There are six official 'comprehensive harm reduction' programs in Virginia, which seek to reduce the negative health impacts of drug use, including overdoses. WMRA's Randi B. Hagi visited with one program in Harrisonburg.
Each Thursday morning, the Strength in Peers van parks outside of the New Season Treatment Center on the south end of Harrisonburg. The center provides opioid addiction treatment. Deborah Mason and Frank Pilkerton set up signs, one that advertises "free NARCAN" and another that says, "need help? We are listening."
[sounds of cicadas, construction]
FRANK PILKERTON: We're just meeting the community where they're at. We just gave a COVID test away.
Both Pilkerton and Mason are peer recovery specialists, meaning they help others healing from substance use, trauma, or mental health issues by drawing on their own lived experience.
PILKERTON: I am just gung-ho for recovery, because I know it works in my life, so I'm just hopeful that it would work in someone else's.
They're also the boots-on-the-ground team for the organization's harm reduction program. For people who aren't yet able to stop using drugs, such as opiates or meth, they provide free supplies that help prevent overdoses and the spread of bloodborne diseases.
PILKERTON: We help people with Naloxone …
Naloxone, also referred to by the brand name NARCAN, is a medication administered through the nose that can reverse the effects of an opioid overdose. The Strength in Peers team gives out the medication for free, and teaches people how to use it.
PILKERTON: We encourage people to do their dosing together, so that they're not separated and they're not doing it by themselves.
They also give out test strips that tell you whether there's fentanyl present in a drug. Fentanyl is a very powerful opioid that may be cut into other drugs, like heroin, without the knowledge of the person buying it. Its potency makes it even more likely to cause an overdose.
PILKERTON: A lot of times, if they're coming out of jail situations or incarceration situations, they may not be able to handle the doses that say somebody out in the community, that has been doing it regularly, can handle.
Only one person came up to the van while I was there – a friendly woman stopped by just to chat, carrying an adorable baby who loved the yellow, star-shaped stress balls that Strength in Peers gives out. After she left, Pilkerton pointed out that some of their folks were in the parking lot, and probably weren't comfortable coming up while I – a stranger – was there with recording equipment. So I tried not to stay too long.
While the NARCAN and fentanyl test strips are openly available, there is one part of the program that the state requires to be carefully regulated – the needle exchange. People who sign up and agree to follow the rules of the program, such as not bringing drugs onto Strength in Peers property, can receive free, sterile needles from the organization and dispose of used ones. From January to June of this year, 89 people participated in the needle exchange.
Executive Director Nicky Fadley explains that this can help prevent the spread of bloodborne pathogens.
NICKY FADLEY: We have, in particular, an epidemic of Hepatitis C. It's so easily spread.
A 2021 report from the Virginia Department of Health says that, in 2019, they received more than 11,000 reports of [quote] "confirmed or probable cases of acute, chronic, and perinatal hepatitis C," [end quote] although it notes that the actual number is probably even higher, given that only about 20% of acute cases are symptomatic.
Harm reduction goes beyond public health, though.
FADLEY: For those of us who come from a recovery perspective, our heart is knowing that, again, all people have value … and although things sound dire and feel really challenging and hopeless, that anybody still can recover.
Strength in Peers started this program in May 2021, after being authorized by the state Health Commissioner. Before 2020, there were just four pilot programs in the state, but changes to state law that went into effect that year have made it a bit easier for other organizations to start their own. Even though they're an authorized program, Fadley still encounters misconceptions about what they're doing.
FADLEY: The main one we hear is that we are enabling people, or making it easier for them to use, and the reality is people are using and they're going to use, whether they have sterile needles or not. … And what happens when people don't have sterile supplies is we have transmission of infection … wounds that get very infected.
Besides saving lives, besides preventing disease, there's another reason to do this work – when people come to trust Strength in Peers through the harm reduction services, they're more likely to reach out if they want to pursue recovery.
Last week, Pilkerton and Mason started leading a new recovery group for those working to overcome drug or alcohol addiction.
PILKERTON: And it was a wonderful experience.
DEBORAH MASON: Yeah, it was.
PILKERTON: … It's all about meeting them where they're at. So we are not telling them, or suggesting that they do anything, but what we do is have them recognize their behaviors. … If they think they can do something else that would enhance their life, we can direct them toward that position.
