Opioids Part 3: Harm Reduction (with Dr. Sydnee McElroy)

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In part 3 of our series on the opioid crisis in Appalachia, we talk to Dr. Sydnee McElroy.  Dr. McElroy is a physician, harm reduction advocate, and podcaster from the great city of Huntington, West Virginia.  We talk to Dr. McElroy about the benefits of harm reduction and the stigmas that still exist creating political obstacles to common-sense practices that save lives. 

Our friends at Cornbreadhemp.com are the sponsors of this series. You can use our promo code “Appodlachia” for 25% off your order at checkout.

Chuck Corra: Now let’s get started. I think it’s appropriate to give a little introduction because we’ve got some new listeners, got some new listeners.  I’m Chuck Cora. Directly in front of me.  And my screen plus about 360 miles away is big John Eisner. We are Appodlachia. Thank you so much for joining us.

We’re here to provide a counter-narrative to the stereotypes that plague Appalachia. We’re also hearing what fun too, John typically intro starts out with just us talking about something completely random, which is. What we intend to do from here on out, but usually I think of something during the week and I can’t remember it and I’ve been getting better at writing stuff down.

So I wrote down a list of four different things, and I want you to pick from those which one we’re going to open the show with. So here we go. All right. This is the list. President’s physical fitness test Matt gates versus Liz Cheney, JD Vance nativist bullshit. Or bamboo ninja is 

Big John: this, wow, man, this is,  I’m torn between two cars. Cause obviously we know JD Vance and we don’t like him. We know that. So I’m like, yeah 

 Chuck Corra: Maybe you went on breaking ground there. 

 Big John: Like we’re not, but I do think we might break ground on two of the topics, which would be did you say, bamboo ninja? A yes.  And president’s physical fitness test

Cause I have a lot of feelings 

Intro – President’s physical fitness farce

Chuck Corra: on that. Okay.  Let’s go to the physical fitness just cause I don’t actually know much about the bamboo ninja thing. All right. That works for me. I’m trying to remember how this came up. I think it was because I was sent a meme about the V sit and reach. Which was where, oh yeah.

 You had your legs spread open and you had your hands, like cross like this and you had to  lean forward. Cause somehow that was a test of physical strength,  let me back up actually, for people that may not understand what the presence, physical fitness testers, I don’t know why if the president had anything to do with it, but it was basically a physical fitness test that you had to do you in elementary school, at least where we’re from.

And it was like a series of  what, like 10 different things. 

Big John: Yeah  it was a series. Yeah. And 

Chuck Corra: you can either get presidential level, which was the blue level,  and then there was a red level. I don’t remember what it was national. I don’t know.  But I w I was terrible at every single thing, except for the V sit and reach everything.

 There was pull ups. I could not do a pull-ups in my life. There was sit-ups push-ups a mile run. God knows what else? I was terrible at all of it, but  the sit and reach, man  I was best in class

 Big John: About the sit and reach. So a lot of people may not know cause  they don’t see us physically, but like Chuck  like I have a, unless you’re watching on YouTube.  They don’t see my back though.  So I’ve got kyphosis, which is  it’s like the  makes my back, do this and hunch over.

I couldn’t run a mile or do a pull-up, but my God, when it came to  That’s when the hunch really helped, because I was able, people are like standing straight up. I’m like, no, don’t do that. Like you don’t need to allow those shoulders really do have to get in there.

And  I’m telling you I’m past the amount that you can go. Like I’m all the way I had to have literally permanent marker drum for me so that people can measure. But it did not matter because as good as I was at that, everything else was terrible. Yeah. So I never got any far 

Chuck Corra: stories. Very similar.

If it sounds like we’re going  to have a V sit and reach off  next time we’re in person.  Because look, I. I, that was the one thing in gym class. I had confidence about literally the only thing I felt good at it. Cause that was 

Big John: terrible. We’ll see. That’s what we’re doing. That’s where we’re different.

I had zero confidence in it because I just knew that it was going to show my hunchback more.  You can take it 

Chuck Corra: with confidence. That’s fair. Back to the presence. Physical fitness test. I. I think I’m going to start a campaign against it because it has the name president on it, which makes me assume that there is taxpayer money involved.

All definitely. And I don’t want my taxes, especially from when I was a kid to be going funding, a program that is set up and reminded me of being fat. I 

Big John: mean, 

Chuck Corra: that’s fair. That’s just me. I don’t know. I don’t know. What did you know, 

Big John: did you know. That. Okay.  Data latcha but torn but different. Cause I don’t run it.

 You normally do it, but I want you to get of, I want you to guess the percentage of kids that fail that test, 

Chuck Corra: is this a real number that you’ve pulled? Yeah. Real numbers. Oh, okay. The amount of kids that fail what’s considered failing. 

 Big John: Okay  this, I think maybe early on statistics, but  they used to pretty much do a pass fail, and I think that they still do it’s in the it’s in, you could have the people who are really high up and then you have people who are at the pass rates and then everybody else who’s side 

Chuck Corra: 65.

Big John: You’re really close 58. 

Chuck Corra: I was shit. I was 

Big John: 50%. Okay.  And.  The history behind this test is not good. Like it was created as just a terrible thing. 

