When ‘just say no’ isn’t enough
Capital Region’s health providers embracing a range of harm-reduction proposals
By Bethany Bump
Audience members listen to a panel discussion thursday at the Hearst media Center in Colonie on the local approach to the overdose crisis, during a daylong conference on policies, programs and practices aimed at reducing the harms associated with drug use.
Cortney Lovell, co-founder of our Wellness Collective who once considered killing herself by overdosing, shares her story during the panel. more than 100 Capital region health providers, harm reduction, addiction medicine and policy organizations took part in the event.
Colonie
The first time Cortney Lovell, a North Chatham addiction counselor, heard about safe consumption sites, she was flabbergasted.
No surprise there — most people are. They’re places where people can use illicit drugs in front of medical staff. If they overdose, staff are trained to respond and assist, administering breathing masks, naloxone or whatever other care is needed to save a life. They don’t exist in the United States but operate in Canada, Europe and Australia.
“My first reaction was, ‘Oh my God, this is the exact opposite of what we want to do,’” Lovell said Thursday. “We don’t want people to use drugs. We want them to stop. And then I thought to the last day I ever injected.”
She was 19 and on the run from authorities. She’d gotten kicked out of the drug dealer’s house where she’d been staying and, by her own admission, burned every bridge she had left. With nowhere to go and no one to turn to, she drove down a rural road and decided to end her life by overdose.
Today Lovell thinks often of the hopelessness that 19-year-old girl felt anytime she works with a person battling drug addiction.
“How many people might we still have today if we just had a safe space for them to go when they felt that way?” she said as part of a panel discussion devoted to harm reduction at the Hearst Media Center.
The discussion, part of a daylong conference titled “Call to Action: A Safety-First Approach to the Opioid Epidemic,” brought out more than 100 addiction-treatment providers, recovery coaches, advocates and policy workers from around the Capital Region. Organized by Whitney Young Health and the Katal Center for Health, Equity and Justice, there was but one requirement for attendees.
“Keep an open mind,” said Keith Brown, director of health and harm reduction for Katal, an Albany nonprofit.
It’s advice that’s often given when talking about harm reduction, a public health philosophy that seeks to lessen the negative consequences of drug use. Grounded in realism and not idealism, it acknowledges that some people will use drugs no matter what and does not demand total abstinence as a condition for receiving help.
Safe injection or consumption sites are among the most controversial of harm reduction proposals. Critics argue they enable drug use and attract crime to nearby communities. Proposed sites in Philadelphia, San Francisco and other hard-hit American cities have been met with intense opposition from federal authorities, who have pledged to shut them down should they dare open.
Supporters point to evidence showing they save lives and help connect people to services when they’re ready to stop using drugs. Users are provided with clean needles, ties and other supplies that reduce infection and disease, as well as life-saving doses of naloxone for when they leave.
Warm, safe, welcoming spaces for drug users are needed now more than ever, panelists said, as evidence and lived experience continue to show that shame, stigma and isolation only drive drug users further into the throes of addiction.
“To think there are people out there right now, just this minute, who think they are not good enough to be alive right now, that is not OK,” said Lovell, who is now 30 and a mother with two children. “So when we say, ‘No, we can’t have consumption spaces,’ we’re saying we don’t support the chance for them to live, to recover, to have a beautiful life like I have today.”
Plenty of less controversial harm-reduction methods exist, including syringe exchange programs and medication-assisted therapies (MAT) which replace one opioid for a much less damaging one in order to ease people through withdrawal.
But stigma still exists, as some providers refuse to prescribe MAT like buprenorphine and methadone, and programs continue to exclude people who aren’t 100 percent drug-free.
A number of providers at the conference expressed disdain at what they feel are outdated and even harmful practices. Just think of your average methadone clinic, said Janice Prichett, former chief behavioral officer for Whitney Young Health, which runs a clinic in Albany.
“Where else do you have to stand in line every day, surrounded by security guards, to get your medication?” she said. “It’s like a penal institution.”