Taking The Stigma Away from Narcan and Fentanyl Test Strips

By David A. Kostival

In finding solutions to the drug abuse epidemic, the term harm reduction has become an important tool for those working in the field. And it has grown from being a term to a grass-roots movement for social justice for those who use drugs.

Carla Sofronski, executive director of the Pennsylvania Harm Reduction Network, said harm reduction is really a set of principles. “Harm Reduction is a set of principles made up of compassion, dignity, kindness and honesty, mixed in with evidence-based practices used to treat substance use disorder with the goal of minimizing risk and harm,” Sofronski said.

The Pennsylvania Harm Reduction Network is a statewide advocacy organization which collaborates with stakeholders which include the counties, local governments, treatment providers, people who use drugs and their families. It’s mission statement says it serves to organize and build power across Pennsylvania to end overdose deaths, drug-related incarceration, the spread of HIV and HCV (Hepatitis C) and many other harms inflicted upon people who use drugs. “The majority of the folks that are within the network are people with lived experience, and what we advocate for is evidencebased policy and treatment programs throughout the state of Pennsylvania.”

In early March, Sofronski visited the Council on Chemical Abuse in Berks County to offer a training on the use and distribution of fentanyl testing strips. “It’s the next step in moving towards more harm reduction evidence-based practices,” Sofronski said. One of the difficulties to overcome is the fact that for a very long time there was a stigma attached to anything that enabled people who use drugs. “People have been taught and conditioned for many, many years by our treatment systems that we were not to enable people, only provide treatment-based options,” Sofronski explained. “But now we’re in 2023 in the middle of a public health crisis where Pennsylvania is the third highest state in the nation with overdose-related deaths. And we have the ninth highest in ranking in infectious diseases such as HIV and HCV, and the reason for that is because Pennsylvania does not implement harm reduction strategies.”

Sofronski praised Berks County for being the first leading county outside of Philadelphia and Pittsburgh to begin making changes and make a shift in the culture. “It’s saying that it is OK to be given naloxone and it is OK for folks to be testing their drugs because at the end of the day, we want to keep people alive,” she stressed. “Embracing harm reduction strategies is to be embracing other pathways to recovery, as opposed to focusing on treatment. That means starting in your own community and being vocal about it.”

Sofronski said it has been a slow evolution in making a change. “Six years ago, I would go to talk to legislators about naloxone and they would say you are enabling people, and I would say that we are enabling breathing,” Sofronski said. “And now they have statewide campaigns for the use of naloxone. We were able to shift and move that culture, and so we need to continue to keep going forward.” Naloxone — also known by the brand name Narcan — is a medicine that is an antidote to opioid drugs. Because opioids slow or even stop a person’s breathing, naloxone helps the body wake up to continue breathing.

Connect with EDI’s recovery specialists at the Community Center of Atonement

Meet with

For more information, visit www.ediinc.org/atonement

Soberstock

“But not only to purchase (the strips) but making sure that they are getting into the hands of people who use drugs is the next step,” she added. “The best strategy to do that would be also to legalize syringe service programs throughout the state.” Sofronski explained that the program is more than handing somebody a sterile syringe, but rather having people working in the program meeting drug users with compassion and care. “It is a way to engage people and by engaging people, you give them dignity and respect with no expectations from them,” she said. It’s considered a low-barrier approach, meaning the red tape is eliminated.

“It is healthcare,” she added. “We know that people are five times more likely to go to a treatment program if they engaged in a certain service program and that’s because the component is meeting people where they are without judgement.” Most areas of the state have first responders and police doing an amazing job with administering naloxone, Sofronski said. But she added that there are still some areas of the state where it is still stigmatized, resulting in police not wanting to carry naloxone.

She said it’s mainly about honest education. “People think that if they were to respond to an overdose and use naloxone, they are scared and think that they may be held liable in some type of way,” Sofronski further explained. “They think if something were to go wrong that they need some type of medical training or some type of certification, and that comes down to education.”

But there’s also a message Sofronski wants people to think about. “We are watching in our country and in the state, the ripple effects of trauma that are going through our families,” she said. “And there is, if it has not already happened to you, a generation of children being raised with no parents that are suffering an immense deal of trauma, which then manifests in mental health issues and leads to substance abuse. Without implementing and learning about different strategies and being open minded, we are also going to see a generation of folks coming through that are very physically unwell due to infectious disease, and due to our poisoned drug supply and the effects that it is taking on their body.”

Sofronski said she has not met one person that hasn’t told here that the overdose hasn’t impacted them in some type of way. “What we hope with the Pennsylvania Harm reduction Network is that as one county agrees and signs on, there will be a snowball effect,” Sofronski concluded. “We need one person to take that leap first and then we can watch others follow.”