La Plata County Public Health Department’s Harm Reduction program is a response to the rise in opioid-related overdoses both nationally and within La Plata County. Overdose deaths have more than doubled nationally since 2018 and in 2022 alone there were 18 fatal overdoses in the county. Harm reduction works to educate our community about the increases in substance use and the associated public health challenges.
Harm reduction in a general sense can be something as simple as wearing a seat belt in a car, wearing a helmet on a bike or wearing a condom during sex. It is focused on reducing the consequences related to substance use including overdoses, cases of HIV and hepatitis C infections. We also refer people to other community organizations and services for basic health care and addiction resources.
Harm reduction programs reduce overdoses by offering prevention supplies such as naloxone and fentanyl testing strips. Narcan is the brand name for naloxone, a medicine that can help reverse the effects of an overdose within two to three minutes and is distributed free through our program. It is a lifesaving medication that everyone should have in their first aid kit. Carrying a small, easy-to-use nasal spray can save someone’s life. Forty percent of fatal overdoses had someone else present and Colorado has a “Good Samaritan Law” in place to encourage people to call 911 to report and receive help for an overdose. This protects the caller and the person experiencing the overdose. You may not know anyone who uses substances, but an overdose can happen anywhere.
We also offer testing strips for populations who may be using substances recreationally to ensure that what they are using does not contain fentanyl. People using a substance can then make educated decisions about whether they would like to use the substance or not.
Safe-use supplies and education also lower the risk of infectious diseases, endocarditis and abscesses related to injection use. The education in itself is priceless. For example, our safe injection kits contain alcohol and BZK wipes, which are safer than alcohol for after use. Alcohol wipes are great for sterilizing the area before an injection and also prevents blood clotting in open wounds. Simple preventions like these will help improve the health of community members who need our services. Harm reduction also lowers the likelihood of discarded syringes by distributing sharps containers for safe needle disposal.
Our entire community benefits from these services by reducing the financial burdens associated with infections such as endocarditis, HIV or hepatitis C. The cost associated with treating a person with HIV over a lifetime is around $620,000 while syringe packs cost about $2 to $4 each.
A common misconception is that harm reduction programs encourage substance use. We feel our harm reduction efforts enable community members who use substances to make more healthy and informed decisions. Our program encourages people to seek out resources and guidance.
One of our biggest obstacles is the stigma surrounding substance use. Social stigma is a natural defense for us and a way to deem what’s safe and what is unsafe. However, stigma surrounding substance use can prevent people from seeking access to better health care. We have worked to decrease stigma locally by relying on staff members with lived experience and a Stories Over Stigma project created initially for first responders to hear firsthand accounts of contributing factors to substance use and personal journeys of recovery.
A harm reduction approach includes meeting people where they are at and acknowledging the realities of substance use within a compassionate, safe space that is free of judgment and expectation. This approach allows people to make the decisions that would best benefit them. We also literally meet people where they are by strapping on our hiking boots and backpacks once a week in order to go out into our community and meet our participants. Harm reduction belongs in public health because we work to reduce infectious disease and increase the quality of life of all for all of our community members.
Sierra Roe is the harm reduction coordinator at La Plata County Public Health, a Colorado Peer and Family specialist and a person with lived experience. Reach her at SRoe@lpcgov.org.