Chuck Corra: I feel so validated now. So 

Big John: some believe that as an Eisenhower  may have created it because he wanted to get kids ready to go to war. 

 Chuck Corra: That would have been great for me because I was  terrified, and I’m not okay.

This is the real story. I was horrified of being drafted into the army because my mom, oh, you’ll know about it when I was like 10 and she said “if they call you up, you got to go.” I was like, “what if you don’t want to?” She said, “that’s too bad.” So for, until the day I turned, I think 26 or 27 years old.

I was horrified of being drafted because that’s the age at which you’re phased out and you don’t have to worry about it but see, that’s really helpful for me because I was terrible at it. And so then I guess I wouldn’t have had to worry about being drafted. 

Big John: I  I share that. I don’t know if maybe that’s a thing that a lot of kids go through, but I had the same thing.

Like I was afraid of being drafted, but I had  a weird. Fears that  they would get rid of the 18 requirement and just start drafting me right out of junior high.    That 

Chuck Corra: was me. That was also your dream for the MBA. 

Big John: That’s the other thing I was going to tell you, my mom would, or my brother actually would be like, ah, you’re, you’ll probably get drafted one day.

And I said, only to the MBA. So you have like little, 260 pound me claiming that I’m going to go to the MBA. But in actuality, I was more likely to be drafted by the military. To point out real quick, since 2013, the test has been replaced. So I don’t think you need to start a campaign to get rid of it.  I don’t like the word replaced though.

Chuck Corra: That implies that something is now taking its place. I don’t know. It was 

Big John: replaced with a more comprehensive program that’s supposed to emphasize. Fitness goals instead of one size fits all a regimen. So it’s designed to be less 

Chuck Corra: humiliated. Oh. So it’s designed to not prepare kids for war. Great. That’s a step up.

Is it, I don’t know. Probably not. 

Big John: Or are we at  are we just not 

Chuck Corra: prepared now? Eventually we’re like, if we’re still in Afghanistan and it’s been, what 20  years basically send me 

Big John: over, you send me over.  Okay. We’re at war. We’re about to go into a battle. I look around, I say, all right, boys, I’ll take it from here.

You should have seen me on the sit and reach. It literally had nothing to do with it. I don’t understand why he picked the sit and reach. 

Chuck Corra: Listen, have you seen me V sit and reach? I can find out kinda with that. Give me one. I can find out cuddle with a visa and reach, bring it. Climbing 

Big John: rope makes sense.

Pull-ups make sense. Pushups, make sense, sit and read 

Chuck Corra: shit and reach for a gun to fight Al-Qaeda with it. That’s right, man. 

Big John: I’m a sit and reach for a donut. If you’re going to tell me that’s physical activity, 

Chuck Corra: speaking of donuts and sitting and reaching donuts are delicious, but John  what else is delicious is CBD gummies from corn bread, hemp.

How do you like that transfer right there, baby? By the CBD gummies. I know people are listening to this. Your inclination is to skip past this out. I get that. I understand it. Bear with me.  We’re enjoyable. People let’s do bear with me. The gummies are delicious. They are I’ve had them. They’re good.

You will not regret it. They’re always full spectrum. That means as much THC is to federal law will allowed. We love that. We love that. Its flower only. Cause why John? Why do we love it? Unlike 

Afra 

Big John: man. We don’t have to worry about picking out the seeds and stems. 

Chuck Corra: Yep. Unlike Afro man and 99% of other CBD brands.

So  a lot of them took after Afro man, but a cornbread hemp didn’t and    there Kentucky’s first USDA certified organic CBD product, none of those bullshit preservatives and other nasty chemicals that will ruin your day and ruin your CBD.  We don’t like that.  But you know what we do like John, the satisfaction 

Big John: guarantee.

30 day money back guarantee. It’s free money on the table. They’ll look  you could, let’s say you got a pack, a 30, you ate them for 29. You say, I don’t like these  Jim gives you your money back. What a deal. Yeah. You get 

Chuck Corra: a full refund. Other cool thing is that cornbread hemp is family owned and they’re based in Kentucky.

Look  we try as much as we can to promote Appalachian businesses. And businesses and Appalachian states, cornbread, hemp, Kentucky, own family owned. You’re not going to be dealing with any of that corporate CBD. So when you go on a cornbread hemp, you can use our exclusive promo code to get 25% off your order at checkout that’s app pod latchet checkout app O D L a C H I a, put that in 25% off your order.

You’ll love it. And thank you for supporting the show and supporting cornbread hemp. Look at a great guy yesterday, Dr. Sydnee McElroy. She is a medical doctor in the great city of Huntington, West Virginia.  And she is extremely active in the harm reduction community. They’re working with the community on harm reduction methods, advocating for policy changes in West Virginia and throughout the country that focus more on harm reduction.

And de-stigmatize the topic of harm reduction. Really excited to talk to her today. Also. Important to point out. She is also a  very well-known podcaster and co-host of the sawbones podcast, a marital tour of misguided medicine, and still buffering both on the maximum fun network with the McElroy family, podcasting fame from the great city of Huntington, West Virginia.

