FDS Insight Newsletter Jul-Sep 2020

44 A SECOND CHANCE : H OW HARM REDUCTION IS SAVING LIVES eople often say that to have a smartphone is to have a world of information, resources, and entertainment at the tip of our fingers. And in a world where it is easier to download an app than to get sufficient health care, researchers and alliances are using the principles of harm reduction to advocate for treatment for those the system has overlooked in the hopes that medical treatment can one day be as accessible as Snapchat. ‘Harm reduction is based on pragmatic strategies that help keep people safe while engaging in high-risk behaviors until they are able to access more long- term therapy,’ Dr. Jacob Sunshine, an assistant professor of anesthesiology and pain medicine at the UW School of Medicine, said. Using the fundamentals of harm reduction, Sunshine recently developed an app called Second Chance, aimed at monitoring opioid use and alerting help in the case of an overdose. Using sonar, the phone sends inaudible sound waves to users’ chests, monitoring the formed breathing patterns that emerge when these sound waves interact with breathing. The current recommendation is that risky behaviors such as injection drug use should be performed in the presence of others so as to increase the likelihood of intervention via naloxone, or Narcan. However, this rationale is exactly that: a rationale that exists in a vacuum, ignoring the countless overdoses and deaths from those who were overlooked due to the inflexibility of the system. ‘We are not advocating it [the app] at all to be a replacement or recommendation for people who are using with others,’ Sunshine said. ‘The intention of this is to provide another option for people who may not meet those recommended behaviors.’ Researchers at Second Chance additionally collaborated with Insite, an injection site in Vancouver, Canada, in order to refine their precision in detecting breathing patterns. Armed with clean needles, naloxone, and treatment options, safe injection sites are the soldiers of harm reduction, giving users not only a safe space to inject but also clean tools to inject with. And by providing this safe space, injection sites give users a chance to have a positive interaction with the medical community, who will, most importantly, ensure they walk out alive. In many ways, injection sites represent the most radical form of harm reduction, and the sheer scale of the opioid epidemic reflects the need for radical approaches. In 2018, an estimated 69,029 people fatally overdosed from opioids. And while many critics assume these sites would encourage drug use, studies at Insite P