Frequently Asked Questions

Harm Reduction

What is harm reduction?

Harm reduction is defined by the concept that it “accepts, for better and or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them” (Harm Reduction Coalition). Harm reduction encompasses a spectrum, including safer drug use with clean syringes, educated drug use to prevent overdose, medication assisted treatment, and complete abstinence. Harm reduction recognizes that people who use drugs are autonomous individuals who can be significantly impacted by their environments and past experiences, and seeks to meet people “where they’re at.” It also realizes that every individual is unique, and what works for one person to reduce harm may exacerbate issues for another.

What is the presence of harm reduction in the US?

Harm reduction has been utilized as an effective public health strategy in the US since the 1980s. It became the most effective HIV prevention strategy ever undertaken through the provision of sterile syringes to people who injected drugs. It has evolved to include layperson naloxone accessibility in almost every state in the country, syringe access programs and legislation to encourage help-seeking for overdoses in over 30 states, housing programs nation-wide that house people who use drugs, and medication assisted treatment in nearly every state. In 2016, federal funding became available to support syringe access programs, and harm reduction has become a national priority supported by the Office of National Drug Control Policy, the Centers for Disease Control, and the US Surgeon General Vivek Murthy, among others.

What is the presence of harm reduction in Arizona?

Although there are several programs throughout the state that operate on a harm reduction framework, they are located in the major metropolitan cities and vastly underfunded and underutilized. However, as harm reduction becomes more accepted nationwide, many programs such as drug treatment, emergency departments, and corrections are utilizing harm reduction principles to keep their clients alive. Sonoran Prevention Works is one of the only organizations working on state and local policy to expand harm reduction opportunities.

How is harm reduction relevant in Arizona?

With a rapidly increasing heroin and prescription opioid epidemic in Arizona, a multi-pronged approach must be utilized in order to curb the mass spread of Hepatitis C, keep new HIV infection rates down, and to keep Arizonans alive. State law enforcement has recognized they cannot “arrest their way out of the heroin problem,” and we do not have enough treatment options available for all who seek treatment. Meanwhile, we have the 15th highest rate of overdose fatality in the nation. People who use drugs are our family members and our friends, and we must challenge our own ideas about what we think is right for them in order to offer non-coercive, evidence-based strategies to facilitate health, dignity, and life.

Overdose

What is an overdose?

All drugs, whether they be prescription medications, alcohol, or illicit drugs, carry the risk of overdose. Although all drugs have different effects on the brain and body, in general an overdose occurs when a person has taken too many drugs or mixed them in a way that causes the body to stop functioning normally.
An opioid overdose occurs when the brain becomes so flooded with opioids that body functions slow down, including breathing. This can happen immediately or over the course of several hours. Once respiratory arrest occurs, the brain dies after four minutes without oxygen.

What is Naloxone?

Naloxone (also known as Narcan) is an effective medication that has been used for 50 years to reverse an opioid overdose. Naloxone knocks the opioids off the opioid receptor sites in the brain, which restores a person’s breathing within seconds. The medication is impossible to abuse and is inexpensive, ranging from $40 to $150 for a kit. Its only side effect is to induce immediate opioid withdrawal and eliminate the euphoric feeling of opioids, which can be extremely uncomfortable for the victim, but not deadly. It is simple to administer; either through a muscle injection, or intranasal through an aerosol spray.

Who should have Naloxone?

Any person who may be at risk from an opioid overdose because they use illicit opioids or are prescribed opioid medications! It is also important that any person who may witness an overdose, due to having friends, family, neighbors, or clients who use opioids, obtain naloxone.

How can I obtain Naloxone?

In May 2016, HB 2355 passed, allowing prescribers to prescribe and distribute naloxone to an individual at risk of an overdose, their friends, and their family. Both the prescribers and the person who administers the medication are protected from certain liabilities. What’s best, most insurance covers it! The law also allows people to purchase it directly from the pharmacy without a prescription, though insurance may not pay for it this way. So go to your doctor, pharmacy, or local community naloxone distributor to pick up a kit!

How does one administer Naloxone?

Visit our overdose prevention page to learn how to administer intranasal and intramuscular naloxone.

Drugs

What are opioids?

Heroin and prescription opiates are called “opioids” because they bind to the opioid receptors in the brain. Prescription opiates include medications like Vicodin, Oxycontin, and Percocet, and can be prescribed by a doctor or taken illicitly. They increase pain tolerance, cause drowsiness, and can produce feelings of euphoria. Opioids can cause physical dependence resulting in a painful and difficult withdrawal period if the person stops taking the opioids. All opioids carry a risk of causing overdose if too much is taken by causing respiratory failure. Additionally, using opioids intravenously can cause soft tissue wounds like abscesses and can increase the chance of transmitting HIV or Hepatitis C if safer injection practices are not utilized.

What are stimulants?

Stimulants are drugs that affect your central nervous system. Some common illicit stimulants are cocaine, crack cocaine, and meth. Some prescribed stimulants are Adderall and Ritalin. Stimulants turn on the pleasure center of your brain and release increased amounts of dopamine, which in turn can aid with organization, energy, concentration, and sex drive. However, after a while the brain can lose the ability to create these feelings on its own without the aid of the drugs and can become permanently altered. Although stimulants do not usually cause physical dependence, long-term heavy use can cause psychological dependence. Some other side effects from stimulants are anxiety, depression, fatigue, agitation, and compulsive behavior. Although a stimulant overdose, also sometimes called “over-amping,” is not as cut and dry as an opioid overdose, it can be life threatening by causing heart attack, stroke, overheating, and suicidal psychosis. If a person uses stimulants intravenously, they create the risk for soft tissue infections like abscesses and transmission of HIV or Hepatitis C if safe injection practices are not utilized.

What about other drugs?

There are many other substances that people use. As a rule, when substances are mixed together, whether purposely or unintentionally, they can become more dangerous. Some other common substances are benzodiazepenes like Valium, which are prescribed by a doctor; alcohol; marijuana; and psychedelics. For more information about why people use these substances, the effects they have on your body, and some of the dangers, check out the Universe of Drugs

Safer Substance Use

How can substance use be safer?

Substance use can be dangerous. Certain substances and methods of ingestion come with different and varying levels of risk. It is important that people who use drugs are as educated as they can be about the drugs they are using and ways to mitigate certain preventable problems. For example, if a person injects drugs, providing education on safer injection options can substantially reduce medical problems, giving that person the opportunity to address self-improvement without the burden of an infectious disease or lost limb. In mitigating the overdose crisis, it is imperative that people who use opioids understand the dangers of mixing substances, drug tolerance, and variation in purity.

Is there such a thing as safer injection?

Using drugs comes with many risks, some of which are physical, psychological, environmental, or legal. Taking drugs through injection is one of the more risky methods. It is unique in that it exposes a person to bloodborne pathogens such as HIV, Hepatitis C, and infections that can cause major damage to the body. It also increases your chance of experiencing an overdose over other methods of ingestion, such as smoking or snorting. However, we recognize that people choose to take drugs for many different reasons, and injection may be the preferred method for some people. We believe that a person who injects drugs should be as informed as possible about the dangers and how to minimize as many risks as possible in order to give them their best chance at having a happy and healthy life. Below are some widely used strategies to avoid some preventable and costly dangers. Learn more here.