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Expert Q&A

Harm Reduction Emphasized in Pennsylvania Governor’s Strategic Plan to Reduce Overdose

Vital Strategies

It’s been more than two years since Pennsylvania Governor Tom Wolf established the Opioid Command Center to tackle the state’s opioid epidemic. Just last month, the Command Center released its new strategic plan, which highlights key accomplishments to date and outlines next steps to help people with substance use disorder. We sat down with Katie Merritt, our Overdose Prevention and Response Coordinator seconded to the Pennsylvania Department of Health, to learn more about the governor’s strategic plan, the focus on harm reduction, and Vital Strategies’ work in the state to reduce overdose deaths.

What is the Opioid Command Center and why was it started? 

In 2017, Pennsylvania had the highest number of overdose deaths in the United States, a grim consequence of the still-growing epidemic of opioid and other drug use. In response, in January 2018 Pennsylvania Gov. Tom Wolf signed a disaster declaration permitting agencies to waive certain regulatory practices in order to more rapidly respond to the crisis. Subsequently, the Pennsylvania Opioid Command Center was established by executive order. Composed of 17 state agencies, the Opioid Command Center’s goal is to reduce the number of fatal overdoses and improve outcomes for people living with a substance use disorder in the Commonwealth. The strength of the Opioid Command Center lies in its partnership with state agencies and organizations doing front-line work to assist people who use drugs. This group has met weekly for over two years, proving their dedication and commitment to reducing overdoses and promoting positive health and social outcomes for people.

The Opioid Command Center recently released a strategic plan. What are the goals of the plan? What does the plan address that the Opioid Command Center hasn’t addressed up to now?

The strategic plan for 2020-2023 outlines the future of addressing substance use in Pennsylvania through the remainder of the Wolf administration. The plan includes strategies to mitigate barriers to evidence based, lifesaving services and will continue to provide a unique opportunity for interagency collaboration. The plan’s five-pronged approach aims to address prevention, rescue, treatment, recovery and ensuring these efforts are sustained. Through the creation of the strategic plan, the Opioid Command Center identified new areas that could help to address current and emerging crises in Pennsylvania. The plan adds a focus on other emerging  trends in drug use, such as the steep increase in stimulant use. In addition, the plan takes a more person-centered approach by addressing mental health and trauma issues which may contribute to a person’s drug use. Finally, the plan seeks to engage stakeholders and the public through increased opportunities for communication, collaboration, and shared action to ensure that the collective efforts already taken are not lost when the next administration takes office.

One of the key components of the plan is harm reduction. What does the inclusion of harm reduction in the plan mean for people who use drugs in Pennsylvania?

Harm reduction is an evidence-based philosophy focused on meeting people where they are and helping them achieve “any positive change.” The harm reduction strategies emphasized in the plan include promoting naloxone availability and supporting syringe access program legislation, to improve access to life-saving resources and services for people who use drugs in Pennsylvania. Currently, state law criminalizes the possession of syringes, which further stigmatizes and harms people who inject drugs by increasing the risk of blood-borne infection and the risk of arrest. The harm reduction work and advocacy of Vital Strategies in Pennsylvania complements the focus of the Opioid Command Center and will help further the goals outlined in the plan.

Vital Strategies’ Overdose Prevention Program has worked to make medications for opioid use disorder (MOUD) available to people involved in the criminal legal system. Does the Opioid Command Center’s strategic plan include goals for ensuring incarcerated people have access to the care they need?

The plan seeks to reduce barriers for individuals with a substance use disorder while they are incarcerated, and upon release. For many years, one of the greatest  barriers to treatment has been MOUD access for people incarcerated in county correctional facilities. Vital Strategies recognizes access to MOUD in jails is critical to reducing the risk of overdose upon release, and engaging people in treatment. The Pennsylvania Department of Corrections is one of the largest medication-assisted treatment providers in Pennsylvania and to have county jails expressing interest in this treatment and jumping on board will save lives and promote treatment, recovery and sustained success post-release. Further scaling up the successful MOUD programs at the state and county correctional facilities is a main goal under the treatment pillar of the plan. The Department of Corrections is also tasked with ensuring appropriate home planning and aftercare plans for individuals exiting incarceration, including connecting them with treatment facilities and supportive recovery services in the community. Additionally, providing naloxone to probation and parole officers as well as returning citizens is a major priority for helping to reduce overdose among the justice-involved population.

What have been some of the successes of the Opioid Command Center?

The successes of the Opioid Command Center include a reduction in fatal overdoses by 18% from 2017 to 2018, made possible by the increased access to the lifesaving drug, naloxone, the influx of resources dedicated to treatment, including emphasis on medications for opioid use disorder (MOUD), among many other efforts. While the initiatives to this point have been successful in saving lives, there is still much work to be done to help those most affected by substance use disorder. The work and partnership of the Opioid Command Center and Vital Strategies has made a tangible difference   towards the reduction of overdoses in this state, which reported the highest number of deaths in the country in 2017. However, the need continues for unique policy solutions and additional resources, especially now with the COVID-19 pandemic. A comprehensive approach, including increased access to MOUD and harm reduction strategies, are key to reducing overdose deaths.

How can the Opioid Command Center and other organizations address the needs of people who use drugs during COVID-19?

For people who use drugs, COVID19 is a pandemic on top of an epidemic. Recent reports are confirming our fears that the coronavirus appears to be contributing to an increase in overdose and other negative outcomes for people with substance use disorder. It is critical, now more than ever, to provide support and resources to people who use drugs. Along these lines, Vital Strategies and harm reduction partners dedicated to reducing deaths from overdose have released “COVID-19 Resources for People Who Use Drugs and Other Vulnerable Communities,” a new toolkit of resources to support both overdose and COVID-19 prevention efforts among these at-risk populations. We need state governments to support people who use drugs and the harm reduction organizations who work with them as they fight for the health and safety of those who are most marginalized and vulnerable.