COVID-19 and Rural Harm Reduction Challenges in the US Southern Mountains
A recent study focused on mostly urban sites in northern states documented challenges syringe access programs (SAPs) faced in supply distribution early in the COVID‐19 pandemic. Our experiences in the Mountain South suggest challenges to rural and southern SAPs are even more pronounced.
Recent data show greater and faster‐increasing COVID‐19 rates in Appalachia and the South compared to other areas. Given inadequate rural health care infrastructure, SAPs are an important link between people who use drugs (PWUD) and health care, including overdose prevention and infection control. Trust between Harm Reduction providers and PWUD is especially important given COVID‐19 and the recent protests against police violence. PWUD are reluctant to call first responders for fear of arrest, particularly where being at the scene of a fatal overdose can result in murder charges. Such fears are likely now compounded by the additional dangers of being transported to a hospital or jail where novel coronavirus risks are heightened. SAPs and other community structures to which PWUD turn for supplies and information need support now more than ever.
Resource gaps facing community‐based Harm Reduction organizations in the Southern Mountains are compounded by a lack of reliable data about overdose, infectious diseases, and other indicators of need. Based on our fieldwork, gaps are substantial in the South and in rural areas, yet are key to demonstrating need and obtaining funding.
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