Since it was announced that Willapa Behavioral Health (WBH) will be taking over the syringe exchange program from the Gray’s Harbor Health Department, there have been some messages sent to WBH on the matter; some are kind and some angry. There was one in particular that hurt my heart. (Please note that it is explicit and I have censored the curse words):
“Thanks for letting us as a community know you dont give a sh** what we think. And you dont care that your running our town. Some people like me are getting real past tired of this bullsh**. Take your f***in dope needles somewhere else and go f*** yourselves I can promise you we will be there every time you nasty f***s are destroying our town.”
WBH is dedicated to helping people, that is the only reason for which we exist. We have programs for substance use disorder treatment, peer services, mental health, case management, psychiatric prescribing, domestic violence perpetrator treatment, WISe, anger management, and primary care. The individuals who work here are some of the kindest, most dedicated people I know. I have seen them weep when a client is suffering and struggling to recover. I have seen them come in on weekends when they should be with their family to make sure a client gets a last-minute placement into treatment.
Substance use treatment is complex. Many people see it as a moral issue that shows poor character, but it is actually a disorder, much like diabetes or other chronic ailments. There is not one set treatment that works. Merely getting angry and telling a person they are nasty and awful is not enough to help them stop their use. In fact, speaking to people like that usually makes the situation much worse. Guilt and shame are terrible feelings that lead people to destruction, and destruction often is self-medicated by substance use.
Nine times out of ten, the people who come in my office for substance use treatment have underlying reasons for their use, rarely is it just for fun. Nothing is fun when it is out of control, and when you hit addiction status, that means there is often a lack of control. The reasons I hear most often are because they were abused as a child, they lost a spouse or loved one and have not been able to work through that pain, they cannot stand to be alone in their heads and using helps them forget, feel normal, or escape the mental or physical pain they are in.
When you see that person homeless in front of the building shooting up, they are in pain and they are alone. That person is someone’s child, sibling, or parent. They had dreams and hopes of happiness once. How can WBH stand by knowing people are in pain, and just watch as a program goes away that could eventually lead to helping them recover? We cannot sit with that on our conscience. We cannot stand by when we have the ability to do something.
Substance use treatment is often about strategy. What works for one does not work for another. You have to come at it from different angles. The syringe exchange program is one of those strategies that has significant research to back it up. It is considered a harm reduction method, and it has a place in treatment.
The syringe exchange addresses multiple safety issues for the community and the individual. It gives a value to the needle so that the consumer is inclined to hold onto it rather than just leave it on the ground. The value comes from the consumer being able to bring their dirty needle and trade it for a clean one. The trade will be one for one. This may seem like it enables a person to use, however, the person will use regardless if we give them a clean needle. Giving them a clean needle helps stop the spread of HIV and Hep C and helps prevent uninsured visits to the emergency room because of infection and complications due to dirty needle use.
At the exchange, the patrons are offered a screening for HIV and Hep C as well as Narcan to prevent overdose death, and offered the option of treatment. It is our intention to help clean up the needle litter and promote responsibility and boundaries with our patrons when it comes to disposal of all items. Patrons will not be allowed to litter at the exchange or use on site.
We are in the middle of multiple epidemics, one of them being with drugs. This is a crisis, when you have a crisis, you start with triaging the situation and addressing the immediate safety of the individual. The needle exchange is addressing the immediate safety and offering other programs to progress to recovery so that the soul standing in front of us has a chance to live out their dreams.
Salina Mecham is interim CEO of Willapa Behaviorial Health, a non-profit agency that offers a variety of services for those dealing with mental health and/or substance abuse issues in Grays Harbor and Willapa counties.