Harm Reduction aims at safer practices

03/16/2018 By Sue Cody 

Three women stand in a windblown parking lot, bundled against the Pacific winter rain. What brings them out on the northern Oregon Coast each Thursday, rain, wind or shine? The sign next to them reads, “Needle Exchange Here.” It means they came because they care. They are part of a pilot harm reduction program started by the Clatsop County Health Department, to reduce the risk of exposure to hepatitis C and HIV.

W2W Harm Reduction FB

“Oregon has one of the highest rates of prescription opioid misuse in the nation,” reports the Oregon Health Authority. And Clatsop County has one of the highest rates of illicit drug use in the state. From 2012 to 2016, there were 14 drug overdose deaths in Clatsop County.

Opioids include morphine, Oxycodone, Fentanyl and heroin, among many others. The illicit use of the drugs can lead to other health hazards.

Intravenous drug users sharing needles with each other run the risk of spreading communicable diseases, such as hepatitis C and HIV.

Discarded used syringes pose a health risk to the community. Anyone who comes into contact with them – kids playing in a park, hikers on a trail or garbage collectors – could be infected if poked by a used needle. To minimize the risks of exposure to disease, Clatsop County began its harm reduction program in October 2017 with a needle exchange.

Some believe exchanging needles will increase and enable drug use. Research shows substance abuse is not increased. The number of syringes does not increase, because each used one is replaced with a new one.

Participation in harm reduction programs like this one leads to a reduction in risky drug use behaviors and a reduction of infected needles in circulation, says Melissa Brewster, pharmacist at CareOregon. Other benefits include a reduction of cases of hepatitis C among drug users and an increase in referrals to substance abuse treatment.

Every Thursday, in Seaside, Warrenton and Astoria, Sarah Mitchell and Sheri Salber from Clatsop County Health Department and Kerry Strickland from Jordan’s Hope for Recovery brave the weather to set up their needle exchange sign and to offer new syringes, safety containers and hope.

 “When we started, there was a high risk of exposure,” says Mitchell, a nurse and prescription drug overdose coordinator with the county health department. “People brought in their own bags with needles sticking out. With harm reduction, we give out sharps containers and new needles.”

On the scene

In Astoria, the needle exchange takes place behind Safeway at the end of 32nd Street near the Riverwalk. People drive or walk up to the tables manned by Mitchell, Salber and Strickland. Salber is the clinic supervisor for the health department, and Strickland formed Jordan’s Hope for Recovery after her son, Jordan, died of a heroin overdose.

As the people approach to turn in containers of needles, one of the Harm Reduction Team members asks a series of questions about health insurance and homelessness, and if connections to those services have been offered.

“We try to have that conversation with everyone who comes in,” says Salber. “We let them know help is available and that people do care.”

With compassion, the Harm Reduction Team asks if medical attention or treatment information is needed.The key is to build a relationship and meet the individuals where they are, says Strickland. “Stigma still keeps people away. We have to build their trust." Salber adds, “Many of these people have lost a lot. But we are here to show that somebody cares.”

During the interviews, some people express an interest in treatment. In those cases, the Harm Reduction Team assists them in calling a detox center. Pathways in St. Helens is the closest detox center that takes the Oregon Health Plan.

County in-patient facilities include Astoria Pointe, The Rosebriar and Awakenings by the Sea. Intensive outpatient facilities include Helping Hands, Klean, North Coast Recovery and Astoria Pointe. For a full list of counseling and recovery options in Clatsop, Tillamook, Columbia and Pacific (Wash.) counties, see Jordan’s Hope for Recovery: www.jordanshope.org

After the conversation, the Harm Reduction Team hands out sharps containers that safely hold used needles. When returned to the team, they are replaced with new containers and new needles at a rate of one-for-one.

Since October, 30.000 needles have been exchanged in Clatsop County.

Looking forward

There is a Community Conversation on Substance Abuse from 3 to 5 p.m., March 21, in the Coho Room of Columbia Memorial Hospital’s Meeting Center, 2020 Marine Drive, Astoria. It is an information gathering session to see what substance abuse looks like in Clatsop County, including what services are available and what is needed. The Northwest Substance Abuse Committee will gather anonymous information to share with community leaders.


The third annual Northwest Opioid & Substance Abuse Summit will be held from 8 a.m. Monday, April 23, to 1 p.m. Tuesday, April 24, at the Seaside Convention Center. The summit offers information and discussion about trauma-informed care and encourages collaboration to de-stigmatize addiction.

This year’s event will emphasize three topic tracks:

1) Substance Use Disorders
2) Chronic Pain
3) Community Action & Advocacy 

The Way to Wellville and its sponsor, Columbia Pacific Coordinated Care Organization, support healthy activities and community safety.