In jurisdictions that embrace harm reduction — the movement to minimize the negative effects of drugs, rather than prohibit them — the response to coronavirus is much different from Iowa’s.
While officials elsewhere are working to preserve drug supply chains, Iowa is doing the opposite. Gov. Kim Reynolds this week ordered vape stores to close, the medical cannabis market is in free fall and Iowa remains one of the minority of states with no legal syringe service programs.
These are not trivial concerns for people with substance use disorders or people who use substances to treat their ailments. Cutting off Iowans’ access to drugs will exacerbate stress and compound the public health crisis at a moment we can least afford it.
In Iowa, tobacco and vape shops are ordered closed, but gas stations and grocery stores remain open. That means many varieties of e-cigarettes and vaporizers are not locally available, while most cigarettes still are easy to find.
That was the situation in Europe, until several countries backtracked and extended shutdown exemptions to vape stores. Unlike here, some foreign governments actually promote vaping because it’s a much safer alternative to combustible cigarettes.
“Most importantly, hundreds of thousands of vapers would have been at risk of gatewaying back to smoking,” Riccardo Polosa, an Italian scientist and founder of a top international harm reduction group, told Filter magazine last month.
Iowa’s medical cannabidiol dispensaries in Davenport and Council Bluffs, two of the state’s largest metro areas, permanently closed last month for financial issues unrelated to coronavirus. That leaves Iowa’s badly broken medical marijuana system with only three stores serving the whole state.
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Even though the cannabis program was not serving enough Iowans to begin with, thousands still could find themselves without their preferred medicine and turn back to much harsher pharmaceuticals.
Iowans who use injection drugs were victims of bad public policy before the virus outbreak, but it could get worse now. People are encouraged to stay home, which goes against the recommendation to not using drugs alone, and there are no legal safer injection sites in Iowa.
There also is no legal system here to distribute new needles to people who use drugs. In the event of a statewide shetler-at-home order, which Reynolds maintains is a possibility, Iowa’s underground syringe exchange program could be subject to enforcement. Giving people tools they need to avoid infections would not be deemed essential because it’s not legal.
In an emergency such as this, the governor has broad authority to relax enforcement of certain rules and regulations.
Reynolds could offer vape retailers the same deal she gave bars, allowing them to do curbside orders and encouraging them to reduce the number of customers inside. She could also explore temporary measures to bolster cannabis sales and stop enforcement of drug paraphernalia laws.
In a more reasonable and compassionate world, injection supplies, marijuana and even e-cigarettes would be included as part of the health care system we are trying to protect during the coronavirus outbreak.
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