It felt truly amazing to have found a place where I was able to be myself without any judgment, stigma or shame. I was able to be open, honest, and learn to keep myself safe while I continued to struggle with my heavy drug use. It made me want to come back, again and again. They didn’t see a weak, pathetic, and hopeless junkie. They saw me….and for the first time, I saw a glimmer of hope. That same amazing experience and glimmer of hope was echoed throughout the Methadone Maintenance Program I entered into after my many failed attempts at complete abstinence. Each failure pushed me deeper into the abyss of addiction and robbed me of any remaining hopes of getting my life back. Yet through MMT, I have been able to regain control of my use and my life, as well as maintain over three years free from opiate abuse.
Without the amazing initiatives of Harm Reduction, I am near certain that I would not be here today to write this article telling you all about it. I would have been another young addict who sadly ended up as just one more forgotten victim of overdose.