Harm Reduction - Saving Lives During Crises - Sheila P. Vakharia PhD MSW

Vakharia PhD MSW Drug Policy Alliance Agenda • The US Overdose Crisis as a Case Study and Comparison • Stimulant Drugs • Drivers and Solutions • Social Determinants of Health • Public Health, Treatment, Harm Reduction • Why This Moment Calls for Harm Reduction • The Harm Reduction Gap 2 A Crisis in Four Waves Federal Class-wide Scheduling of Fentanyl Analogues COVID-19 80,000 Wave 2 Wave 3 Wave 4. [...] Reduce contact between marginalized people who use stimulants and law enforcement 8 Access to harm reduction and treatment “Our harm reduction playbook was built around opioids” -Shilo Jama, People’s Harm Reduction Alliance Seattle, WA 9 10 11 Access to harm reduction and treatment Stimulant-specific resources and support • “Law of attraction” or “if you build it they will come”; • Culturally-spec. [...] “Twin epidemics” and the interconnectedness between opioids and stimulants7,8,9,10 • Underdosing and lack of access to MOUDs 12 Policies for harm reduction and treatment • Decriminalize and fund all drug using and checking equipment/supplies; -Safer injecting equipment; Safer smoking equipment; Drug-checking equipment • Overdose Prevention Centers (Allowing Smoking); • Expand Evidence-Based Contin. [...] 13 Reduce contact with law enforcement • Decriminalize drugs; • Explore regulatory models and safe supply models, including medication options; • Divest funding from enforcement towards health-promoting options; • Medical and mental health first responders to emergencies/overdoses; and • Invest in community-building and response to crisis. [...] 5) 16 Why Harm Reduction? 1/3 Thinking beyond binaries – “either/or” • Drug use occurs on a continuum • Not all use is problematic – Use is not “abuse” • Use can vary from drug to drug; day to day • Harm is relative Solution-oriented, creative, and nimble • Drugs carry risk; risks can be reduced • Many potential areas to intervene and help • Even occasional and social users can be helped 17 Why Ha.