This is a presentation I made to the NC Statewide Community Planning Group, HIV Group. The Human Rights Watch performed a study entitled "We Know What to Do: Harm Reduction and Human Rights in North Carolina."

1. We Know What to Do:
Harm Reduction and Human Rights
in North Carolina

2. “[T]he question is not whether we know what to
do, but whether we will do it. Whether we
will fulfill those obligations; whether we will
marshal our resources and the political will to
confront a tragedy that is preventable.”

3.  Access to clean needles prevents
• HIV transmission
• Hepatitis C infection
 Providing
clean needles and “works” is an
evidenced-based approach used in the US
and globally.

4.  Providingclean needles is part of the harm
reduction approach.
 Thegoal of programs and policies based
on harm reduction is to make risky
behaviors less risky.
 Harm reduction makes injection drug use
the only mode of HIV transmission to
show long-term, consistent decline.

5.  An example would be comprehensive sex
education for youth and young adults
Risky behavior – unprotected sex w/o birth
control
Risks – pregnancy, STIs including HIV
Prevention – education, proper condom
use, access to another form of birth control
Result – possibility of engaging in sexual
activity, but with tools to prevent risks

6.  Lower HIV risk
 Lower hepatitis C transmission
 Prevent accidental overdose
 Provide a gateway to health care and
treatment
 Reduce law enforcement needle stick
injuries
 Reduce the number of contaminated
needles in the community

7.  Thereis no evidence that clean needles
increases drug use or drug-related crimes.
 However harm reduction programs can
provide a link to drug treatment and other
health services.

8. Harm reduction information:
 North Carolina Harm Reduction Coalition
• www.nchrc.net
 Project Lazarus
• www.projectlazarus.org
 Harm Reduction Coalition
• www.harmreduction.org
 Harm Reduction Journal
• www.harmreductionjournal.com

9.  The Southern US ranks the highest in
• Number of people living with HIV
• Number of people dying of AIDS
• Rates of new infections
 North Carolina has an estimated 35,000
people with HIV/AIDS
 The rate of new infections in NC is 41%
over the national average
 One in three people diagnosed with HIV
already have AIDS

11. A person can purchase needles at
pharmacies
BUT
 Itis a class A misdemeanor to possess or
distribute syringes or other paraphernalia
that may be used for injection of illegal
substances

13.  Medicaid
• Covers some dependence treatments, but limited
eligibility
 Patient refusal
• Many health programs and services refuse drug
users
 Health of drug users
• Multiple health problems – drug
dependence, mental illness, HIV, HCV…

14.  Drugoverdose is the second leading
cause of injury death
 How many North Carolinians died in 2009
due to overdose?
 Preventioncan be taught via harm
reduction programs

15.  Federal ban lifted in 2009
• State law restricts the access of these programs
 Cost effectiveness
• ER care for overdose - $20million a year in NC
• Each prevented overdose saves $20,000 to
$30,000 in medical expenses and lost productivity

16.  Universal Declaration of Human Rights
 International human rights law
• Appropriate health care
• Racial disparities
• Drug dependence is a disability
 International
Covenant on
Economic, Social and Cultural Rights

17.  Needle stick injuries
• 30% of police officers experience a needle stick
• 27% experience 2 or more injuries
 Why?
 Needle decriminalization
• In Connecticut, there was a 66% drop in injury
• Similar reductions shown in international prison
settings

18.  There
is anecdotal evidence that this can
happen.
to carry condoms  reduced
 Afraid
condom usage
 Similarpractices documented in places
like Miami and Washington, DC

19. Government of North Carolina
 Legalize the possession and distribution of sterile
syringes.
 Enact a 911 “Good Samaritan” or “Medical
Amnesty” law to protect those who seek help for
an overdose victim from arrest for drug offenses.
 Ensure that police and prosecutors do not use
condoms as evidence of prostitution.
 Ensure access to affordable drug treatment that
includes opioid substitution therapy and provides
harm reduction education and information.

20. City and County Governments
 Work with state health officials and harm reduction
experts to implement and support syringe access
programs.
 Ensure that safe disposal of used syringes and
police protocols for safely handling syringes are
part of these programs.
 Work with police departments to ensure that
individuals are not
arrested, harassed, searched, detained or
otherwise punished based on their possession of
syringes or condoms.

21. State Public Health Officials
 Promote harm reduction education and information
throughout the state.
 Promote syringe decriminalization and apply for
federal funding to support syringe distribution
programs.
 Work with harm reduction experts to promote
increased access to Naloxone to prevent overdose
among drug users by authorizing and supporting
its distribution through trained peer counselors and
other outreach workers.

22. We Know What to Do:
Harm Reduction and Human Rights in North
Carolina
http://www.hrw.org/news/2011/09/13/we-
know-what-do

23. Melicia Laroco-Molter, MPH
Melicia.laroco@gmail.com
Tonya Del Soldato
Peaceogreen@gmail.com