Addressing Misconceptions about People Who Use Drugs

By Magalie Lerman December 14, 2015

Advocates for public health and harm reduction approaches to injection drug use often encounter arguments suggesting that people who inject drugs (PWID) cannot or will not prioritize their health care. Evidence suggests otherwise. Here are the facts:

  1. Communities of PWID have lowered their HIV risk by 60-90% in areas with syringe services programs (SSPs). Using a sterile syringe and clean injection equipment for every injection is a fundamental step PWID take in caring for themselves. 
  2. PWID are high utilizers of naloxone, which, according to the Centers for Disease Control and Prevention (CDC), has helped save 10,000 lives in less than 5 years.
  3. Since Medicaid expansion, hundreds of PWID have begun opioid replacement treatment after enduring long waiting periods caused by an oversaturation of limited resources. 
  4. PWID who begin methadone and other substitution therapies adhere to treatment regimens as well as other requirements imposed by clinics and doctors. 

More consideration and credibility must be given to science, not stigma. There are no medically supported reasons that PWID cannot adhere to HCV treatment regimens or HIV pre-exposure prophylaxis (PrEP), which require less monitoring and oversight than methadone clinics. In fact, studies show that PWID, when provided non-judgmental medical care, have higher rates of HCV treatment adherence and low rates of reinfection.  Not all PWID are ready for substance use treatment or are a good fit for PrEP. This is why a grounded, harm reduction approach is necessary in HIV and viral hepatitis prevention, care and treatment. People who inject drugs can and do care for themselves and their communities when medical professionals and community-based service providers give them the opportunity to do so. Access, not drug use, is the issue.  It is on us as public health professionals to give PWID what they need to care for themselves and their community.