It sounds like a movie plot: Iowa native makes good, gets an important job in Washington, DC where she learns a lot, then returns and uses that knowledge to help folks back home. But this story didn’t come out of Hollywood. It’s happening in Iowa City.
That’s where Sarah Ziegenhorn runs the Iowa Harm Reduction Coalition (IHRC), a non-profit group that’s already making a big impact on the opioid crisis in the Hawkeye State. Many days you can find her alongside IHRC volunteers handing out free harm reduction supplies in Iowa City, Des Moines, Cedar Rapids, and elsewhere. That is when she’s not advocating for policy change at the state capitol. Or when she’s not studying for a medical school exam. Because this full-time activist/full-time student is working toward becoming a doctor.
After Ziegenhorn received her undergraduate degree, she landed a job in Washington at the Institute of Medicine, a health policy think tank. She also worked with the syringe exchange program and harm reduction organization, HIPS, where she learned the importance of mitigating the negative consequences of drug use.
Returning to Iowa to attend medical school, she quickly realized she could apply the knowledge she had acquired in her home state where expertise on harm reduction was almost nonexistent. And so IHRC officially started on January 1, 2017. It operates a drop-in center and a dozen outreach sites that give away safe supplies to prevent infections among people who use drugs. Six months later, the organization started a naloxone distribution program, and today provides a mail-based service so that naloxone may reach people across the entire state. IHRC is also actively engaged in advocacy and education.
“There’s not robust familiarity with harm reduction in this state,” Ziegenhorn says. “We fill a need by providing basic naloxone training for people who use drugs.” That fits with the group’s motto: Meet people where they’re at.
“Our approach to substance use focuses on mitigating the harms, morbidity and mortality associated with drug use. Rather than condemn, harm reduction recognizes drug use is something that’s part of our world. Instead of ignoring consequences, we take a realistic, pragmatic approach. It’s a set of tools and approaches that people practice and apply every day.”
That approach is bearing fruit. Within IHRC’s first year of operating, drug overdoses in Iowa dropped 18 percent. While IHRC does not take all of the credit for this, she notes, “There’s probably some connection between the decreases and what we’re doing.“
Ziegenhorn remembers meeting a long-time IV heroin and meth user in his 20s more than two years ago. “We interacted with him a dozen times over 6-8 months and at first he was hostile and suspicious of our organization. However, he kept coming back for more and more naloxone and eventually reversed 24 overdoses. This helped him to develop a sense of personal power and self-efficacy, and eventually, we were able to help him access treatment. He became an advocate and public speaker addressing academics and legislators. Now he’s doing well and helps take care of his mother and his relationship with others has improved. He’s had a huge shift in his quality of life.”
That, Ziegenhorn says, is the payoff for IHRC’s efforts. “People are so overwhelmed to be treated like human beings. Giving naloxone takes a minute out of my day; but to people who use drugs who have never seen naloxone before, it’s like Christmas Day. We help people realize their inherent worth and value.”
Iowa Harm Reduction Coalition was a featured award winner in the 2019 Innovation Now project of the Addiction Policy Forum.