Hampshire HOPE: Harm reduction force asks, ‘Where are you, and what do you need?’  

  • Elizabeth Mansfield and Emily Moner.   SUBMITTED PHOTO

Published: 5/25/2020 11:10:52 AM

Before COVID-19, a typical day for Tapestry’s harm reduction staff included visiting recovery homes, meeting with people in our offices to exchange syringes and explain safer drug use practices and distributing naloxone. When the pandemic struck, most of these activities came to a halt.

Harm reduction aims to accept people as they are while offering information to support safer choices. Harm reduction at its core provides an opportunity for human connection. These connections encourage participants to put aside shame and stigma to deal with the reality of what is.

If they are using substances, we provide them with supplies, such as sterile syringes and the overdose-reversal drug naloxone, to reduce risks to their safety. If they are looking to stop or change their use, we offer resources and support that might help.

When many agencies began operating remotely in response to social distancing guidelines, we knew we had to find new ways to nurture this human connection. The work could not stop, not even for a day.

We needed to reach out to people who use drugs while also keeping our staff and those we work with safe from the virus. While our Holyoke office has relied on an outreach van for some time, in Northampton we had only dreamed of such an approach. The pandemic kicked that dream into reality.

Thanks to funding from Baystate Health, we took our harm reduction practices on the road, filling the van with supplies similar to what we offer from our brick and mortar sites: sterile syringes, other sterile injection supplies, naloxone, hygiene products, beverages, small food items. From the van, we could also offer a chance for a listening ear.

With office hours temporarily modified, the van helped fill the gaps. A typical day began at the temporary ServiceNet shelter in Northampton High School. Welcomed by staff and residents, we made our way through the building, saying hello, encouraging people to approach us when and if they were ready. For some people, help might mean exchanging syringes or taking a supply of naloxone. Others might need information about Hepatitis C or simply to have a conversation that helps build trust. Down the road, that bit of trust-building might motivate them to reach out.

We also leave the van to venture out on foot down Main Street and onto the bike paths, seeking out those who may not be using a shelter. We keep an eye out for both new and familiar faces, sharing information and supplies as needed.

Word of mouth is powerful. Recently we spoke with someone in recovery who was unfamiliar with our services. This individual had naloxone but did not know how to use it, so we offered on-the-spot naloxone training and provided information about our services.

Harm reduction does not require abstinence or seek to fix behaviors; it is based on the principle that recovery looks different for every individual. Harm reduction practices reduce overdose death rates, minimize infection rates and stop the spread of diseases such as hepatitis C and HIV. Harm reduction also provides family and loved ones with education, resources and understanding.

COVID-19 has resulted in more individuals experiencing some of the isolation faced by Tapestry participants on a daily basis. Even before social distancing, our participants often separated themselves from others out of fear of judgement. This isolation puts them at higher risk of overdose and death.

The pandemic has forced many who already feel ostracized to shrink even further away from others. Tapestry’s harm reduction outreach has expanded, but our mission remains the same: access without stigma. Our mobile outreach has been so effective, we hope to continue it even after our offices hours are fully restored.

As we focus on nurturing connections, we work in partnership with efforts such as MANNA, which provides healthy meals to those in need. Prior to COVID-19, MANNA welcomed us frequently to attend community meals and provide naloxone training and education. Throughout this pandemic, MANNA has continued their unwavering support, providing ample snacks, drinks and other food items for us to distribute from our van.

The world looks very different than it did two months ago. Words like “social distancing,” “quarantine” and “isolation” are now embedded in daily vocabulary. Through it all, armed with personal protective equipment, Tapestry harm reduction staff continue the fight against another epidemic — the opioid epidemic — which on average takes the life of 41 people per day nationally, according to the Centers for Disease Control and Prevention

The opioid epidemic isn’t going away while we battle the COVID-19 pandemic. We are well aware of this and continue to work hard to answer the fundamental question of harm reduction: Where are you, and what do you need?

Elizabeth Mansfield, MSW, program manager and Emily Moner, M.A., harm reduction counselor, work at Tapestry, which is part of the Hampshire HOPE opioid prevention coalition run out of the city of Northampton’s Health Department. Hampshire HOPE members contribute to this monthly column about local efforts addressing the opioid epidemic.


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