BUCKHANNON — It’s not all about needles.
That’s the point, Laura Jones, the executive director of a free healthcare clinic in Morgantown, tried to drive home Friday night during a special presentation at the Public Safety Complex. Milan Puskar Health Right was the first free healthcare clinic in the state to offer the LIGHT syringe access program, a multi-faceted initiative based on the theory of harm reduction that, among a range of other services, supplies opioid and heroin users with syringe access kits and safe syringe disposal.
But access to clean syringes is just part of what the LIGHT program — which stands for Living in Good Health Together — provides, Jones explained to the group of first responders and community leaders gathered in the PSC’s Community Training Room.
“It’s not just about giving out syringes,” Jones said. “It’s a whole program that involves assessing people for all kinds of concerns.”
The LIGHT program not only helps drug users access clean syringes, safe syringe disposal kits and Naloxone (the general name for the opioid antagonist that can reverse a heroin overdose
and HIV testing; wound care; addiction treatment referrals; referrals to primary care doctors; family planning supplies; mental health counseling; peer recovery support; and social service referrals.
So, what does the harm reduction program at MPHR have to do with Upshur County?
On Friday evening, Upshur County Health Department nurse director Sue McKisic announced she’d asked Jones to speak because the health department will soon be partnering with MPHR to bring harm reduction clinics to Upshur and Lewis counties on the second Thursday of every month.
Beginning in May, the clinics will take place in two locations — in the parking lot of the health department and at the intersection of Routes 4 and 119 in an effort to serve both city and rural county residents. The clinics will take place in white, unmarked vans.
“The addiction crisis, which has resulted from the opioid crisis, is an ongoing problem and concern,” McKisic said at the outset of what she said would be the “first in many harm reduction educational presentations.”
“We need to be educated and view this with an open mind … so we can understand the issues we are facing, whether it be as a parent, a child, a community leader or an addict,” McKisic added. “The epidemic literally affects every one of us.”
The LIGHT program’s ultimate goals are to stop the spread of diseases that result from shared needle usage — including Hepatitis C, Hepatitis B and HIV — and hopefully, encourage intravenous drug users to seek treatment. The need for harm reduction programs in stem from the accompanying health crisis in West Virginia. For instance, the Mountain State is number one in the country in the incidence of new cases of Hepatitis B,
which are likely a result of shared needles and the opioid epidemic, Jones said.
There are also a high number of babies born in the state with Neonatal Abstinence Syndrome, the correct term for children who have been exposed to opioids in utero. Abstinence syndrome means the babies are going through withdrawal — not that they are addicted, Jones said.
“Addiction has behavior attached to it, so you can go through withdrawal but addiction would mean that you would go out and seek that drug,” Jones explained. “Babies are not capable of addiction because they cannot go out and seek drugs.”
Jones described harm reduction as a realistic approach to nudging users closer toward recovery. Harm reduction is a theory of how to manage risky behavior — including drug use and other potentially self-destructive behavior — by developing techniques to reduce the harm that results from those behaviors. It’s an alternative to abstinence or going “cold turkey,” Jones said.
People who use heroin are highly unlikely to stop “cold turkey” because doing so would make them violently ill.
“Until they are ready and treatment is available, harm reduction keeps them alive and as healthy as possible,” Jones said. An effective harm reduction approach incorporates empathy and compassion; requires humane treatment that acknowledges the dignity of each individual; and avoids shaming, blaming and judging participants.
“We know shaming and scaring people doesn’t work,” Jones said. “When we first opened up, we had people coming up to the front desk and saying, ‘thank you for being nice to me’ because they were used to people shaming, blaming and judging them.”
“We accept that drugs are part of our world, and that’s not going to change anytime soon,” Jones added, “so, we’re not encouraging them to use. What we’re doing is encouraging them to use safely. Our underlying goal is to help them move toward recovery, but until they’re ready for recovery, we want them to be as safe as possible so we meet them where they are and try to figure out, ‘What are the things that might motivate them toward recovery?’”
Jones said research demonstrates users who attend a syringe exchange program are more likely to ultimately enter recovery.
“People who come to a syringe exchange are already demonstrating that they care enough about themselves and other people to find ways to be safe, and so we celebrate that fact. If you’re willing to come in and admit you have a problem, that’s step number one toward treatment.”
Jones also said the idea that drug addiction is a choice is
“We all kind of have that internal feeling that people who use drugs are making that choice or that morally they are doing something they shouldn’t be, and the reality is that yes, they made a choice (to use initially), but they did not choose to become addicted to heroin or opioids. Addiction is different from using drugs.”
In May, four individuals — a social worker, registered nurse, nurse practitioner and peer recovery coach — will be facilitating the harm reduction clinics when they begin in Upshur County. On Tuesday, McKisic told The Record Delta she wants to emphasize the health department is not promoting intravenous drug use, but rather trying to prevent the spread of disease.
And she doesn’t want anyone to think the department is supplying needles to drug
“Anybody who is a diabetic and truly cannot afford needles and alcohol pads, we will provide those to them, too,” McKisic said. “We will not turn them away.”
At Friday night’s presentation, McKisic said she’s spent a great deal of time wrestling personally and spiritually with the concept of giving clean needles to intravenous drug users, but has concluded it’s the right thing to do.
“That’s not just some drug user,” she said. “That’s someone’s child.”
To learn more about the LIGHT program at Milan Puskar Health Right, visit https://mphr.org.