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Meeting Your Population Where They Are: North Carolina Harm Reduction Coalition

 |  Jack Ahern  | Philanthropy Journal News

As the Philanthropy Journal begins a new cycle on our editorial calendar, we will periodically revisit previously featured organizations. The below feature from the North Carolina Harm Reduction Coalition is a follow up to Reframing the Drug Debate from September 2015. 

Special to the Philanthropy Journal

By Tessie Castillo

Jesse Bennett is no ordinary outreach worker. Every week he rolls up to Raleigh’s high drug use neighborhoods in a truck laden with syringes, naloxone (a medicine that reverses opioid overdose), biohazard containers, hygiene supplies, and a come-as-you-are attitude. Regardless of where people are in their drug use, Jesse treats everyone with fairness and compassion, and helps them take small steps towards healthier lives.

Bennett works for the North Carolina Harm Reduction Coalition (NCHRC), a statewide nonprofit whose aim is to improve the health and well-being of people affected by drug use and drug policies. Overall goals include lowering the skyrocketing rate of drug overdose deaths, reversing the uptick in HIV and hepatitis C transmission caused by shared injection supplies, and steering drug policy towards a path that recognizes drugs as a public health problem, not merely a criminal one.

Jesse’s goal on outreach is to save lives and reduce the transmission of harmful viruses. That outreach is also about providing hope and opportunity. “Syringe exchange programs are about more than minimizing the spread of disease,” says Bennett. “It’s about the relationships I build with each participant. It’s about building trust so they feel comfortable talking to me about health care decisions like wanted to get tested [for HIV] or look into [substance use] treatment options. It’s great being someone they look to for help through that process.”

The relationships that Jesse has built through non-judgmental outreach have resulted in many people finding the strength to make positive changes to their lives, such as seeking treatment or saving the life of a loved one who has overdosed. The outreach is personal to Jesse, who is also a person in recovery from heroin use. “I didn’t have these services when I was using drugs so it feels good to know that there are tools now to help people stay alive and safe,” he says.

Organizations like NCHRC often recruit volunteers and staff members who, like Jesse, are former clients. In most cases, clients first become volunteers with NCHRC because they want to give back to the community. NCHRC cultivates these volunteers and teaches them the skills necessary to be an outreach worker. In time, when a new position opens up, these volunteers may be hired as staff members. Their personal experience, ability to relate to the struggles of existing clients and knowledge of drug user habits and frequented areas make them uniquely qualified for these positions. NCHRC works with them to teach new skills and to show support through difficult situations such as relapse. NCHRC does not automatically fire employees who relapse but works with them to help manage their drug use or get them back to recovery.

Most NCHRC’s outreach workers manage syringe exchange programs, which were legalized in North Carolina in 2016 after a years-long grassroots community campaign led by NCHRC and its allies. Currently, there are 21 syringe exchange programs run by community groups, churches, and public health departments across the state. In addition to partnering or managing several of these programs, NCHRC distributes naloxone kits to prevent overdose deaths. To date, the organization has distributed over 51,000 free naloxone kits to people at risk for an opioid overdose and their loved ones. Since August 2013, 8,473 successful reversals have been reported by people who used the kit to revive someone after an overdose.

NCHRC also partnered with the Fayetteville Police Department to launch the South’s first Law Enforcement Assisted Diversion (LEAD) Program. Under LEAD, officers can choose to divert people charged with low-level drug or sex work offenses to social services instead of jail. The pre-arrest diversion means that people can receive help and support – whether through housing, treatment, medical care or employment – before being arrested and charged with a crime that could affect their job and housing prospects for the rest of their lives. Additionally, NCHRC runs a program in Greensboro, North Carolina, that tests people at high risk for hepatitis C and offers linkage to care services for those who test positive.

NCHRC’s different programs tackle a variety of drug-related issues, including the risk of overdose, blood-borne disease transmission, and the collateral consequences of a criminal record for drug offenses. But the organization’s real contribution is its distinct voice on an issue that often lacks input from the very people most affected by it.

“Harm reduction brings people impacted by drug use to the forefront of discussions on drug policy,” says NCHRC’s Executive Director Robert Childs. “People who use drugs need to have a voice in the issues that affect them and to be part of community solutions.”

Advocating for the rights of drug users is not an easy or popular position. Like many issues, drug policy is often a politicized and polarizing topic with those who believe in for compassion towards drug users often pitted against those urging “tough love.” But the tide is changing. Years ago, most of the public bristled at the idea of equipping active drug users with a medicine that could reverse an overdose, arguing that it would encourage riskier drug use. As for the idea of syringe exchange – that conversation was shut down before it even started.

However, in recent years North Carolina has taken steps to increase naloxone availability, legalize syringe exchange programs, and offer people who use drugs a place at the table in policy discussions. The pivot towards harm reduction has largely come because the public and policymakers are recognizing harm reduction as a legitimate, effective and cost-saving strategy that is proven not to increase risky behavior. Instead, outreach workers like Jesse Bennett, who offer hope and compassion to people long without either, are helping drug users towards positive change, one small step at a time.


Tessie Castillo has served as Advocacy and Communication Coordinator for North Carolina Harm Reduction Coalition since 2010. She is the agency’s only registered lobbyist and has successfully advocated for several new laws pertaining to overdose prevention, naloxone access, law enforcement needle-stick injury prevention, and the legalization of syringe exchange programs. She produces the majority of NCHRC’s media articles on harm reduction, drug policy reform, criminal justice and law enforcement issues.

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