HCV Prevention: The Importance of Harm Reduction
If we are to truly address the rate of new hepatitis c infection and see the tide shift in the rates of new infections among the community identified as PWID (People Who Inject Drugs) we need to embrace harm reduction as a key piece. There is a reluctance to invest in this approach for a number of reasons, but as I see it, the most obvious argument against is that we are facilitating and promoting drug use when we provide safer ways for people to use drugs.
I don’t see it as an issue about whether using drugs is a good thing. Clearly drug use is not something we see as a positive activity in our communities or society. No person ever starts their life wanting to be a drug user when they grow up. There are any number of reasons why it is not something we wish for others. There are many reasons why people become involved in drug use, and I will not begin to discuss them here.
It is a rare person that has not been touched by drug use of a family member or friend, or been involved themselves. This includes pharmaceutical drug use because this is a growing issue in our society which we need to address in a similarly thoughtful way.
Just saying no does not work. It never did.
Drug use will continue.
Safe drug use is what will help stop the spread of hepatitis c. In my work as a peer navigator the majority of questions from young people are about risk factors associated with their own status, the status of a sexual partner, or fellow drug user. This is not what I hear very often from the older people I speak to but this is not to say it is exclusively age specific.
Developing and implementing harm reduction programs is key in HCV prevention. Baby Boomers are not seen as transmitters of the virus. There are some who may be actively involved in drug use but as I see in the research and multitude of literature on harm reduction, they are not the target audience with safe practices around drug use, education and Harm Reduction.
Why do we not embrace harm reduction in our communities?
Good question, I ask.
Local, state or provincial and federal governments need to embrace harm reduction, and to fund the implementation of these programs as an integral part of any comprehensive response to hepatitis c.
There is a component of discrimination (stigma) underlying why there is no meaningful or robust adoption of harm reduction as part of the response to HCV.
Unfortunately stigma continues to obscure the important issues around HCV.
Sadly, the notion that a drug user has simply made bad choices in life, and should therefore be punished is not uncommon thinking in my own experience. In our society this often equates with failure, and collectively we dismiss those who fail as losers ,and in doing so we send them to the margins. Poverty is often a companion with drug use, and this serves to further marginalize people. Demonizing people and marginalizing them is a convenient way of not dealing with HCV in an intelligent and compassionate way. Punishment is not the solution to lowering new HCV infection or increased drug use.
Not only do we need to slow the rate of new infection if we are committed to seeing eradication, but we need to seize an opportunities to help in other ways. Harm reduction is not the solution for all of the people affected or at risk. The issues around equity are non-medical but need addressing also.
Access to harm reduction, which can be a pathway to better health care can lead to an improved quality of life.
A better quality of life benefits us all.