Effective July 1, 2017, the Code of Virginia, Section 32.1-45.4 authorized the implementation of Comprehensive Harm Reduction (CHR) programs during public health emergencies in order to combat the impact of the opioid crisis in Virginia. Since the approval of this act, CHR sites in Wise County, Richmond City, and Smyth County have been authorized and are providing services.

The three CHR programs are in the early stages of operation, with the first site opening in July 2018 and the most recent site opening in December 2018. As expected with program start-ups, initial uptake at each site was slow, but utilization has grown as awareness of the programs increased and potential participants gained trust in using the services.

The CHR sites provide sterile hypodermic needles and syringes and dispose of used ones, provide harm reduction counseling and educational materials, test for human immunodeficiency virus (HIV), hepatitis C virus (HCV), and other sexually transmitted diseases (STDs), distribute opioid overdose reversal agents and condoms, and provide referrals for substance use disorder (SUD) treatment, other medical care and social services.

Program data collected by the Virginia Department of Health (VDH) were provided to independent evaluators at the University of Virginia’s Center for Global Health in the School of Medicine for assessment and inclusion in this report.

Across the three authorized sites, 241 participants enrolled and received over 28,000 sterile syringes in exchange for nearly 25,000 used syringes. Of the 45 participants newly diagnosed or previously diagnosed with HCV, 41 (91%) were linked to HCV care. Sites provided 325 doses of naloxone to participants who reported 32 overdoses reversed. In total, 85 participants received referrals to SUD treatment with 28 of the participants attending their first appointment. An additional six participants are awaiting available appointments and eight have reported becoming abstinent from drug use.

The report appendix includes additional data analyzed by VDH comparing program metrics from Virginia CHR programs with those from other states. CHR sites continue to report data, with most current information available at http://www.vdh.virginia.gov/disease-prevention/chrdata/ .