So  very excited to have her on the show. And I know that you all will really love the conversation.

Interview with Dr. Sydnee McElroy

Dr. McElroy. Thank you so much again for joining us.  I wanted to start.  We’ll definitely get into a discussion about the recent legislation in West Virginia, about a harm reduction and syringe service programs. But I  first I’m interested in learning about a little bit more of like why, what harm reduction is, what that means to you and why it’s important to you as a medical professional.

Dr. Sydnee McElroy: Sure.  I think that’s a great question because I think a lot of people tend to assume  first of all, when you say harm reduction that if you’re not in this world, you might not know what we’re talking about.  And then secondly, it, they  reduce it to, oh, you mean a syringe exchange and that’s the end of it.

 So I think it’s important to understand what harm reduction is as an entire concept, because we do harm reduction. In our life all the time, especially like from a  a medical standpoint, from a wellness health care standpoint, wearing your seatbelt as harm reduction.   We take part in risky behaviors and we try to do things to mitigate that risk.

And  that’s at the heart of harm reduction.  In my mind, it’s no different than taking care of a patient who has CIPD and still smokes.  I’m not going to say well  until you quit smoking, I won’t give you any inhalers. I won’t admit you to the hospital. I’ll take care of you, encourage you.

This would also help. And then when you’re ready to take that step, I’m there for that to harm reduction is the same idea when applied to people who use injection drugs. So certainly part of that is what gets all the publicity  clean syringes, access to clean syringes.  But the other part of it is talking about  PE with people who use injection drugs  they’re the experts on it.

So let’s talk about how we keep you safe as a person and healthy and while you’re still engaging in these behaviors that as a medical professional, my thought is, are risky. Are dangerous and do have a lot of problems associated with them. How do I help keep you as healthy and safe as possible by providing you with all of the equipment that is necessary by giving you resources, by giving you access to medical care?

That’s a big part of it is  I work. Primarily with persons experiencing homelessness in our community here in Huntington. And so a lot of those patients do use injection drugs and because they feel comfortable with me, I can not just talk to them about safe ways to use drugs, but also let’s look at your skin.

Let’s see. Is there, do you have any infections right now? How are you feeling? Are you healthy or have you been sleeping outside? Let’s talk about it. Health issues related to that. Are you safe? Are you being abused or threatened in any way? All of those things can be addressed as part of harm reduction. And then I think the other piece of it,  that is so important to our community and to public health as a whole is when we do all these things, we can reduce the transmission of bloodborne illnesses like HIV and hepatitis.

We reduce infections like endocarditis infection of the heart valves and infections of the bones like osteomyelitis all of these really serious that infections that consume lots of health care resources.  And then hopefully this provides an opportunity for recovery for a lot more people.

And we know that’s true,  that kind of normalizing.  You are a human and you are a person and you are looking for help. You’re looking for companionship. You’re looking for friendship and understanding and extending that hand is a way to help people take that step. Once they’re ready. 

Chuck Corra: Yeah  you make a lot of really great points there, especially with kind of deconstructing what it actually is.

Cause like you mentioned, for people that are not familiar with the term, it’s going to come off as foreign to them and something that made me think of that too. It was what you mentioned in your op-ed from, I think last month where you talked about how. Syringe exchange PR or certain service programs are an important conduit to people getting access to Narcan in order to reverse an opioid overdose.

And I thought that was a really interesting segue to that. I’m wondering if you can explain the connection there and how things like syringe service programs can help fight. The opioid crisis and help provide for people because it’s something that I think a lot of people don’t really know about the here syringe service program, they think injecting drugs, and that’s where it stops.

Dr. Sydnee McElroy: I think the piece of it, the Narcan or Naloxone part of it is really something that a lot of us were working during this past legislative session to try to talk to our representatives about. The about the bill that was going to address syringe service programs and harm reduction programs in the state too.

 To try to make it better. And I wish I w there were so many things to focus on. I wish we would have talked about the Naloxone part more. Cause I don’t know that it occurred to people. Naloxone can reverse an opioid overdose. So it is a life-saving drug. It is the same idea as having an epi-pen available to someone who might have a severe allergy.

 It is absolutely life-saving. And so if we’re in the business of. Trying to affirm life, trying to take care of people, keep people alive, give people the chance to survive.  This illness that is addiction, this medical condition and get to recovery. Naloxone is absolutely essential.

 We know it is in order to get Naloxone. We do have in West Virginia, a standing order, which means you don’t need a prescription. If you go to a pharmacy, you can get Naloxone there without a prescription. Now just because that exists doesn’t mean it’s really that easy.  The F the people where you go to whatever pharmacy you use, they have to know that too.

And  I will tell you that is not always the easiest transaction, but you can go get it without a prescription. You could also have it prescribed to you by a medical provider.  Assuming that you’re forthcoming about the fact that either you use injection drugs or someone you’re close to do then you could get it from a provider.

 But I’ll be honest. A lot of the clients that I work with, a lot of my patients, get it from the shelter where I work. Or they get it from the harm reduction program. Those are the main ways that people access that so that they can have it with them because we know that is the key is to not just have it in the hands of people in the hospital, not just have it in the hands of first responders.

