Some methods of harm reduction, such as providing clean needles, can be a contentious subject.
“A lot of people say, ‘You’re enabling drug use. Why don’t you help people stop using?’” says registered nurse Kate Newcombe.
But some may be surprised by what her work entails, and the value of harm reduction and education.
Kate works with the Calgary Urban Project Society (CUPS), where she supports vulnerable Calgarians with their health needs. She also works with Safeworks, an Alberta Health Services harm reduction program in Calgary.
“I’ve found it helpful to work for both CUPS and Safeworks because it’s increased the number of clients who follow up after hepatitis C diagnosis,” Kate says. “Someone can be diagnosed at Safeworks and I can ask them to come to CUPS for treatment. I even give them my CUPS phone number and let them know they can call me with any questions. They’re familiar with my face and feel more comfortable coming in for treatment.”
Hepatitis C is transmitted by blood and attacks the liver. Kate says many people who’ve contracted it don’t notice; they may feel tired or have no symptoms at all.
“When you’re homeless, you might be tired for a number of reasons, not solely because of the Hepatitis C,” says Kate.
In the past, hepatitis C was treated with a weekly injection for 24 to 48 weeks. And the side effects were awful: irritability, flu-like illness, fatigue, nausea and more. Plus, it only worked about 50 per cent of the time.
But in recent years, treatment has improved immensely. Clients can take an oral pill for eight to 24 weeks, depending on which type of hepatitis C they have and the extent of their liver damage. It provides a 95 to 98 per cent chance of a viral cure, and the side effects are mild: headaches, some nausea and slight tiredness.
Although these pills were approved by Health Canada a few years ago, their widespread use has been limited by their high price tag. Recently, pharmaceutical companies negotiated with each Canadian province and territory and agreed to a price. As of April 2017, these medications are fully covered by Alberta Health for many of Kate’s clients.
“Since April, we’ve had about 15 people complete their treatments at CUPS and be cured of hepatitis C,” Kate says.
One aspect of harm reduction is handing out clean needles and drug
equipment. It’s polarizing, but Kate supports it. And here’s one of
the reasons why: each hepatitis C treatment pill costs hundreds of
dollars. Taking them for several weeks costs tens of thousands of
dollars. But a complete drug kit available at Safeworks or CUPS, which
comes with a needle, syringe, cooker, water, vitamin C, tourniquet and
antiseptic wipes, costs about one dollar.
“That’s why harm reduction and handing out clean needles is so
important,” says Kate. “It’s much more effective to prevent hepatitis
C than to treat it after the fact.”
Kate’s often heard harm reduction described as enabling. Enabling safer consumption, yes, but the goal is to reduce the harm associated with taking drugs, such as overdoses and other drug-related episodes.
Kate says her team spends a lot of time educating their clients and not everyone is ready to pursue addiction treatment right away.
“We want to build the relationship so that if or when they want to
stop using drugs, they’ll come to us and we can refer them to
effective resources,” says Kate.
Kate fully supports supervised consumption sites, like the one that’s being planned for Calgary. Evidence shows that by acting as a point of referral for medical care, drug treatment, mental health care, and social services, supervised consumption sites can lead to an increased uptake of health and social services to improve the overall health and well-being of illicit substance users.
Further, “Research shows communities are safer and drug use does not increase from these sites,” Kate says. “It’s going to save a lot of lives, and be an opportunity to connect with more clients.”
Kate Newcombe graduated from the University of Calgary bachelor of
nursing program in December 2015. She also has a degree in
biological anthropology that supports her understanding of people as
cultural groups. She was nominated as a Rising Star for the 2017
CARNA Awards of Nursing Excellence.