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States adopting practical ‘harm reduction’ approach in effort to stem tide of overdose deaths

by Deb Miller ~ August 2016 ~ Stateline Midwest »
Drug overdose deaths are becoming all too familiar, even if the epidemic hasn’t spread yet to the state in which you live. In 2014, the last year for which the U.S. Centers for Disease Control and Prevention has compiled data, 47,055 individuals died of a drug overdose. Opioid-related overdose deaths — from prescription pain killers or heroin — accounted for 61 percent of the total that year. In the Midwest, opioid death rates in 2014 were higher than the national rate in three states: Michigan, Ohio and Wisconsin.
Besides law enforcement strategies, many states are adopting a public health approach known as “harm reduction” — a set of practical policies and ideas aimed at reducing negative consequences of drug use.
For example, prescription drug monitoring programs, now in place in all 11 states in the Midwest, require prescribers of controlled substances to report their prescriptions to a state database.
States differ in their requirements to check the PDMPs. Indiana and Minnesota require checks only for opioid treatment, workers’ compensation and pain clinic prescribers. In Wisconsin, prescribers are not required to check for other opioid use before issuing a prescription. The strictest mandate, which Ohio has adopted, requires all prescribers to query the PDMP when initially prescribing and then again at three-month intervals.
All Midwestern states except Kansas have adopted laws to increase access to naloxone, a fast-acting antidote taken via injection or nasal spray, to a person suffering from an overdose. Four of the states allow possession of naloxone without a prescription by people who might live with drug users or be users themselves.
And six states in the region — Illinois, Michigan, Minnesota, North Dakota, Ohio and Wisconsin — have “good Samaritan” laws that encourage individuals to seek medical help for those with a drug overdose. Under these statutes, the person reporting the overdose (as well as the individual suffering from it) does not face criminal charges related to drug possession.
One of the more controversial strategies is the use of syringe exchange programs. Only two Midwestern states (Indiana and Illinois) explicitly allow exchanges. Michigan, Minnesota, Ohio and Wisconsin have removed barriers to the operation of exchanges by decriminalizing possession of syringes and drug paraphernalia or by allowing prevention of blood-borne disease.
Indiana’s law was passed after an explosion of HIV cases related to sharing needles in the town of Austin.
“Our legislation was based on overwhelming research supporting syringe exchange as a highly effective harm-reduction measure,” says Indiana Rep. Ed Clere. “Anecdotally, we hear that more addicts seek treatment through the exchanges than through other social services, that police are less likely to be accidentally stuck by used needles and that visits to emergency rooms have decreased.”


Brief written by Deb Miller, CSG director of health policy.