The Baltimore Harm Reduction Coalition (BHRC), a public health organization, held a workshop on opioid overdoses and Naloxone on Friday. The event took place in the SPARC Women’s Center in Baltimore and was lead by speaker Harriet Smith, the executive director of the BHRC.
Smith gave a presentation that covered a wide array of topics including what harm reduction is, stigmas surrounding opioid use and how to properly administer Naloxone. Naloxone is a medication designed to treat opioid overdose, which should be available from licensed pharmacists without a prescription under a standing order that exists in Maryland.
Ensuring that people who need Naloxone are able to access it is one of the main goals of BHRC. The coalition focuses on helping Baltimore residents, who have historically been ignored or targeted.
“We work to mobilize community members to advocate for the health, dignity, safety and respect for people targeted by the war on drugs and anti-sex-worker policies,” Smith said.
The coalition’s goals also include larger, more systemic changes to help such groups. Smith underlined the importance of being able to easily access Naloxone.
“We make it harder for people to take a slightly safer route with their drug use. We expect people who want to get methadone to have an ID and to have health insurance,” she said. “That is not harm reduction at this larger level – we need to have easy access to all the things that people might need.”
Smith explained that the BHRC focuses on ensuring the health of sex workers and people who use drugs because of how they have been ignored and mistreated by society as a whole.
“We focus specifically on [marginalized groups] because of the history of criminalization of sex trade and drug use,” she said.
Smith elaborated on the effects of stigmatization, highlighting the impacts it can have on an entire community. She argued that negative attitudes toward and criminalization of these groups of people can make it difficult for them to get help.
“You are talking about even more marginalization, and when you have that isolation [and] marginalization, pushing to the side, pushing underground, it is riskier no matter [what] the behavior is,” Smith said.
A large focus of BHRC relates to the stigmatization of opioids in a racial context. Smith noted that although statistically little has changed with regard to which groups use opioids, it is because of the growing publicity surrounding the issue in white communities that there has been a growing movement to prevent opioid overdoses.
“The numbers don’t necessarily prove that this is more white than it was before or anything like that,” Smith said. “This is really about how we perceive overdose and how we perceive who overdoses and who is worthy of assessments. Who is worthy of getting locked up forever and who is worthy of ‘Oh, we need to talk about compassion.’”
Although the changing stigmatization that surrounds opioid overdose has lead to better care for those who suffer from drug addiction, there is still an issue surrounding usage in areas with many drug users. Rachel Gillett, a Hopkins School of Nursing student, explained how the existing stigma reduces the likelihood for people to help those who need it.
“A lot of people see stigmatized behavior such as drug use as something that is different or bad or wrong or other, and so people are less likely to want to help people who are for example suffering from overdose,” she said.
BHRC also explores many of the misconceptions that exist within the stigma, including the growing belief that most opioid overdoses are caused by prescription drugs, such as Oxycontin.
“Prescription rise is relatively stable throughout 2007 and 2016,” Smith said. “There are some estimations that it is because opioid prescriptions have remained stable — but as people get cut off from their pain medication, where are you going to go but buy unregulated substances? And that’s where the fentanyl and heroin can come in.”
Gillett added that because there are so many misconceptions and a general lack of knowledge surrounding drug-related issues, college students should be educated about this subject.
“In situations such as college campuses with a lot of youth coming together, the youth population is more likely to engage in risky behaviors. Harm reduction in and of itself is probably most beneficial to use for the youth population,” Gillett said.
Smith also believes in increasing the accessibility of risk reducers such as condoms and Naloxone to the youth community.
“It is really important for universities, whole cities and whole institutions to embrace access to accurate information around sex, accurate information around drugs and really give people all the information they to be able to make informed decision about their behavior and have access to whatever they need to make them slightly safer,” she said.
BHRC works towards increasing the education and availability of anything that would help reduce risk. This includes hosting public trainings, like the one on Friday, to explain how to administer the life-saving drug Naloxone. At the end of the training, attendees were provided with emergency intramuscular Naloxone medication.
Smith explained that BHRC hosts public trainings once a month around the city, in places of worship and neighborhood associations, aiming to reduce risk on a wide scale. She added that the group also attends talks on the Homewood campus to educate students about the benefits of easily accessible Naloxone.