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Harm reduction to fight opioid crisis discussed

Times West Virginian - 1/11/2019

Jan. 11--MORGANTOWN -- Harm reduction programs to combat the opioid crisis were discussed Thursday as West Virginia University School of Public Health hosted a panel discussion.

Held in Morgantown, "Harm Reduction and Syringe Services Programs: Public Health, Law Enforcement and Local Perspectives" was opened up by WVU School of Public Health Dean Jeffrey Coben.

He noted that a little less than a year ago, the West Virginia Department of Health and Human Resources submitted a formal opioid response plan to the governor and the state legislature.

"That plan, which was the result of an intensive effort including local and national experts and significant public input, included a list of 12 high-priority recommendations for immediate action and implementation in West Virginia to help address the opioid problem," he said.

He said one of the priority recommendations was that West Virginia should strengthen its support of harm reduction policies and programs.

"Having been personally a member of that panel, I can tell you we were provided with very compelling evidence on the effectiveness of harm reduction programs, their importance as a strategy to help curb the epidemic and the need to expand these efforts across the state," he said. "Yet over the last year, we have seen both here in West Virginia and elsewhere that there are challenges with implementing harm reduction programs in local communities. In some cases, these challenges have led to a lack of community support and actual discontinuation of programs. So, this is the context for our discussion today. On one hand, we have had strong recommendations for expanding harm reduction programs across the state while on the other hand, we have experienced some significant challenges with implementing these programs in local communities."

One of the three panelists, Holly Hagan, a professor with the NYU College of Global Public Health and co-director of the Center for Drug Use and HIV/HCV Research, discussed methadone and buprenorphine to treat opioid use disorders.

She said they have benefits, such as reducing opioid use and injection and reducing bacterial and viral infections.

However, she said methadone and buprenorphine are highly stigmatized.

For instance, she said the language to describe them reinforces stigma. And she said methadone and "bupe" are among the most heavily regulated and high-threshold drugs in the United States, with them having more regulation than for opioids themselves.

In 13 states, Medicaid does not cover methadone, she noted.

In addition, Hagan talked about syringe service programs, or SSP's.

She said resistance to SSP's is based on the supposition that they will encourage drug use and increase crime, but there is no

evidence that SSP's increase drug use or crime.

Rather, she said, SSP's are shown to reduce drug use in a community because they become a main source of referrals to medication-assisted treatment (MAT).

She also said SSP's reduce the number of discarded used syringes in the community.

In addition, she said SSP's prevent HIV transmission.

She noted that when New York City expanded its SSP's from 250,000 syringes a year to 3 million, the rate of new HIV infections fell from 4 percent year to less than 1 percent a year.

She also said SSP's are highly cost-effective.

Eric Hrin can be reached at 304-367-2549.

Eric Hrin can be reached at 304-367-2549, or ehrin@timeswv.com.

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(c)2019 the Times West Virginian (Fairmont, W. Va.)

Visit the Times West Virginian (Fairmont, W. Va.) at www.timeswv.com

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