With rising substance use disorders and overdose numbers across the country, harm reduction remains a contentious issue.
Some feel the process encourages more people to use by decreasing risk of death, while many health experts say fear of death tends not to be the make-or-break in someone’s continued addiction. On top of that, needle exchange programs specifically have broader community health implications beyond the individual, according to Lewis County Health Officer Joe Wiley, because they help cut down on the spread of HIV and hepatitis.
That said, the Lewis County Board of Health, health officer, Department of Health & Social Services, volunteer health advisory board and staff from Gather Church in Centralia, which provides harm reduction among other substance abuse services, joined together in a candid conversation on the topic in a meeting earlier this month.
Among other services, Gather Church holds a needle exchange program and distributes Narcan in Lewis County, a life-saving drug that reverses opioid overdose. Staff from the church shared their experience with these programs.
Increasing the safety of substance use encourages more using, Gather Pastor Cole Meckle said, was a common misunderstanding. However, many people begin down the path of addiction to combat pain, he said, and are only pushed further when pain is increased.
Commissioner Sean Swope, who has publicly disagreed with Gather’s harm reduction programs in the past, thanked Meckle for the in-depth presentation and for being willing to have conversations on the topic. Previous Board of Health meetings have also covered the topic, with Wiley saying the department receives frequent emails asking for a stop to the programs locally.
Swope asked if there was a point, especially with the rising potency of fentanyl, that overdose death tolls would surpass the cost benefit of needle exchanges.
To this, Meckle said most fentanyl overdoses are not from intravenous use, but from oral delivery of the drug or smoking.
“To know somebody is using a dirty rig (needle) over and over again, something that's meant to be used one time and after it's used twice and third times and four times, it's not only contaminated, but it also turns into a like a fish hook on the end and just tears somebody's skin apart — and despite that level of pain, despite that level of infection, despite that level of ongoing trauma that somebody seems to just be willingly imposing on themselves, it's not an incentive to stop,” Meckle said.
To his point, advisory board Vice Chair Mary McHale gave unscripted testimony on years struggling with addiction.
“Narcan kept me alive multiple times when I overdosed on opiates,” McHale said. “Access to needle exchange meant that when I was ready to get better, I didn’t have any ongoing health issues as a result of using.”
McHale said their motivation to stay clean came after meeting and eventually marrying a partner with a child and wanting to “get my act together.” Alongside that, the process was helped through highly supportive family members, they said.
“I’ve lost a lot of friends who didn’t have access to those services, and so I’m just very appreciative because you all are saving lives in our community,” McHale said, later adding, “If you don’t have that experience, it can seem like a wild idea to give people clean needles. Like, I get that. And it absolutely saves lives.”