Tony Kirkman

Tony Kirkman is the executive director of the Piatt County Mental Health Center.

Piatt County readers, I need your help. I find myself being the Natalie Imbruglia of mental health because I’m “Torn.”

Not cold, shamed or lying naked on a floor, but more indecisive. You see, I’m trying to navigate best approaches to aid my friends in the recovery community. While I realize we need to do a lot more than “Just say No to Drugs,” some of the current proposed harm reduction treatment methods for recovery cause me to ask a question of whether this is help or harm.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA) website, harm reduction is “an approach that emphasizes engaging directly with people who use drugs to prevent overdose and infectious disease transmission, improve the physical, mental, and social wellbeing of those served, and offer low-threshold options for accessing substance use disorder treatment and other health care services.”

As you can see in harm reduction, abstinence is not the sole objective, rather wellness, even marginally is what is stressed. Some of the recovery harm reduction techniques are the distribution of Naloxone (Narcan, a life-saving drug designed to stop the effects of opioid overdose), Fentanyl Test Strips, and Safe Needle exchange programs. One of the more progressive approaches that is currently being discussed within committees at the Illinois Legislature is a Safe Usage Program. As reported by NPR Illinois,

“In Illinois, one state legislator wants to provide a legal path for another approach: allowing people addicted to drugs to take illegal substances under the supervision of a medical professional. State Rep. LaShawn Ford (D-Chicago) has proposed the creation of safe consumption rooms — also referred to as supervised injection facilities.

Proponents of similar programs around the world argue they allow people who suffer from addiction to take substances in a safe environment and reduce the likelihood of fatal overdoses. “We know that not meeting people where they’re at to provide the support that they need to end the struggle of a substance use disorder only harms the community with loose needles [and] only harms families with preventable drug overdoses,” Ford said.”

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Currently at The Center, we provide Naloxone Training and Distribution as this seems to be one of the “bottom rungs” of harm reduction. We are NOT in the position to even entertain Safe Needle exchange and/or Safe Usage programs at this point as we lack appropriate medical and/or security protocol, so this eliminates any ethical debates on these methods.

However, what about Fentanyl Test Strips? Honestly, I just don’t know, and I’m glad I don’t make these big decisions in a vacuum. Instead, I will lean on the expertise of my professional staff, members of the recovery community, friends within the medical community, my wise Board of Directors, and you, if you are willing.

At the current moment, my struggle is here: Naloxone is a reactive measure to save someone’s life and is normally administered by someone else other than the person consuming the opioid, Fentanyl Tests Strips are done PRIOR to usage.

Is this harm reduction technique permissive and/or make usage easier? When my thoughts move in this direction, it brings my mind to a similar debate regarding the distribution of condoms to teenagers. Does the distribution of condoms to youth encourage promiscuity or is it a smart, harm reduction technique to reduce teenage pregnancy or the community STD rate?

ell, I don’t know about you but at the High School I attended, we did not distribute condoms and (shockingly) teens were still engaging in this activity. I’m guessing here in Piatt County, we could ban all condom distribution and it would do little to slow down teens from...wait, did I get a little too real for some of you?

Seriously, harm reduction methods have their place in healthcare, and sometimes I and other healthcare workers need to examine our own biases and thought patterns to see if we are actually getting in the way to an individual’s path to recovery. With the understanding that all treatments should be client-focused, the best type of treatment for any situation is the one that works for THAT client. Still, I wonder are these techniques hurtful or harm-reducing?

Tony Kirkman is the executive director of the Piatt County Mental Health Center.