All those things are important, but we also need it in the hands of people in the community, people who are with those who use injection drugs and people who are using injection drugs, they’re usually the ones administering it and saving each other’s lives. And. I am very worried that with this new legislation, it’s going to be so much harder for them to access that in a really regular way.

Big John: An interesting thing that keeps coming up when we either talk about harm reduction or specifically here in West Virginia. One of the biggest arguments that people like to come up with is that harm reduction gives addicts or users an excuse to continue or a reason to continue abusing drugs.    Obviously, you’ve stated all of these great benefits.

What do you say to somebody when they make that argument? Because I know senators are making it on the floor of the Senate in West Virginia.   So what do you say to that?

Dr. Sydnee McElroy: The first thing is to acknowledge, I understand why you would think that.  I can, and I think that’s a really important thing to in having these conversations.

When I first had the idea introduced to me, my gut reaction was.  Isn’t that kind of enabling. And a lot of people have that initial reaction, and that’s why I think it’s really important not to immediately.  Cause at this point I’m a very emotionally invested in harm reduction, but not to have that emotional reaction and say  I understand why you might think that, okay.

But we have decades of data that says otherwise, because syringe service programs and harm reduction programs have existed since the seventies really  they were a lot more prominent other places throughout the world, especially in the UK  that there were lots of these programs long before they came to the United States.

And what we actually know is that. People who use injection drugs, people who have an addiction are going to use drugs, whether the needles they have been used before have been used by somebody else or brand new out of the package, that’s the way addiction works. So we can accept that as a reality. And then say, wouldn’t we rather, if they’re going to use those drugs until they’re ready for recovery if they’re going to use the drugs anyway, wouldn’t we rather them be able to prevent the spread of HIV, prevent the spread of hepatitis and prevent themselves from getting  I can’t tell you how many patients I’ve cared for with these bacterial infections that you get from reusing needles or using a needle that wasn’t cleaned properly that are just.

 They’re horrible. They’re painful, they’re devastating. They require weeks of IV antibiotics. They require surgery quite often.  Extended hospital stays.   It’s a really horrific thing to see someone go through.  And we can prevent all that with, by giving them these needles. Th they’re not going to not use, they’re just going to use.

An unclean needle. 

Big John: Yeah. I used to always when people would say that to me, you might, my dad was an addict when we were growing up, but he wasn’t he didn’t inject anything. His big thing was like, Oxy loved the pop all the time, but I always said.  It’s funny because whether somebody was trying to help him or not, he wasn’t it was his decision to stop and he, it wasn’t going to make him do more or make him do less.

He, it was his  he was always doing the same thing over and over again. So I wish that there would have been opportunities for harm reduction, where we were living. Cause maybe that could have helped somehow.  But  in my opinion, I don’t think it, I don’t think it’s a negative at all. I think  maybe there’s a percentage chance that somebody fixes that or fixes themselves the other.

The other argument that we hear that this one is, I think the hardest one maybe to get around or at least needs more publicity, there needs to be some type of message that corresponds to it. And that is you have legislators now who are saying that harm reduction sends a bad message to our youth, essentially saying we tell them that drugs are bad, but then we do these kinds of things.

And I  Although I disagree with them. I don’t, I haven’t heard really anything from the other side to go against that.  Is there a message from those who support harm reduction  discussing that 

 Dr. Sydnee McElroy: I think that isn’t something that we, I would say at least that I have spent a lot of time, like talking about that specific part of it.

   But I would say a couple of things to that one in part, I don’t know that it would occur to me to address that specific issue because our kids know.  They know this as a problem. They know they’re their friends, their parents, their grandparents, their aunts, their uncles.  I don’t know anyone, myself included, I don’t know anyone living in West Virginia who hasn’t been touched by this in some way.

So these kids are living it and they’re seeing it. I think these kids would prefer if they can have their parents come back to them. And be in recovery and have survived the illness that is addiction.  They would choose that every time, so the message we’re sending is your friends, your family, your parents, they matter to us.

They matter to us as a society, they matter as people they’re worth something.  Which is a more powerful message in general, not just these people that you might know or love or care about, but people matter. Individual humans matter in their lives matter. And to treat people with compassion and understanding and not just be punitive because you don’t like something they did is a reality that’s such a huge value to pass on to our children and something.

I try to instill in my children, forgiveness, compassion there, but for the grace of God, I go that kind of attitude.  That.  And  I, as a lifelong West Virginia, and I don’t know, what’s more, West Virginia. And then that kind of approach to your fellow humans.  That’s how I was raised.

 It speaks to me. 

Chuck Corra: I wanted to pivot to, and  and the governor and among the  in my opinion, a lot of detestable things that they’ve done this year  is that they took up and passed and the governor signed SB three 34, which was a really a. Put a lot of strict limitations on certain service programs.

And I think you  I think you mentioned it or referenced it at least to some extent  and an episode of Saba that you did on harm reduction about how it’s not effectively banning these programs. But it’s essentially regulating them out of existence. And I’m wondering from your perspective, as someone who both is involved in the community, there’s also a health care provider.

