In this article, I will discuss the ways that public health responses have failed to meet the needs of the public, and I will attempt to analyze the ways that the opioid epidemic and the Covid-19 pandemic highlight some of these failures. In some ways, these failures to respond effectively to public disease outbreaks are a sign of outdated thinking and ignorance. Ignorance is always a problem, and the outdated thinking that I am referring to is connecting substance use disorder to criminal behavior. Because our society has now treated drug addicts as criminals for many decades, public health officials have problems implementing much-needed harm reduction strategies. I do not use the word ignorance here in a negative sense, but education is a huge factor in public health because often these problems are left to public officials. In my home state of Indiana there was an HIV outbreak in Scott County, and Mike Pence, the governor of Indiana, failed in the response because he let his personal prejudices affect his decision making. He did not allow the effected county to set up free needle exchange programs. Healthcare workers all know that harm reduction strategies, like needle exchanges, are critical in public health, even more so when there is an HIV outbreak happening. Mike Pence did not listen to health care experts, and people suffered and contracted HIV because of it. The important thing to note in that case was that Mike Pence failed because he did not listen to health experts, and he did not want to help addicted people, because he considered them all criminals, at least at that time. In the Covid-19 pandemic, we have seen Mike Pence more effectively engage with experts in infectious disease. When people are well informed, they are more likely to listen to experts and make decisions that can save lives.
In the substance use disorder field, we are always at risk of succumbing to our own stigmas and biases, but public education is a path that can lead us to a less biased, less prejudiced process for public health solutions. In the state of Alabama, there have been cases that were treated in a manner similar to the Scott County case in Indiana. Alabama rehab and drug treatment workers know that stigma can be a stumbling block. In 2018, a bill finally narrowly passed that included a pilot program for needle exchanges. This was after years of being unable to have basic harm reduction in the state that would protect the public from HIV and Hepatitis. I have a quote from the Alabama Political Reporter that includes some important facts that Dr. James W. Galbraith Jr. of the University of Alabama at Birmingham. Dr. Galbraith is an emergency room doctor who has worked with substance use disorder sufferers for years, and interestingly he brought up the Scott County Indiana case on the floor of the Alabama State Senate.
This is from the Alabama Political Reporter on Dr. Galbraith’s comments,
“Galbraith said that he has been on the frontlines of the state’s opioid crisis working at UAB’s emergency room. Galbraith said that communities with high rates of intravenous drug users have a. high risk of HIV and hepatitis C. North Jefferson, Walker, Winston, and Franklin Counties have very high rates of intravenous drug users. In Scott County, Indiana over 200 people became infected with HIV through intravenous drug use. Those 200 HIV positive individuals will cost $250 million for 20 years.
“We have an ongoing Hepatitis C epidemic in this state mainly in Jefferson and Walker Counties stretching up to Appalachia,” Galbraith said. This service can refer users to rehab, help prevent overdoses, protect police officers from accidental needle stabbings, and can provide mental health guidance.”
We know that communities like Dothan, Alabama and Enterprise, Alabama have been failed by their representatives in the past, just like we were in Indiana. Alabama rehabs and clinics for drug and alcohol use disorders are full and we are in the midst of a global pandemic. Right now is the best possible time for people to become educated about public health policy, and for the rest of the week I will be writing about the opioid crisis, the Covid-19 pandemic, and the problems that we are facing in Alabama, Indiana, and all over the country with these two concurrent crises. If you are in Alabama or Florida and need more information on rehabilitation and treatment, please visit the programs page on this website.
By T.A. Cannon (Contact me at TACannonWriting@gmail.com)
“Senate Health Committee narrowly approves needle exchange program for addicts” by Brandon Moseley. The Alabama Reporter, January 25, 2018.