A University of Virginia’s College at Wise senior’s research on Comprehensive Harm Reduction programs has been published in the Journal of Community Health.

Logan Baker, a Dickenson County native, shows data from his research represents one of the first attempts to gauge support for and knowledge of CHR programs in the central Appalachian region of rural Virginia. Baker, who also serves as student representative of the UVA Wise College Board, believes the research data is one of the first attempts to assess stigma towards people who inject drugs in the central Appalachian region of Virginia.

Baker found that 10 percent of participants identified as a person who injects drugs, and 50 percent of participants said that they knew someone who injected drugs.

“There was an association between increased stigma towards people who inject drugs and decreased support for CHR programs,” Baker said.

The research is an integral component of community-based interventions. Baker thinks the findings from the study will be used to better inform community stakeholders in rural communities in central Appalachia.

“Growing up in Dickenson County, I have seen the effects of the opioid epidemic firsthand,” Baker said. “With people who use opioids increasingly turning to injection drug use, the risk of an outbreak of Hepatitis C Virus and HIV skyrockets. Dickenson County has an acute rate of HCV more than 13 times the state average. The rate of acute HCV in Dickenson County more than doubled within the span of three years.”

According to Baker’s research, an outbreak of HCV among people who inject drugs can be indicative of an impending outbreak of HIV.

“Comprehensive Harm Reduction programs are an evidence- based intervention designed to reduce the risk of infectious disease transmission among people who inject drugs,” Baker said. “CHR programs are very dependent upon public support, as a CHR program in Charleston, West Virginia recently closed due to public opposition. I conducted this research in order to understand how a CHR program would be received in Dickenson County. I hope that this data will inform community stakeholders when designing interventions for people who inject drugs in Dickenson County.”

The spread of infectious diseases is a major risk of injection drug use. Baker found that cases of acute HCV infection increased 98 percent in the United States between 2010 and 2015. Rural areas have been hard hit by increased injection drug use and outbreaks of Hepatitis C, and HCV rates in central Appalachia have risen dramatically in recent years.

The research shows a 364 percent increase in new HCV cases in the central Appalachian regions of Kentucky, Tennessee, Virginia and West Virginia among persons aged 30 years or younger between 2006 and 2012. Comprehensive harm reduction programs are designed to reduce the risks associated with injection drug use, such as the spread of infectious diseases like HIV and HCV. Baker’s research shows that in addition to reducing the incidence of infectious diseases, CHR programs are also associated with a reduction in injection drug use. Also, new users of CHR programs are five times more likely to enter drug treatment and three times more likely to stop using drugs than those who do not use CHR programs:

Baker used a convenience sampling of adults in Dickenson County taken between June and August of 2018. Participants ranked their agreement with a series of questions regarding knowledge of CHR programs, queries about injection drug use in their community and questions designed to assess stigma. Co-authors of the research were Margie Tomann, Wally Smith, and Tauna Gulley.

Photo of Logan Baker