What’s the real impact of this and what burden is it going to place on the community? And non-healthcare 

Dr. Sydnee McElroy: the, in terms of individual programs throughout the state. I know there’ve been several who have come forward already and said, ours will. Close under these new guidelines, we will not be able to  achieve the cause what it is.

It’s a licensure program, which is by the way, when you’ll see a lot of people say, it’s the strictest in the nation. and it’s the most difficult legislation in terms of having a harm reduction program. It’s because it requires that licensure, which no other state does. There are lots of other pieces of it that other states might require, but to do all of this and then obtain a license to run a program that’s unique.

 And it takes another step and it requires so many different levels of government to sign onto a letter to buy in.  That  it’s going to be incredibly difficult for some programs throughout the state to meet all of those requirements and some will close. Certainly.  I think  I don’t know what the question we’ve all had is will they close the 90 days after the bill was signed?

Or are they going to close when we have to apply for licensure? Which I think is like in December.  But there’s been fear.  We know some will close completely. But what the other affect some specific issues with the bill, one is you have to have a state ID to use these harm reduction services.

That’s going to be, it’s going to reduce their effectiveness. So it’s not that the programs would close if that was the only stipulation it’s that a lot of people are going, they don’t have a state ID.  Again, with the community that I work with, it’s incredibly rare for them to have an ID.  And if we don’t.

If they don’t have one, they can’t go. And so if you have a program that will serve. The community, but only a small fraction of it can actually access it. You’re not going to see those big public health benefits, the people who can go still benefit, but you don’t see the big things, the reduction of the spread of HIV, which is absolutely critical in Kanawha county and Campbell county canal where they have the most concerning HIV outbreak in the country and Cabo county, where we have our own HIV cluster.

And I guarantee you, we are seeing the tip of the iceberg in our communities.  The very tip  I think unfortunately there’s a lot we don’t know about already. And once all of the stipulations of this bill go into effect, it’s going to get much worse. So I think all those things, some programs will close.

Generally. They’ll all become less effective because of these requirements.  And  I don’t know. My hope is that enough of us are passionate about it and can work together in court. I’ve actually been talking with people who work with harm reduction programs in several different parts of the state to try to come up with a coordinated effort, to keep as many as possible alive, and to keep resources going throughout the state to try to coordinate to some extent because I feel like there are going to be placed in the state where right now, I don’t know what Charleston’s going to do.

And  that’s where a lot of our  people who use injection drugs, people living with HIV, that’s where they are. So I think it’s a really concerning situation. I think in Cabo county, our program. What I believe is we will stay open, but I think we’ll probably serve a smaller percentage of the community and we’ll be less effective, unfortunately.

Yeah. 

 Chuck Corra: It’s really shameful, to see that and to think about it because there are so many broad-reaching implications of just a bill like that. You think about all the people that go to those places for the resources, like we mentioned, especially about a Knox and that won’t have that resource anymore.

Anything about these communities you mentioned. The requirement for a state ID, really, interestingly enough, mirrors, a lot of voter restriction laws in these countries as well. And it targets people who are of low income or experiencing homelessness, those types of things. And they’re the ones that benefit the most from this.

I’m curious, and I don’t know if you’ve had any conversations with lawmakers or maybe talk to people who have  There’s obviously a huge stigma around syringe service programs and I’m wondering if that is a prevailing stigma within the people who are pushing this. Because when I read up about some of the reasons and justifications for why they want to pass this bill, it’s oh,  we want to make things safer.

Because this is this wild west unregulated needle exchanges. We’re just here stepping in to take the little role of government to make things more safe. And that doesn’t seem to be the case for me, but I’m just  wondering if the stigma of this in your opinion  has an outside influence. 

Dr. Sydnee McElroy: It absolutely has an outside influence because the truth is the programs we have in West Virginia.

 And I can’t speak to every single one because I don’t know all the ins and outs of every single one, but generally speaking, the ones that I’m familiar with and especially a lot of ours are run out of health departments. These are not the wild west of harm reduction programs. These are. Closely regulated, tightly run monitored programs that already a lot of the stipulations in the bill were that if you’re going to have a harm reduction program, you have to provide recovery services.

Sure.  Access to things like that. You have to provide access to. STI screening and treatment. And yeah, a lot of health departments do that, but like beyond that things like you have to provide vaccinations and access to birth control and family planning and all that. We already do that.  These programs do these things, so they were already very closely run and in some ways already a little over-regulated because of a lot of local government action to try to tighten controls for the same sort of stigmatized fear-mongering kind of reasons.

Even a little more tightly than really, we’d like to see if you’re talking from a pure CDC, like what would they recommend perspective a good harm reduction program wouldn’t even attempt to do a one-to-one needle exchange. You wouldn’t use the word exchange. The idea is people come in and when they need needles, you give them to them.

That is a more effective pro when we know that we have the data to back it up, but we already were reducing that that we were already tightening that to try to avoid this kind of situation.  So what they’re regulating was unnecessary, to begin with, what they’re going to do with this is just reduce the effectiveness and a lot of the.

