“I died this weekend,” a client told me recently.
I work at a harm reduction non-profit in Salt Lake City, and I wish I could say this was the only time I’d heard that statement. We serve people who use drugs. We provide lifesaving equipment that prevents infection, bridges clients to resources and offers a safe, judgment-free place for people to be their whole selves.
Without naloxone, a lifesaving opioid reversal medication, that client would’ve been dead, along with countless others. Naloxone is an important tool in the harm reduction toolbelt, but it is not enough. If we spend all our energy pulling people out of a river and never go upstream to find out why they’re falling in, we’ll always have to fund rescue efforts.
Harm reduction is the upstream — it is a preventative service that needs expansion and support, as it not only helps those we serve, but all of us.
The need for harm reduction services is apparent in Utah. The National Survey on Drug Use and Health estimates that 12% of the population uses an illegal substance, which equates to about 400,000 people. Between May 2016 — when syringe exchange programs were legalized in Utah — and June 2023, health officials say 10,500 individuals enrolled across all harm reduction agencies in the state.
While we acknowledge the success of those that have been reached, proportionally, growth of harm reduction programs is required to meet the needs of all who use drugs. Sharing and reusing syringes is associated with higher likelihood of transmission of infections, including HIV, hepatitis C (HCV) and infective endocarditis. Injection drug use is the second leading cause of HIV contraction in Utah, after sexual contact. Salt Lake County has the highest rate of people living with HIV/AIDS, with nearly double the state rate. Hepatitis C is also a concern, as most new HCV infections are due to injection drug use. In Utah, cases of HCV doubled from 2014-2020. During that time, 57% of acute HCV cases were attributed to injection drug use as the most common risk factor. Rates of HCV increased by 7% from 2020-2021, and new cases are increasing most rapidly in individuals younger than 30 years old.
Rates of overdose continue to rise each year and though naloxone is available, overdose deaths have become “the leading cause of injury death in Utah, outpacing deaths due to firearms, falls, and motor vehicle crashes.” An estimated 90% of overdose deaths were unintentional or undetermined intent. People who use drugs do not intend, or deserve, to die due to a lack of access to naloxone, fentanyl test strips and other lifesaving supplies.
Harm reduction services are a low-cost, effective way to reduce rates of HIV and HCV infection, reduce overdose deaths and bridge a vulnerable population with essential resources.
Syringe services reduce sharing and reusing syringes, resulting in a reduction of HIV and HCV incidence by 50%. HIV and HCV transmission is reduced by two-thirds when combined with medications to treat opioid dependence. The rhetoric of harm reduction promoting drug use is false, as data shows that new users of syringe service programs are five times more likely to enter drug treatment and three times more likely to stop using drugs than those who don’t use the programs.
Perhaps the individual costs don’t concern you, but the societal costs affect all of us. In 2007 — the latest data available — $11 billion was spent for healthcare costs alone in the U.S. for “drug treatment and drug-related medical consequences.” Imagine if we were to prevent the infections from ever happening – treatment for HCV is upwards of $30,000 alone — the cost savings would be exponential.
Another benefit of harm reduction is the reduction in syringes in the community. It may seem counterintuitive and you may ask, “How are you lowering syringes by giving them out?” But what syringe exchange does is incentivize people to dispose of their syringes properly.
The National Institute on Drug Abuse reports that “comprehensive syringe services programs are associated with a decrease in syringe litter in the community, in part because they allow people to safely dispose of used syringes.” We have clients who will collect syringes with the intent of bringing them to a harm reduction program.
This helps all of us.
Utah needs greater support, both monetarily and socially, for harm reduction services throughout the state. Harm reduction not only helps a stigmatized community obtain lifesaving resources, but it helps all of us be healthier — physically, financially and environmentally.
Consider getting involved with a local harm reduction program by volunteering, donating or simply being an ally for the work. Vote for legislators who prioritize prevention programs like harm reduction. Legislators: Make funding decisions based on facts and improving the collective good of the people you serve. We need it.
(Ellen Seely) Ellen Seely is the Disease Prevention Program Manager at Salt Lake Harm Reduction Project.
Ellen Seely is the Disease Prevention Program Manager at Salt Lake Harm Reduction Project. She is a graduate student in the University of Utah Social Work program and has worked in the public health field for 15 years. When not at work, Ellen loves to sing and perform, go to concerts, travel and spend time with her daughter.
The Salt Lake Tribune is committed to creating a space where Utahns can share ideas, perspectives and solutions that move our state forward. We rely on your insight to do this. Find out how to share your opinion here, and email us at voices@sltrib.com.
