Tennessee Harm Reduction Workers Combat Stigma to Save Lives

Overdose deaths in Shelby County, Tennessee have increased 62 percent this year compared to the same period in 2018, according to local health department data.

Tennessee’s overall rate of drug-related deaths, at 24.3 per 100,000 residents, is much higher than the national rate of 19.2 per 100,000. Shelby is the state’s largest and most populous county, containing the city of Memphis. Most of the deaths there involved opioids; as of a December 7 report, Shelby had suffered 299 suspected opioid-involved deaths in 2019.

Shelby County Health Department officials say that the rate of increase would be even worse if they had not responded with preventative and harm reduction measures. As the Memphis Commercial Appeal reported, Shelby County has partnered with the state government to distribute harm reduction experts and resources throughout the state.

So far they have stationed 13 “regional overdose prevention specialists” throughout Tennessee to distribute naloxone kits and connect people with substance use treatment services. But harm reduction advocates who work directly with people using drugs in Tennessee say the state should be going much further.

“Tennessee is really far behind,” Sara Alese, executive director of the Tennessee Recovery Alliance in Knoxville, told Filter. She works to distribute naloxone to her friends, peers and whomever else she can get it to.

“There’s no access to naloxone unless you’re a nurse, no one is distributing it at the level at which people need it,” she continued. “And it’s very conservative here; officials think that to be ‘in recovery’ means you must be abstinent. I can only imagine if we did drug checking and people actually knew what was in their drugs, but I would get laughed out of the room if I proposed that to state officials.”

In September, the Trump administration allocated about $2 billion to be divided among all 50 US states, territories and the District of Columbia to respond to opioid-involved overdoses. Tennessee was allocated $46.7 million, which will be distributed over two years. The money comes from the Substance Abuse and Mental Health Services Administration (SAMHSA), and will fund services for opioid use disorder treatment, prevention and recovery. The Centers for Disease Control and Prevention (CDC) is also allocating $6.7 million to the state health department to better collect real-time data on overdose deaths and develop responses.

Alese said harm reduction work in the state must focus on raising awareness about safer drug use, while also reforming policies to allow for more naloxone access and drug checking. And she believes the people who actually use drugs know best what will help them.

“I’m helping form groups of people who use drugs, because they can help inform stakeholders about how to build these programs,” she said. “We need to build more allies. Our metropolitan counties are all so disconnected, but that’s where people from rural counties will come to receive these services. Some of these policy changes will literally save my friends’ lives.”

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