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Recovery From Addiction Is Optimal, but Harm Reduction Saves Lives, Too 

Living Clean

For Drug addicts, the obvious way to get truly healthy and return to being a functioning member of society is to stop using and stay stopped.

That's a no-brainer, and there are many treatment programs and support groups in the Charlotte area that are more than happy and willing to help addicts get clean and begin their journeys in recovery.

But recovery from addiction is not always so simple. Some addicts get and stay clean for decades, others get clean but experience occasional relapses, and still others never experience sustained recovery at all.

For syringe-using addicts in the Charlotte area who have not yet made the decision to stop using, or for those who sometimes relapse and use again, needle-exchange programs and other harm-reduction efforts save lives and curtail diseases such as HIV and Hepatitis C.

That's where Cat Nelson comes in. The 32-year-old has devoted the past two years of her life in Charlotte to providing clean needles to intravenous drug users, as reported in this week's cover story by news editor Ryan Pitkin.

Nelson, a former IV user herself, became aware of the effectiveness of needle-exchange programs and other harm-reduction efforts, such as Naloxone — which revives users who have experienced overdoses — while struggling with her own addiction about a decade ago.

It's been a tough road for Nelson. Providing IV drug users with the tools to help them continue using seems counterintuitive to some, and has been controversial both locally and nationwide. But harm-reduction efforts have proved hugely successful at preventing the spread of disease, according to numerous studies over nearly four decades, including ones done by the Centers for Disease Control and the World Health Organization.

In Charlotte, more and more people are coming around to the importance of harm-reduction programs for addicts, as the nation's opioid epidemic continues to claim lives. After years of working a needle-exchange program out of her car, Nelson now has a growing team of local allies, both private and professional.

"I think everyone's been touched in one way or another in Charlotte by the opioid epidemic, so people's attitudes are changing and they're becoming more open," Nelson tells Pitkin. "Seeing these professionals who are listening to me, and hearing me out, and interested in helping — it's just very encouraging."

Nelson is part of the new Charlotte Regional Harm Reduction Coalition, a group that is pushing for a fully funded needle-exchange program in the city. She continues to run her own program, the Queen City Needle Exchange, from 2 to 6:30 p.m. each Friday, but tells Pitkin she gets calls from addicts seeking supplies throughout the week.

"Until we can be open five days a week, we're going to be slow, because people will find other ways to get syringes," she says.

That means IV drug users who have run out of clean supplies and are unable to get more are more likely to spread disease in the Charlotte area, something that can easily be remedied with a 24-hour-a-day program.

Needle-exchange programs, or NEPs, first crept into mainstream consciousness during the early years of the HIV/AIDS pandemic that became a major public health crisis in the 1980s.

In the United States, one of the earliest advocates of NEPs was Jon Parker, a former IV drug user who in 1986 began a program in New Haven, Connecticut. By the later '80s and early '90s, programs had sprung up in New York City, San Francisco, Los Angeles and other large urban areas, and today they've spread to 36 states. In 2016, then-N.C. Gov. Pat McCrory signed into law a bill allowing drug users to exchange needles here.

The growing acceptance of NEPs has come because they work. In the 1990s, federally funded studies by the CDC, the National Academy of Sciences, the Government Accountability Office and other organizations provided conclusive evidence that NEPs reduce the spread of HIV among IV drug users and their families, and that they do not encourage increased drug use. In fact, addicts who participate in harm-reduction programs are five times more likely to seek treatment for their addictive disease, according to the Journal of Substance Abuse Treatment.

Although numerous organizations support NEPs, including the National Institutes of Health, the American Medical Association, the American Psychological Association, the American Bar Association, the CDC and the WHO, exchange programs still have detractors.

Creative Loafing has long supported any efforts to help drug addicts and those who suffer from other mental health-related diseases. These are problems that affect all of us in some way, but often don't get the attention they deserve because people aren't comfortable talking about them. At CL, we will continue talking about them, because our lives, or the lives of some of our family members or neighbors, depend on it.

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