Over the last year, West Virginia harm reduction activists and organizers have faced hurdle after hurdle as more people suffer fatal overdoses or get sick from injecting drugs, and while the state and localities pass legislation against services that could help them.
Save A Life Day 2021, where 17 counties are participating to distribute hundreds of naloxone doses to people, has reminded some of these organizers what can be accomplished when people come together under difficult circumstances.
“It’s incredible to see the way people come together for this, in a good way, but then not come out in other times, or for other related actions,” said Stacy Kay, co-founder of Solutions Oriented Addiction Response (SOAR), the Charleston-based grassroots harm reduction group that organized the event. “I mean, imagine if we could do that? It would be incredible. We would save more lives. We would accomplish so much more for the better.”
There will be 11 sites in Kanawha County distributing free Narcan and training people on how to inject it. Other counties participating Wednesday include Cabell, Berkeley, Monongalia, Cabell, Harrison, Wayne, Logan, Marian, Jefferson, Putnam and Morgan. Ohio and Wetzel counties held their distributions last week, and Boone, Mercer, McDowell and Wyoming counties will have theirs at a later date.
For a full map of locations, visit: https://bit.ly/WVSaveaLife2021Map
Save A Life Day is an annual event, and this year has the most participation of any to date, said Joe Solomon, with the harm reduction group. There are 100 volunteers to train people to administer naloxone.
“This is more buy in and support than we’ve ever seen,” said Sarah Stone, co-founder of the harm reduction group. “That’s a good sign, and it is a bit hopeful, for us at least.”
There are dozens of partners and sponsors. The state Office of Drug Control Policy is behind the event, but most of the coordination and organizing fell on members of Solutions Oriented Addiction Response.
The harm reduction group has been distributing naloxone for years. In 2020, the group distributed more than 6,700 doses in Kanawha County. To date in 2021, members have distributed 10,171 doses. That doesn’t include thousands of doses provided from the group to other health organizations struggling to meet the need with the supply available to them.
Comparatively, per the state Office of Drug Control Policy, there were 1,259 naloxone doses distributed by the state in Kanawha County in 2020. Data for 2021 is not yet posted.
Naloxone, Kay said, is something that needs to be available to people as easily as possible these days.
Fatal drug overdoses in the state, once seemingly on a downturn, ramped back up during the pandemic. Per the state, at least 1,275 people died of fatal drug overdoses in West Virginia during 2020, compared to 878 in 2019.
Kanawha County, which reported 156 fatal overdoses in 2019 — there were 152 in 2018 and 151 in 2017 — reported 207 fatal overdoses in 2020, a 51 case increase.
A majority of those deaths involved opioids, which naloxone is meant to reverse.
“That’s one person dying more than every other day in Kanawha County from what could have been a prevented overdose,” Solomon said.
Experts expect the death data from 2021 to be even higher as drug use rates are reportedly on the increase nationwide.
All this is compounding as a national naloxone shortage is limiting the resources available to people on the frontlines — often those who use drugs — trying to save lives.
“What we have now as far as naloxone doses is what we have now. There are no new shipments coming in,” Solomon said. “That’s scary. It’s a really, really scary — and dangerous — place to be. We now have a Narcan access problem, on top of an overdose epidemic, on top of an HIV problem, on top of a hepatitis problem.”
Complicating all of this is stigma surrounding drug use, addiction and even opioid overdose reversals. There are still people out there, Stone said, who are critical of naloxone because it saves the lives of people who use drugs.
“It doesn’t make any sense, and it’s an argument made — every time — without any compassion for who that person is: a person,” Stone said.
Stone, who is in longterm recovery herself, said there are several volunteers for Save A Life Day who have been revived by naloxone in the past.
“To me, it’s everything that [they are] still alive, sitting here and helping us pack up these boxes,” Stone said. “That is everything, period.”
A person’s worth, Stone said, should not be tied to their sobriety. That mindset is problematic, she said. It excuses doing harm — through policy or otherwise — to vulnerable, already marginalized people.
“That’s one of the missions of SOAR, and stigma — that’s the reason we exist, why we formed,” Solomon said. “To fight against it and come together around solutions, with everyone at the table. We wish it wasn’t needed, that our leaders and others would figure it out by now, but they haven’t.”
Stigma is an incredibly damaging response to harm reduction efforts, Solomon said — even if it’s targeted at just one part of them, like syringe service programs, as was the case in Charleston and at the state level this year.
When limits and caps are put on what kinds of public health services can be offered and in what ways — especially when they aren’t backed by science, as was the case locally — Solomon said there can be a blanket decrease in the services that are utilized, including those like Naloxone, family planning and wound cleaning.
Last fall, when the harm reduction group came under fire from city council in ongoing debates that lasted months, Solomon said that was a real risk.
“If we were passive, if we gave in to that stigma and pressure, our [naloxone distribution] numbers would have went down off a cliff,” Solomon said. “The work, it’s harder today. On some level, though, it is easier to be criminalized because it’s clear, given the legislation we saw a few months ago, where the state and where the city stands on these issues. They do not stand with science, and they do not stand with doing everything possible to save lives.”
And while the work can be more difficult, Solomon said there is a more positive environment for naloxone today than there was even three years ago.
State law passed in 2018 allows for a standing prescription for the medication, meaning anyone can access it through a pharmacy in the state affordably. The act of carrying naloxone seems more accepted, and the drug in general is becoming normalized.
This gives Solomon hope for what the landscape could look like for other — many contentious and stigmatized — kinds of harm reduction services in the future.
“If we continue with this mindset and tone, focused on bringing people together to find solutions instead of, you know, turning against each other or tearing efforts down, think of what else we could get done? What other milestones can we hit?” Solomon said. “It takes a village to save a village, and we’ve built a village.”