 The rhetoric that they would tell me when I would speak to some of my representatives and people who were concerned was it increases crime. There’s no data to back that up there. There is no city in the US where they had a harm reduction program and crime increased. There are some places where it goes down.

There are some places where it stays the same. It doesn’t go up. So that’s a myth. The other thing is needle letters. That was the biggest thing. And all of the really overwrought, emotional stories that people like to tell on the Senate floor, in the house floor, whereof kids finding needles in the park, which by the way, I have two small kids.

I’m raising them in Huntington. We’ve played in the park many times. I’ve never found a needle anywhere. I’m not saying it doesn’t happen. I’m just saying. Lived here, my whole life, raising children here never found one.  But even if there were, there is no evidence that harm reduction programs increase the amount of needle litter in a community, the needle litter is there because we have people who use injection drugs.

And because that’s so terribly stigmatized, they’re forced to live on the outskirts of society. And not interact consistently with medical care, with places to dispose of their syringes. They, many of them don’t have a home where they can use and have a needle disposal system and all those things that are why that’s happening.

It has nothing to do with the harm reduction program. So eliminating them won’t fix the needle litter.  There, there was one study that suggested eliminating. It might make it worse, but it certainly isn’t going to improve it at all.  And no matter how many times  I can’t tell you  I’ve given this speech to people and written emails and made phone calls till I was blue in the face.

And it just, I don’t know, it just didn’t seem to make a dent. Because people are so predisposed to believe drugs are bad. So people who do drugs are bad and they end up doing bad things like throwing needles all over the ground and committing crimes in my community. And so it’s just a, not in my backyard attitude, send them somewhere else.

Big John: It is easier to get votes with a saying you stop needles in the playground than it is to say you helped to you helped people maybe become clean.    Which is really sad. And especially in a state like West Virginia, we should be we actually should be honoring people that, that help people get clean.

Cause  it’s  an epidemic here.  You mentioned this a little bit, but. I guess maybe  discussing what’s the outlook here?  So let’s say a state like West Virginia, obviously Appalachia all across Appalachia. We’re seeing these types of issues. We’re seeing that  harm reduction in legislatures  is constantly being shunned  across the region.

So what’s the outlook. If you know this bill obviously passed, it was signed into law.  And let’s say they close  w  we see a bunch of closures. What’s the outlook for those communities. 

 Dr. Sydnee McElroy: I think fortunately I would love to say that those of us who are involved with harm reduction and that have been anticipating and working to address this, I would love to say that, oh, we’re going to, our whole plan will be spring.

We’ll spring into action. And we’ll cover every deficiency and there’ll be no effects felt. But that  I think that would be an overstatement, I think in communities where their PR, where their programs close, they’re going to see  More morbidity related to IV drug use. So you’ll see more patients overdosing and.

More deaths related to overdose. You’re going to see more people admitted to the hospital with serious infections.  And it  hepatitis C is a problem essentially everywhere where people are using injection drugs. So you’re going to see more of that, but specifically in communities where we already see HIV, that’s going to spread.

And I think something that’s really important to note is that even in places in the state where we don’t have HIV outbreaks, If you have people who are using needles and sharing needles, and you have hepatitis C they’re already, we know just history tells us statistics, tell us we will HIV in those communities eventually as well.

And we were saying that. In Huntington.  I have been practicing medicine here for a decade and we were in training here for longer than that, we were saying that we would see an HIV outbreak here if we didn’t do something long before it came. So these are predictable courses.  We looked at Scott County, Indiana.

We knew what could happen here and we didn’t do enough to prevent it. I don’t mean everyone. Here in Huntington. Dr. Kilkenny who runs our health department and our harm reduction program is an amazing public health advocate. And he works his butt off, but we don’t have enough of those people.

 We have some of them, we have some really hardworking, well-meaning caring people who have the knowledge and the background and the drive, but there’s never enough. And. We saw HIV come and it will spread to other parts of the state where these programs close and people are going to lose people.

 That’s the other part of it. It’s all this idea that people who use drugs deserve punishment.  That’s really at the core of this and. There, these are our people, the people I take care of.  I know a lot of them, I went to school with them. I know their families like I’m, I can’t I’m  they’re not others.

They’re not from somewhere else. There are people and we’re going to lose more of them  than we already have, which. We’ve already lost more than  stutter, like relatively than anyone else in the country. 

Big John: It’s see. I think  people miss that a lot, especially when it comes to cause obviously like drug use or elite  anything illegal people  people throw their hands up because   they do want punishment.

You’re right. And I think that for a lot of people, they forget that  the end punishment for a lot of these people is death and. I  obviously  this is not  you, we can call it a crime, all we want, but it’s not a crime that should be punishable by death. And  they said  you should have resources  that can fix that.

So I’m with you on that quick question. Are our doctors, a lot of doctors in agreeance with you as the field split?  I’m not actually  heard anything like how doctors feel about it again, general. 

 Dr. Sydnee McElroy: The majority of healthcare professionals support harm reduction for the very, very basic reason. It’s  I think a lot of doctors can get  unemotional about  the science is there.

The data is there, the evidence is there.  The overwhelmingly there, and this is not a controversial area of medicine. There are controversial topics in medicine. This isn’t one, this works. A lot of people might not want to be the one in the health department handing out the needle.     I might be more unique in that respect.

