Experts point to harm reduction as one tool against addiction epidemic | Health

The addiction crisis in West Virginia, and nationwide, is complex. 

“There’s no perfect program,” said Donnie Varnell, former Special Agent In-Charge for the N.C. State Bureau of Investigation’s Drug Diversions Unit. “Law enforcement is not perfect. Medicine is not perfect. Harm reduction is not perfect. But you try to help as many individuals as you can.”

Varnell was one of three speakers Thursday at a West Virginia University School of Public Health panel discussion about harm reduction programs.

For Varnell, harm reduction is one of the many tools that can be used in the fight against addiction, and against the spread of disease often associated with intravenous drug use. 

“I like lights and sirens and kicking in doors,” Varnell quipped. “But I like helping people.”

He said the so-called “war on drugs” was never started by police officers, but by the laws enacted by voters and politicians. But he noted, “The problem doesn’t go away because we make it against the law.”

Nationwide, there has been a shift toward treatment for individual users and prosecution of drug traffickers. 

“Some people make their fortune on the misery and addiction of other people,” Varnell said in terms of the need for criminal penalties. 

But for the individual user, he said officers must oftentimes look the other way, especially at harm reduction programs (such as needle exchange sites and overdose prevention centers). 

“Law enforcement and harm reduction — we have to step out of the way.”

He said with drug users in the hands of addiction specialists, law enforcement officers can focus on other matters. But that’s not to say harm reduction isn’t part of law enforcement’s job, too.

Varnell led an effort in North Carolina to distribute naloxone, an opioid overdose reversal medication. At first, it was controversial. But Varnell said face-to-face meetings made all the difference.

“It saves lives. It saves police officer lives,” he said.

Both Varnell and another presenter, Dr. Holly Hagan, said fentanyl is a growing part of the problem. Fentanyl, a synthetic opioid, is 50 to 100 times more potent than morphine.

Hagan, a professor at New York University College of Global Public Health, said fentanyl is not going to go away.

“We’re going to have to adapt to it,” she said. 

Hagan, also co-director of the Center for Drug Use and HIV/HCV Research at NYU, emphasized the need to eliminate stigma associated with addiction. 

“Harm reduction services should be provided in a nonjudgemental way,” she said. “This is an essential element to success.”

She said harm reduction does not minimize or ignore the dangers of illicit drug use, but it does provide an avenue toward a healthier lifestyle — whether that’s receiving unused syringes or enrolling in treatment. 

Most resistance to harm reduction programs, she said, comes from two fears: fear that the program will encourage drug use and fear that crime rates in the community will spike. 

“There is no evidence of either,” Hagan said. “Harm reduction can refer individuals to medication-assisted treatment. They can also reduce the number of discarded syringes.

“There is no reason to believe harm reduction poses a threat for uses, or the communities.”

WVU School of Public Health Dean Jeffrey Coben said solutions, including harm reduction, must be addressed. He noted the public health and economic toll of the crisis in West Virginia. 

“This crisis demands our attention, our focus and our action.”  

— Email: wholdren@register-herald.com and follow on Twitter @WendyHoldren