Hannah Edelman / Delaware News Journal
Hear from Leslie Palladino on the importance of harm reduction to treat opioid addiction.
- Harm reduction can prevent fatal overdoses and stop the spread of HIV and hepatitis C
- Funds from a new federal grant will help bring harm reduction education to kids in middle and high school in Delaware
Every month, outreach workers and volunteers with local nonprofit Impact Life go out into Wilmington with a trunkful of “blessing bags” and Narcan.
The bags — filled with toiletries and condoms — are for the city’s sex workers, a population that advocates say is underserved when it comes to addiction treatment. The overdose-reversing drug naloxone is for anyone who will take it.
On their most recent night of outreach, Impact Life Director Leslie Palladino packed up 105 two-dose boxes of naloxone. By the end of the night, they were all gone. It’s a success, Palladino said, because it means more lives can be saved in the community; but it also points to a larger problem — the lack of access to harm reduction resources.
For many people living with addiction, recovery simply isn’t in the cards yet. But outreach work by people like Palladino — many of whom are in recovery themselves — means when community members decide they’re ready to get sober, “they’re not these completely broken human beings.”
Whether it’s access to clean needles or supervised injection sites, the strategy of harm reduction seeks to lessen the negative effects of drug use. It’s based on the increasing understanding that addiction is not a choice, but rather a disease.
Brandywine Counseling & Community Services prevention program manager Holly Rybinski drew a comparison between someone with substance use disorder continuing to use drugs and someone with Type 2 diabetes refusing to make any recommended lifestyle changes.
Regardless of a diabetic person’s lifestyle choices, no doctor would refuse to give them insulin, Rybinski said. Giving people the tools to safely use drugs until they’re ready for recovery should be treated the same way, she said.
“You can’t get clean if you’re dead,” Rybinski said.
As part of her job, Rybinski helps to oversee Brandywine Counseling & Community Services’ syringe services program. Every weekday, people across Delaware can bring used needles to RVs parked at pre-scheduled locations and receive the same number of clean needles back, along with safety tools like alcohol wipes and bleach. They also can get free condoms, HIV screenings and fentanyl test strips.
Rybinski explained that by giving people access to clean injection supplies, the program decreases the risk and spread of HIV and hepatitis C. The service is also free of judgment: Many of the outreach workers have dealt with addiction in the past, and some have even used the very same syringe exchange program.
And if one of the syringe exchange’s regular customers decides they do want to enter treatment or access resources, the team in the RV is ready to help. Rybinski estimated that since the program began 15 years ago, over 16,000 Delawareans have been referred to treatment.
“Sometimes it’s just as simple as building rapport, so at the end of the day, when they have that small window where they’re like, ‘I’m tired of this, and I’ll do whatever it takes to get sober,’ they have a number to call,” Palladino said.
She and Impact Life CEO Domenica Personti have known some of the local sex workers for more than eight years, and greet them by name when they see them in the community. Others are newer to the world of prostitution; they have whiter teeth and lack the rough skin that comes from long days spent out in the sun.
Almost all of them are also addicted to drugs, a fact that compounds the risks of disease, violence and death.
The women look out for each other, Palladino explained. If one leaves with a “date,” the others make sure she returns safely. They warn one another of certain cars to avoid and, when resources like the ones Impact Life gives out are available, where to find them.
Even with dedicated outreach workers in the field, Personti said Delaware’s addiction resources “pale in comparison” to other states’. She hopes that a new $400,000 grant to her nonprofit from the Substance Abuse and Mental Health Services Administration will change that.
Impact Life is one of 25 organizations nationwide to receive what Personti called “unprecedented” funding as, in the past, “the federal government hasn’t really put funds behind harm reduction in any large manner like this.”
Personti plans to put the grant, which comes from the American Rescue Act, toward harm reduction services for kids in middle and high school. While the young ages targeted has drawn criticism from some, Personti pointed out that many of these children already are dealing with drugs and addiction in their daily lives.
“We want to hope and pretend and believe that that doesn’t happen, but unfortunately it does. It happens every day.”
One in 1,949 Delawareans died of drug overdoses in 2021, according to the state’s Division of Forensic Science. Another 42 died of suspected overdoses in May 2022 alone, according to the Department of Health and Social Services. It’s the highest count of fatal overdoses ever recorded in Delaware.
One way to reduce these fatalities is to give kids the knowledge and tools to best respond to any addiction-related challenges they may face, including overdoses, Personti said. This could take the form of school programs; naloxone handouts and training; or education on Delaware’s “Good Samaritan” law, which protects anyone calling 911 for drug-related emergencies from prosecution.
“People are afraid of what they don’t know or they don’t understand,” Personti said. “And so if you can teach them, you can educate them and you can give them factual evidence that supports it, then hopefully, we can shift their perspective.”
How to find help
Delaware Hope Line: 833-9-HOPEDE for free 24/7 counseling, coaching and support, as well as links to mental health, addiction and crisis services. Resources also can be found on the Help is Here website.
Suicide and Crisis Lifeline: 988
SAMHSA National Helpline: 800-662-HELP (4357) for free 24/7 substance abuse disorder treatment referral services. Treatment service locators also are available online at findtreatment.samhsa.gov or via text message by sending your ZIP code to 435748.
Syringe Services Program: Mobile outreach sites are available statewide for free needle exchanges, HIV and hepatitis C screenings and treatment referrals. See the monthly schedule online at brandywinecounseling.com/ssp.