State and local organizations across Connecticut are working to establish and bolster harm reduction strategies to prevent drug-related deaths and promote education on overdose and infectious disease transmission.
About 692 Connecticut residents have died from an overdose from January to the first week of July of this year, according to the state Department of Public Health. Last year, there were 1,464 confirmed fatal drug overdoses.
“The true best practices of harm reduction are found when you get out into the community, find out what the people you’re trying to help save need … all the while connecting them to services and resources that have value to the people you’re serving,” said Mark Jenkins, founder and CEO of the Connecticut Harm Reduction Alliance.
“The idea is to listen to their needs and provide those needs. It's not a cookie cutter." What is harm reduction?
The Substance Abuse and Mental Health Services Administration defines harm reduction as a series of community-based public health strategies that engage with individuals who use drugs to prevent overdose, reduce infectious disease transmission and empower individuals who use drugs to improve their well-being.
Services can include connecting individuals to education on overdose and infectious disease transmission as well as distributing drug use basics, such as clean needles and syringes. These strategies significantly prevent drug-related deaths and increase access to health care, social services and treatment.
Harm reduction is most commonly associated with drug addiction; however, Jenkins said that harm reduction services are a "laundry list" and can be a lot of things to a lot of people. Jenkins compared harm reduction to wearing a seatbelt while driving, using a life preserver out at sea or assigning designated drivers before a night out drinking with friends.
Jenkins said the heart of harm reduction is engaging with at-risk people several times without judgment or the expectation they will eventually get treatment.
For example, harm reduction services at the alliance include helping individuals access other necessities, such as suitable housing and nutritious food. By addressing these necessities, Jenkins said this can help lessen the barriers associated with basic daily living.
Jenkins also emphasized that harm reduction strategies for drug addiction should be available without expecting an individual to recover. He explained that addiction services and treatment are successful for a limited number of individuals.
So, instead, he explained that harm reduction "finds [the] ways and means to keep you safe in your use to help reduce or prevent fatalities by means of overdose." What does harm reduction look like?
The Connecticut Harm Reduction Alliance helps serve more than 3,500 people across the state, according to its website.
Services at the alliance include overdose prevention training, drug treatment referrals, syringe exchange, HIV and Hepatitis C screenings and housing referrals. The alliance also regularly distributes free Narcan, fentanyl test strips, wound care supplies, condoms and food to their Hartford and New Haven offices and mobile outreach units.
"We are a social justice movement. We're about education," Jenkins said.
At the state level, there are several new initiatives for harm reduction to ensure that "there are no wrong doors" when seeking out harm reduction equipment, said Marie Buchelli, public health services manager for the state Department of Public Health TB, HIV, STD and Viral Hepatitis section.
Buchelli explained that to reduce the risk of human immunodeficiency virus, or HIV, harm reduction means teaching about the risk of blood-borne infections caused by injecting drugs with contaminated needles, how to take care of an injection wound and providing access to HIV and hepatitis screenings. She added that they also hand out condoms and provide education on adequately using them.
Similarly, the Department of Public Health announced the upcoming arrival of new vending machines with harm reduction necessities, such as Narcan, in late August.
Buchelli explained that the department partners with local organizations to place and stock a vending machine outside. The goal with the vending machines is to have essential supplies available at all hours and is not monitored.
The department is also expanding their services with harm reduction "rovers," said Ramon Rodriguez-Santana, epidemiologist for the state HIV Prevention Program. He described the rover as a toolbox with huge wheels that carries different items for harm reduction. The rover gives the harm reduction units more mobility and allows them to expand their reach because it can be taken on rough terrain, such as sand and wood.
The Connecticut Harm Reduction Alliance has similar rovers at community locations throughout New Haven. Their rovers have supplies like xylazine test strips, Narcan and fentanyl test strips.
Rodriguez-Santana added that harm reduction work often results in a network between clients and staff with an open door policy that empowers clients to reach out whenever they need assistance.
"We don't only serve people who inject drugs. We also serve the crack-smoking population and sex workers … to reduce their harm," Rodriguez-Santana said. "Whenever they're ready to change behavior, we have them in a network so we could easily help them navigate a system that sometimes can be difficult." Empathy & understanding
Dr. Jody Terranova, the deputy commissioner of the state Department of Public Health, often visits Hartford and New Haven harm reduction sites. She described the staff at locations as "engaged and passionate" whenever they are trying to help the walk-up clients, answer any of their questions and provide them with immediate help in whatever form that takes.
From giving out snacks to helping take care of open wounds, Terranova said that the staff at harm reduction locations are willing to listen to a client's situation and educate them.
"Letting individuals know that there is someone out there that cares about them and understands that even though they're choosing right now to do something that is not in their own best interest, we're here for you when you're ready to make a change," Terranova said.
Health Equity reporter Cris Villalonga-Vivoni is a corps member with Report for America, a national service program that places journalists in local newsrooms. They can be reached at firstname.lastname@example.org and 203-317-2448. Support RFA reporters at the Record-Journal through a donation at https://bit.ly/3Pdb0re.