As the nation responds to an escalating polysubstance use crisis, many Appalachian communities have placed renewed focus on comprehensive harm reduction via needle and syringe exchange programs (SEPs). According to the Centers for Disease Control, rates of acute hepatitis C (HCV) increased over 400 percent among Americans ages 20–29 between 2004–2014, presumably as a result of sharing syringes during injection drug use. Similar trends have been observed in Virginia, leading the former state Department of Health (VDH) Commissioner to declare a public health emergency several years ago. Eventually, the rapid rise of acute hep C pushed state legislators to authorize comprehensive harm reduction through passage of HB 2317 in 2017.
However, almost two years after the law was signed by former Governor Terry McAuliffe, only three of the 75 eligible counties across the state (including just one of the top 10 counties by HCV rate) have been approved to move forward with comprehensive harm reduction. Indeed, the first program authorized by the state has been successful, but is only engaging 24 unique individuals. This in a state with 8.5 million people and over 2,000 cases of HCV among young adults reported in 2017 alone.
Clearly, Virginia’s approach is not meeting the scale of the problem. According to former VDH Commissioner Marissa Levine, “the barrier has been law enforcement.” It’s true that many communities interested in moving forward with harm reduction have faced intense resistance from local police. However, on closer examination, the real failure lies in a structural approach that delegated key public health decision-making to members of law enforcement in the first place.
[For more on this story by Sanjay Kishore, Sandeep Kishore, go to https://blogs.scientificameric...of-substance-misuse/]
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