There were 737 overdose deaths in 2017 in Alleghany County, Pennsylvania, where Pittsburgh is located. At Prevention Point Pittsburgh, a nonprofit that has provided health services to people who use drug since 1995, Bloomberg Fellow Sarah Danforth has a frontline view of the crisis. She oversees three harm-reduction programs — needle exchange, wound care and peer outreach — that aim to make using drugs a less dangerous behavior. 

Sarah was drawn to the Johns Hopkins Bloomberg School of Public Health, in part, because of its faculty’s innovative research into evidence-based solutions to the opioid epidemic. We spoke with Sarah about her job, community outreach and why harm reduction works. 

Sarah Danforth

Can you walk us through the three harm-reduction programs you run? 

People drive from across western Pennsylvania to pick up supplies, such as clean syringes, at our needle exchange sites. They also have access to wound care and infectious disease testing. It’s a way we can help make peoples’ lives healthier.

Through our peer outreach program, three people in our needle exchange program distribute naloxone, a drug that can reverse opioid overdoses, to drug users in their neighborhoods. This outreach means people will have access to lifesaving medication in the case of an overdose. I think it’s important to have peers in this role because they have credibility in their communities as people who have knowledge and experience about naloxone. 

What sort of effect have Prevention Point Pittsburgh’s programs had?

In 2017, people who got naloxone from our needle exchange reported 635 overdose reversals. That’s drug users saving the lives of drug users. It’s a rare spot of hope in this epidemic.

And our wound care program helps people begin to develop healthier habits. When someone is involved with drug use, it can be isolating. They often only talk to other drug users. The wound care program gives them the chance to talk to someone who is not a drug user. If a doctor or nurse takes the time to show someone how to properly use a tourniquet so they can have a healthier injection practice [to prevent the spread of infectious disease], it shows they care. I’ve seen a lot of positive change happen from that. People use our wound care program and then take positive steps towards improving their health, whether it’s lessening drug use, making their drug use a more sterile practice or going into treatment. 

You do a lot of community outreach about needle exchange. What’s that like?

It really varies. Unfortunately, people have a lot of fear about needle exchange programs. They think if a needle exchange program is set up in their neighborhood, it will increase drug use or violence. But there’s lots of evidence showing that’s not the case. Needle exchange sites reduce crime in neighborhoods and drug use. 

I try to have the same approach with fearful community members that I have with someone using our programs. I meet them where they are and respect where they’re at. That’s what harm reduction is about: Meeting people where they are and providing support. It’s an honest way of interacting with people. That’s why it works.