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Steve Davis: Headbangin’ to Harm Reduction


Steve Davis may be a metalhead, but the West Virginia University Health Sciences Center researcher approaches public health with gentleness. His work deals with harm reduction, a strategy that minimizes the negative effects of drug use rather than insisting on abstinence from it.

I have been drawn to thrash metal, in particular, and heavy metal, in general, precisely because the lyrics often involve seeking a deeper understanding of social problems and the human condition.

An associate professor in the School of Public Health, Davis has researched how syringe-exchange programs can help to prevent the outbreak of diseases—like hepatitis C and HIV—in people who inject drugs. His focus on harm reduction reflects recommendations from the World Health Organization, the United Nations and the Centers for Disease Control and Prevention. All three agencies suggest harm reduction as an evidence-based way to safeguard communities against infectious diseases and overdose deaths. 

And according to Davis, solving social problems in such an evidence-based way has a lot in common with the music of Metallica, Black Sabbath and Iron Maiden.

Q: What inspired you to make harm reduction a focus of your research?

A: When I began my doctoral studies in 2014, I was shocked to learn that West Virginia had one of the highest incidence rates of hepatitis C virus in the country. Further inquiry into the causes of this health disparity revealed that most of the new cases were observed in people who inject drugs and share contaminated syringes. Naturally, I was interested in a potential solution to this problem, and a review of the literature revealed the great success European countries have had with reducing hepatitis C infection in people who inject drugs by implementing syringe-access programs. These programs provide clean syringes in exchange for used syringes to prevent infectious disease in a nonjudgmental manner. This approach resonated with me personally given my background in social work, which emphasizes meeting people where they are. More specifically, although syringe-access programs have a goal of facilitating linkage to treatment, they understand the reality of addiction, which often progresses through stages of change whereby people may be contemplating making a change but not yet be ready to change.

Q: Research—into any topic—is all about discoveries. Can you describe a time your research led you to a discovery that surprised you?

A: As part of my harm-reduction work, I conducted qualitative interviews with syringe-access-program attendees to go beyond the quantitative incident rate numbers for a deeper understanding of the problem. During one of these interviews, while probing for feelings and opinions about hepatitis C infections among people who inject drugs, one interviewee commented that hepatitis C was like “a pair of Levi’s jeans.” When I asked the attendee to clarify this statement, they explained that everyone has a pair of Levi’s jeans and, thus, everyone has hepatitis C. This revelation highlighted the challenge we have as public health practitioners in promoting behavior change when the perceived threat and severity of the disease is low.

Q: Your research into harm reduction is rooted in acceptance and understanding, yet I understand that you’re a long-time fan of thrash metal—a genre of music that might strike the casual listener as anything but accepting or understanding. Why do you like thrash metal so much?

A: I have been drawn to thrash metal, in particular, and heavy metal, in general, precisely because the lyrics often involve seeking a deeper understanding of social problems and the human condition. Some examples that come to mind include Metallica’s “Master of Puppets” (the problem of addiction), Gojira’s “Global Warming” (the problem of climate change) and Iron Maiden’s “Afraid to Shoot Strangers” (the problem of war). Songs contemplating the human condition include Iron Maiden’s “Infinite Dreams” and Black Sabbath’s “Heaven and Hell.” The often misunderstood “violent” sound of the music, to me, reflects a refusal to be satisfied with the status quo, which is consistent with public health practice. In public health, we are not satisfied with merely accepting human suffering that shows up “downstream” in individuals due to “upstream” societal and structural factors. As a guitar player, I also appreciate the highly technical nature of metal music.

Q: You also happen to be a huge Batman fan. What makes Batman such an appealing superhero to you?

A: Batman appeals to me precisely because his only superpower is his mind. Bruce Wayne is a human being who, through great personal sacrifice and hard work, has trained his body and mind for the sole purpose of serving others. Such service is also performed in the shadows. He has a secret identity and eschews all public recognition and praise to the point of being ridiculed and criticized for being nothing more than a wealthy, lazy bachelor.