Comprehensive Harm Reduction (CHR) is a set of public health strategies intended to reduce the negative impact of drug use including HIV, hepatitis C, other infections, overdose and death among people who are unable or not ready to stop using drugs.
CHR includes the distribution of sterile and disposal of used hypodermic needles and syringes, education, referral to drug treatment, testing, and an array of other health services.
Effective July 1, 2017, the Code of Virginia Section 32.1-45.4, authorizes the State Health Commissioner to establish and operate local or regional comprehensive harm reduction programs during a public health emergency. Such programs shall be located in communities where data indicate a risk of transmission of, or increases in the transmission of, HIV, viral hepatitis, or other blood-borne disease because of injection drug use. On November 21, 2016, State Health Commissioner Marissa J. Levine declared the Virginia opioid addiction crisis a public health emergency.
Jurisdictions eligible to provide Comprehensive Harm Reduction (CHR) services in 2018 were determined using an enhanced selection method. Previously, the selection of jurisdictions was based on case rates per 100,000 individuals for thirteen opioid indicators. This method excluded some densely populated areas of the state, which have large case counts, but low case rates compared to less populated areas. To provide services to those most affected by the opioid epidemic, VDH decided to use both case rates and case counts to determine jurisdictions eligible to provide CHR services. The Secretary of Health and Human Services and the Secretary of Public Safety and Homeland Security approved the change in selection criteria. All agencies interested in providing CHR services must complete an application process (see links below).
For general information on opioid addiction:
If you need assistance with substance use:
- VaAware-Addiction Prevention and Recovery Resources, or call the
- National Helpline, 1-800-662-HELP (4357)
For questions about HIV or hepatitis contact the Virginia Disease Prevention Hotline at (800) 533-4148 or firstname.lastname@example.org. For information about CHR programs, contact Bruce Taylor at email@example.com or (804) 864-8015.
Resources & Helpful Links
- REVIVE! Opioid Overdose and Naloxone Education
- VaAware-Addiction Prevention and Recovery Resources
- VDH Opioid Dashboard
- CDC Program Guidance for Syringe Services Programs, 2016
- amfAR Fact Sheet on Public Safety, Law Enforcement, & Syringe Exchange
- FAQs for the Public
- Legislation Authorizing Comprehensive Harm Reduction in Virginia
Information for Agencies Seeking Approval to Operate a CHR Program
- Virginia Standards & Protocols for Comprehensive Harm Reduction Programs
- Application to Operate a CHR program in Virginia
- Security Plan for CHR program
- CHR Program Work Plan Template
- List of Eligible Localities
- Mid-Atlantic AIDS Education and Training Center-Inova Health System
- Mid-Atlantic AIDS Education and Training Center-Virginia Commonwealth University
- Virginia HIV/AIDS Resource and Consultation Centers
- OHSA Bloodborne Pathogens Standards (29 CFR 1910.1039)
- CDC Guide to Infection Prevention in Outpatient Settings: Minimum Expectations for Safe Care
- USPHS Guidelines for Management of Occupational Exposure
For more information about Comprehensive Harm Reduction programming or syringe services, please contact Bruce Taylor, Drug User Health Coordinator, at firstname.lastname@example.org.
Last Updated: January 15, 2020.