The DETAILS BLOG
Capturing Stories from the Field: Reflections, Challenges, & Best Practices
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Olivia Halle, Public Health Intern, NaRCAD Tags: Harm Reduction, Health Disparities, Stigma, Substance Use  What do we owe to people who have been stigmatized due to circumstances beyond their control? The people of the historically redlined neighborhood of Kensington, Philadelphia come to mind, having been stigmatized for too many reasons: their race, their socioeconomic status, and an increased access to drugs in their neighborhood. As drugs become more potent, such as the synthetic opioid, fentanyl, and the sedative, xylazine, more people have been severely affected by opioid use disorder, and the people of Kensington are no different. But where this neighborhood’s circumstances differ is that they have been victimized by city officials who have capitalized on the stigma of drug use in order for financial benefit. City officials owe it to the people of Kensington to allocate the necessary resources and funds to help reclaim their neighborhood. The city government gentrified Kensington by pushing the people with chronic substance use disorders who are experiencing home insecurity onto Kensington Avenue. This engendered an open air drug market with hundreds of people actively using drugs such as fentanyl and xylazine, better known as “tranq”. The redlining of Kensington has led to low owner occupancy, the lowering of property value, increased segregation, and an overall lack of financial resources injected into the community. The dehumanization of the people that are experiencing unstable housing, a portion of those due to the chronic use of substances, has resulted in this gross and condoned mistreatment by city officials, who capitalized on this situation in order to reduce surrounding property values. It is those same officials who sought to capitalize on vulnerable people that must be the ones to find compassion and recognize that the people of Kensington Avenue are their neighbors too.  How do we begin to repair these complex harms? Harm reduction is an effective direct response to the rise of drug use and seeks to well equip people who use drugs with life-saving tools and information, and the emergency medical setting can be an access point to those services. Emergency clinicians are often the main point of care for people who use drugs or experience housing instability. By using a strategy like academic detailing (AD) within the emergency medical setting, trained public health educators can encourage emergency medical staff to integrate harm reduction as a critical tool to increase safety for people who use drugs. Detailing would raise awareness and give hope to people with OUD by providing destigmatized access to care, leading to fewer overdoses. AD can also provide the necessary education in equipping emergency clinicians with person-first language. When many people who use drugs have little trust in the healthcare system, it is vital for emergency clinicians to lead with compassion when caring for people who use substances. Connecting people who use substances to harm reduction services not only ensure safe practices in the person seeking out harm reduction services, but enable a sense of agency that often fades when experiencing housing instability. Increased referrals from emergency clinicians to harm reduction services would support people who use drugs in living safer lives, increasing community connection, trust in the healthcare system, and a greater sense of dignity.  The people of Kensington gathering to support increased funding in their neighborhood. ©Co-Creating Kensington https://www.kensingtonplan.org/ Funding these relatively inexpensive interventions is critical. In 2023, the city of Philadelphia announced that $7.5 million dollars from national opioid settlement funds would be directly funneled into Kensington’s schools, parks, foreclosure prevention, and rental assistance. These services, which can be accessed through Co-Creating Kensington, in conjunction with harm reduction services such as Prevention Point Philadelphia on Kensington Avenue, would help to destigmatize home insecurity and drug use when paired with AD. While $7.5 million dollars will barely scratch the surface of what is owed to the Kensington community, it will begin to mobilize reparations. The people of Kensington, Philadelphia deserve better. They deserve access to harm reduction services and OUD treatment with the full support of the city behind them. By continuing to fund community-directed services, along with academic detailing and harm reduction, city officials can take these first steps to begin to repair harm and restore agency, security, and hope to the people of Kensington. Biography. Olivia is a summer intern helping the NaRCAD team through providing feedback and support on usability of NaRCAD’s online materials and training sessions. She also aids the NaRCAD team through conducting literature reviews along with organizing and collecting data for online toolkits covering critical academic detailing areas.
Olivia is an incoming sophomore at the University of Washington studying public health gaining exposure to the field through her summer internship at NaRCAD. Olivia provides insight into how academic detailing and other evidence-based public health research can be more digestible to a greater audience. Olivia enjoys reading and practicing yoga in her spare time. Comments are closed.
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