Overview of Harm Reduction and Sterile Syringe Access

1
Overview of Harm Reduction and Sterile Syringe
Access
Anna Benyo Syringe Access Policy Coordinator Harm
Reduction Coalition New Jersey Syringe Access
Informational ForumFebruary 28th 2007
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Topics for Today

• Overview of Harm Reduction
• Principles and practice
• National scope of sterile syringe access
• Opportunities and challenges
• Harm Reduction Coalition
• Resources for providers and communities

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Working Definition of Harm Reduction

• Harm Reduction
• A set of practical, public health strategies
  designed to reduce the negative consequences of
  drug use and promote healthy individuals and
  communities.

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Key Principles of Harm Reduction

• Designs promotes public health interventions
  that minimize the harmful affects of drug use.
• Understands drug use as a complex, multi-faceted
  issue that encompasses behaviors from severe
  abuse to total abstinence.
• Meets people where they are in the course of
  their drug use

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Key Principles (continued)

• Ensures that people who use drugs have a real
  voice in the creation of programs.
• Affirms people who use drugs are the primary
  primary agents of change.
• Empowers communities to share information and
  support each other

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Social and Environmental Factors

• Harm reduction recognizes that the realities of
  poverty, class, racism, social isolation, past
  trauma, sex-based discrimination and other social
  inequalities affect vulnerability to, and
  capacity for, effectively dealing with
  drug-related harm.
• It does not attempt to minimize the real dangers
  associated with licit and illicit drug use, and
  how those issues impact our lives.

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Harm Reduction Practice Calls For

• Non-judgmental, non-coercive provision of
  services
• Low-threshold program models
• Resources to people who use drugs

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Harm Reduction Sterile Syringe Access history
and timeline

• First started in Holland in response to hepatitis
  B outbreak in the 1980s
• First legal program in United States started in
  Tacoma, Washington in 1988
• Rooted in activism and advocacy

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Goals of Harm Reduction

• Prevent disease
• Sterile syringe access to prevent HIV and
  hepatitis
• Reduce mortality
• Overdose prevention with training and naloxone
  distribution link to medical care and social
  services
• Treatment for drug dependence
• Buprenorphine or Methadone Maintenance
• Empower communities and reduce stigma
• Community organizing and engagement

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Efficacy and Outcomes

• Syringe access programs are the most effective,
  evidence-based HIV prevention tool for people who
  use drugs
• Seven federally funded research studies found
  that syringe exchange programs are a valuable
  resource
• In cities across the nation, people who inject
  drugs have reversed the course of the AIDS
  epidemic by using sterile syringes and harm
  reduction practices.

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Key points in research syringe exchange does
not

• Syringe exchange does not encourage drug use
• Syringe exchange does not increase crime rates
• Syringe exchange does not increase needlestick
  injuries in the community

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Syringe Exchange Does.

• Syringe exchange reduces HIV infection.
• Syringe exchange reduces risk for hepatitis C
  infection.
• Syringe exchange programs link participants to
  drug treatment, medical care, housing, and other
  other social services.

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Injection Drug Use national scope

• Estimates of current injection drug users in the
  United States range from 354,000 to over 1.3
  million.
• Injection drug use occurs in every socioeconomic
  and racial/ethnic group and in urban, suburban,
  and rural areas.
• The majority of injection drug users are men, but
  between ¼ and 1/3 of injection drug users are
  women.

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The NEED for Syringe Access Harm Reduction

• Over 8,000 people are newly infected with HIV
  every year due to syringe sharing.
• Over 15,000 people are newly infected with
  hepatitis C every year due to syringe and
  equipment sharing.
• Overdose is the nations 2nd leading cause of
  accidental deaths.

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Demographics

• African Americans account for over 50 of all
  AIDS cases attributed to injection drug use,
  while Latinos account for nearly 25.
• Among women, an estimated 61 of AIDS cases are
  due to injection drug use or the result of sexual
  contact with someone who contracted HIV through
  injection drug use.
• Younger injection drug users generally become
  infected with hepatitis C within two years.

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Sterile Syringe Access Programs

• Nearly 200 syringe exchange programs currently
  operate in 38 states, Puerto Rico, Washington DC.
• Access includes syringe exchange programs,
  over-the-counter pharmacy sales, syringe
  prescriptions, and secondary exchange
  (distribution informally through peer networks)
• Endorsed by American Medical Association,
  American Public Health Association, US Conference
  of Mayors, among many other legal, medical, and
  policy institutions

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Syringe exchange program models

• Storefront
• Street-based (fixed sites roving sites through
  mobile vans and/or walking teams)
• Peer and secondary exchange through networks
• Underground, unauthorized programs (operating
  under the radar)

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Opportunities and Challenges the good news and
bad news

• GOODNew Jersey authorized sterile syringe
  access!Improved access to syringe and harm
  reduction methods will benefit individual and
  communities.
• BAD
• Federal ban on syringe exchange funding. There
  is no federal funding or national policy for
  syringe exchange.

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Harm Reduction Coalition (HRC)

• Education, Training, Technical Assistance,
  andCapacity Building
• Harm reduction methods and practice
• HIV prevention in communities of color
• Sterile syringe access expansion
• Hepatitis C prevention and awareness
• Overdose prevention and response
• Pilot innovative program models -
  Buprenorphine treatment
• Advocacy, community organizing and policy
• - national, regional and local levels

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HRCs Resources

• National Sterile Syringe Access technical
  assistance to expand syringe access, provide best
  practices, program models, advocacy, and
  training
• Overdose train service providers, drug users,
  and their friends/family members how to prevent
  and respond to overdoses
• Hepatitis C provide expert training about
  hepatitis prevention, treatment, and care issues
  specifically designed for active drug users
• Buprenorphine low-threshold pilot intervention
  to increase access to opiate substitution
  therapies
• HIV training and capacity building to programs
  working primarily with the African-American
  Community (CDC DEBIs)

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Contact Information

• For training information
• Rebecca Stryjewski
• 212.213.6376 ext 18
• stryjewski_at_harmreduction.org
• For questions about citations or syringe access
• Anna Benyo
• Syringe Access Policy Coordinator
• 212.213.6376 ext 49
• benyo_at_harmreduction.org
• Thanks to Drug Policy Alliance New Jersey,
  Roseanne Scotti, and Meagan Johnson