California Harm Reduction Programs are COVID-19 First Responders
Jenna Haywood, Capacity Building & Community Mobilization Manager, Harm Reduction Coalition
Harm Reduction Programs have been first responders during this pandemic, stepping into new roles to meet community needs and moving through the uncertainty and panic in lockstep to maintain services. It’s almost as if they’ve done this before. And they have. Created in direct response to the HIV/AIDs epidemic, harm reduction services are rooted in a kind of community care that centers the most impacted and vulnerable populations, resulting in a public health service structure that benefits everyone. While California faces a $54 billion dollar deficit due to COVID-19, we must not overlook the value of harm reduction programs as pillars to our public health infrastructure and as essential services during this pandemic.
Harm reduction programs offer a roadmap for cost-effective and impactful networks of care that other California healthcare sectors could learn from. Their response to COVID-19 makes this strikingly apparent. While emergency departments and primary care clinics have seen a decline in people who use drugs and unhoused people utilizing services, harm reduction programs are busier than ever providing care to some of the people most vulnerable to COVID, including California’s large number of unhoused individuals. These programs are continuing their typical services like distributing the overdose reversal medication Naloxone and safer drug use supplies. In addition, programs are now filling gaps left by shuttered services and overcoming obstacles other providers cannot because their approach to care is centered around building trust and connection that is able to be maintained through these moments of unrest and fear. These services work because they operate on the belief that meeting the needs of the Californian who experiences the highest level of stigma will raise the standard of care for the entire community.
In addition to everyday services, since COVID-19 hit, harm reduction programs have been successfully getting people into housing who have been rejected from every other social service agency or deemed ‘hard to keep housed’; they are organizing food drives in their neighborhoods, serving hot meals when so many services have shut down; they are providing charging stations to help participants access tele-medicine; they are keeping the community safe by providing personal protective equipment, handwashing stations, hygiene kits, and other COVID-19 supplies that are so hard to come by; and they are continuing to find innovative ways to navigate their consumers to treatment, mental health care, and other services. Most importantly, they are doing what they have always done best, providing non-judgemental, compassionate care.
We have seen the ramifications of disinvestment in public health across the United States within the last few years. Counties in Indiana, West Virginia, and Ohio have seen devastating outbreaks of HIV among people who inject drugs after they failed to support access to sterile injection equipment. California is not immune to this kind of outbreak. We don’t have to look far to see the consequences of a weakened public health system that has never fully recovered from the 2008 recession. This is evident in our STD rates, which are the highest in the nation, by the estimated 400 thousand Californians that are infected with hepatitis C and don’t know it, as well as in the extreme health disparities that continue to impact communities of color and our state’s native population. Without continued and increased investment in our fragile public health infrastructure, we face deadly and costly outbreaks that will outlive COVID-19. Because harm reduction programs target precisely these problems through compassionate, socially mindful care with low overhead, they are crucial to mending this infrastructure.
The California Department of Public Health has designated Harm Reduction Programs as essential services during COVID-19, acknowledging the indispensable work they do. However, it is critical that these programs be recognized for their work not just through state backing but also with ongoing, sustainable monetary support. Looming economic hardships will likely mean increased drug use, housing insecurity, and added homelessness, and subsequent higher risk of overdose — in fact, we are already seeing these things happen. Harm reduction programs and their staff and volunteers play a unique public health role as specialists in outreach and engagement for people who use drugs, unhoused people, and other groups who face barriers to care in traditional settings. COVID-19 brings a newfound urgency to maintain these services for the protection and wellbeing of Californians.