Like I, and I enjoy this work. I enjoy being able to do this.  But generally speaking, the medical community is United that, yeah, this is effective at works. We should be doing it.  Why are we regulating it at all? Like, why is the government getting involved in this area of health care? Cause that’s what it is.

It’s. Healthcare it’s providing treatment for a disease. And why did the government decide to  stick its hands in this when there are so many other areas of healthcare where they trust our judgment and our science and our evidence to do the right. 

Big John: Yep. All about those votes. I just always liked to continue to bring it back there.

     Ultimately we know now in, in a state like West Virginia, this bill is passed. This will go into effect. Jim justice has signed it and it’ll go into effect  in a lot of places around Appalachia.  I predict because of how many bills are coming up.  What do you think organizations or people can do to help?

 I know that they’re limited in some sense  but are there options for people that want to maybe either get involved  or want to help a donation or anything like that? 

 Dr. Sydnee McElroy: I think so in terms of donation, too, I would say  there’s two different pieces to think about moving forward, the harm reduction programs themselves  when it comes to like actually handing out.

Equipment that people will use to do drugs so that the needles and everything that comes with that  that piece of it is going to really have to be run by the program. So I don’t know that there will be a lot of opportunity to donate specifically to that.  But the Naloxone piece, the Narcan part of it, that really is something people could  Do more for, because we can still hand out.

And I’m part of groups that do that too, that just go around, handing out Narcan and we do it through fundraising.    You can get some grant funding for it, but not huge grants. So we do that by raising money, getting Narcan, taking it out and giving it to the community. A lot of places I know in Huntington and I’m sure most places in West Virginia are the same.

Your local health department will probably teach you. You just check online or call they’ll have classes where you can learn how to use Narcan administered appropriately, and then give you some to carry with you. And I think  that is maybe the most important thing.  If there’s one piece of all this, other than the understanding and the compassion and all that, that you can take away as an action, it would be that if you’re not already certified to do that, Look into it.

Cause it takes no time. It’s super Narcanned, especially now we have the nasal sprays, not just the injections. There’s the auto-injector, which talks to you. It’s a little thing that like, literally tells you what to do.  Take the cap off, put it on their leg. Hold still.  It’s super easy and you can learn how to do it.

You can get the Narcan, you can carry it with you, and you can save a life. Really it’s the same as having an epi-pen to save somebody’s life. If they get a, B, a, B, C,  so I think that’s a really powerful thing that people can do and pay attention to. There will be fundraising efforts around this without.

Money to buy the exact equipment. There will definitely be fundraising efforts around this, within your local community that I would look out for.  And then the other thing is, look for opportunities to volunteer and connect, especially with a community of marginalized people, where you live.  I know, and understand and feel so much more in touch with all of this now because of my work at harmony house in Huntington, because these are the people that I spend.

A good bit of my time with now. And I, once you do that, it’s so hard. Like the stigma it’s so much easier for it to fall away. All of that stuff that you were  I don’t want to say taught in school or at home or anywhere necessarily, but it was  ingrained in us from society that people who use drugs were scary or bad.

It was spend a few weeks with them because they’re not there. People. And sometimes they’re making a decision that isn’t the best for them and their health, but  who doesn’t.  We all do. We all make decisions where I’m going to eat this big piece of cake, even though I know it’s not good for me, or   or  drinking is  a thing that a lot of people engage in to their own.

   Sickness or discomfort or whatever, and we don’t stigmatize those people the way we do injection drug users. So I would really encourage you to look for outreach opportunities, whether it’s going and volunteering to feed people or going with an outreach committee to hand out like  little care packages or hygiene bags in the streets there, I guarantee you, there are efforts like that in your community and just engage with people, get to know them.

Chuck Corra: That’s all  really great advice. And I think especially  encouraging people to challenge the presumption  of how you view somebody who is a drug user  and emphasizing compassion over punishment and starting to treat addiction like a disease instead of a character flaw is something  that’s so important  with just changing the narrative around that.

And that’s something that. I know that John and I, when we started this podcast, we really wanted to focus on about stereotypes around the region. But even with something like this, where it’s ingrained in you a certain mentality, when you’re young, it’s so important to challenge that presumption and encourage others to that as well.

So I really appreciate you bringing it up.  Dr. McElroy, thank you so much for coming on.  We’ve been wanting to talk about harm reduction. I think pretty much ever since we started this about a year and a half ago, and I think that you were the perfect person to have on to discuss it, especially within this context.

 Again, we really appreciate, and  we know from other people we’ve talked to and Huntington Cabell county around the area of all the important work that you’re doing, and I know that it’s really appreciated. So thank you so much.  Thank you both so much for inviting me. It was my pleasure to come and talk to you both.

Dr. Sydnee McElroy: And I will always talk about harm reduction. So thank you.

Chuck Corra: that was our interview with Dr. Sydnee McElroy. John, your thoughts. I 

Big John: another big get, especially, and I’m not talking about the podcast side, I’m talking about the medical side because, cause  I  Obviously everybody loves what they’re doing.  They have a ton of followers or whatever, but it’s really what Cindy’s doing  during the day and helping all these people, that is the more impressive part to me.

And   I threw it in there cause I wanted to know  there, I think there were two questions where I kinda  played devil’s advocate on what people would say outside. And I think. I think people need to listen to what Sydnee is saying and use that in their everyday dialogue, because that’s the, those are the type of answers that need to start being sent around in these communities so that we can start being more accepting and understanding what the real problems are rather than  picking and choosing our 

Chuck Corra: face.

Absolutely. I completely agree. And I think that she’s a really great messenger for that. And. The work that she’s doing in her community as being replicated throughout the country. I know by a lot of other people, but she’s really leading that and being a leading voice on it. And she has a really important and influential platform that she uses to do that with.

So I really appreciate her coming on the show. She’s welcome back. Anytime we loved having her and it was really cool conversation.    We’re reaching towards the end of that episode. It’s  been a day, been a week. Maybe it’s a Tuesday  when this comes out, but  every day is a day that we need a little bit of beef John’s on a vegan diet.

So we’re rebranding this a little bit as impossible beef with big John. When he’s the gentlemen and gender nonbinary folks worldwide, we are pleased to present to you.  self coming to you, live from a foreclosed Ponderosa back to back world champion.

Big John: this week. Pretty simple. Chuck, we recently joined tech talk. Okay. Much 

Chuck Corra: to my chagrin. 

Big John: Yes.  We’ve been getting some followers, which is really cool. What  people are liking some of the stuff, but what I’m not liking about Tik TOK, Jack is all the damn stereotypical crap. There are so many people that push Appalachian 

Chuck Corra: stereotypes.

 I don’t know if you heard, but Heidi just grunted in the background. So she agreed. Heidi hates 

Big John: this big dog hates this. Look at big dog look big dog. I know you’re upset.  

Chuck Corra: Hates it. Just look at it. Can’t even sit anymore. She’s like, all right, we’re 

Big John: done. Doug is ready to take on these stereotypes.

Big John makes sense on Tik Tok. All these videos are being produced. And I keep noticing that some of the ones are like tagged app  Appalachia. And is that.  There’s just stereotypical content that continues to push all the things that we continue to fight against. And not only that, Chuck, but I don’t know if you’ve noticed Tik TOK is in my opinion, worse than YouTube when it comes to comments.

 I think the comments on there are first off they’re most of them are not most, but a lot of them are disgusting, and yeah.    A lot of the disgusting ones tend to be people who are trying to push back against what we’re saying by trying to argue stereotypical things that continue to be pushed by different media outlets or narratives or whatever.

It’s people who don’t actually understand the region, and we’ve said this over and over again, but my point is, and the reason I want to bring this up, Is, there are a lot of kids on Tik TOK and there are a lot of Appalachian kids on Tik Tok. And so when they see that it’s going to continue down the same road that we were on.

So you and I, we faced a lot of the stuff face to face, but they’re facing it all over the internet. It’s even but growing up Appalachian is really tough right now, too. This is only going to make it worse. It’s going to make people, if you thought code-switching was bad, I think it’s going to get even worse than that.

 If we continue to not fight back against what’s going on Tik TOK and really start to say where we’re not only controlling our narrative on Twitter and everywhere else, we’re taking it back on Tik TOK, too. 

Chuck Corra: Take taking it back on tick-tock and  were ticked, talked off about it were ticked 

Big John: Talked off and we’re ready to take over.

Chuck Corra: Loaded to bear. Okay.  Then we’re going to try to do it.   It’s pretty easy to go viral nowadays, so we’ll figure it out. Yeah. 

Big John: W  but there are people doing it  there’s, we’re going to, we’re going to keep pushing our same stories. There’s people like Danielle, Kirk, who has  she’s done a lot for the region on Tik TOK.

I think that’s great. It’s somebody that we’re going to have a show 

Chuck Corra: that your guests of the show. 

Big John: Yes.    These, there are people on there that are fighting the good fight. I just think we need to make it. No. Now Chuck, before we take over Tik TOK. Okay. Before our eventual takeover. We need to let people know that this 

Chuck Corra: is why.

Yep. There you go. There. You heard it first right here from the horses, mouth of the impossible beef, impossible horse smell.  Don’t eat that meat though. Cause it’s horse meat.  I don’t know where I’m going.  Thank you for that.     Rallying the troops very important.  Especially the ones that failed the physical fitness test.

Love to see it. Yep. We’re going to be, we’re going to be on there. We’re going to be doing our thing where we pushing back against the bullshit. Cause that’s what we do here on iPod lash. Thank you all so much for listening. Join us online. I’ll let you.com. Follow us on all the social media, including tick-tock Instagram, Snapchat, Friendster.

Zenga store visit our store T public it’s in the link tree link. You’ll find it. I’ll put 

Big John: public.com/pod latcha 

Chuck Corra: even. Oh shit. There you go. That’s all right. Yep. You can buy a shirt there to support us and support yourself. Buy clothing yourself. We’ll love to see it. Love to see it. Don’t love to see people naked, at least not in that context.

Thank you for listening. Have a wonderful week and good night.

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