Author: Justin Mckibben
Back in February of this year the mayor of Ithaca, New York began pursuing a plan that would establish safe heroin injection sites in Ithaca in an attempt to battle the opiate epidemic raging across the country. This controversial harm reduction tactic is getting brought up a lot more lately. Other states are also looking into starting up similar contingencies for their citizens. Now, the Big Apple is set to spend quite a bit of money and resources investigating the merits of safe heroin injection sites. That’s right, New York City is now taking a closer look at how safe heroin injection sites operate, wondering if it might be a decent plan after all.
Talking about the tab…
One of the big things people seem to be focused on right now is the money. Some believe providing addicts with a clean, medically supervised facility to use is a waste. They believe that what it will be doing is promoting heroin addiction while enabling it, all at the city’s expense.
So far, the tab is already pretty steep. The City Council has announced it will be allocating $100,000 to study the practice. This money will go to the Health Department for a nine-month study to determine whether it makes sense to open safe heroin injection facilities.
Shouldn’t be much of a surprise that these desperate times have called for such desperate measures in New York City. The study comes as the Big Apple is still reeling from a record 937 fatal drug overdoses in 2015, a 66% increase since 2010. With 2016 coming closer to the end, it is a wonder if this will be another record year for the five boroughs. Overdose death rates are a huge factor in a lot of new movements for change.
What are safe heroin injection sites?
Safe heroin injection sites are facilities where intravenous drug users are permitted to use the drug intravenously under medical supervision. The sites offer a place where addicts can use without fear of arrest, in case of an overdose. The idea is to have staff trained and available to be able to save lives. At the same time, the hope is to reduce other risks associated with intravenous drug use.
Several safe heroin injection sites already exist in dozens of cities outside the United States. Should America be next? Some of the countries who use this practice include:
Council Speaker Melissa Mark-Viverito commented saying,
“It’s been done and been implemented in other areas [of the world], so we just want to look up what the viability would be in New York,”
This seems like a pretty fair response to the epidemic; trying to explore and educate officials on more options that could help. And beyond reducing overdose deaths, HIV and viral hepatitis transmission, safe heroin injection sites work to connect addicts with drug-treatment options. So it isn’t just about giving them a safe place to get high, but also making them feel safe and supported whenever they try to get help.
Conservatives in opposition
But of course there is a great deal of opposition. Michael Long, the state Conservative Party Chairman, claims the $100,000 could-
“- be put to better use than sending a message that it is OK to use intravenous drugs as long as you use a government-sanctioned place.”
However, the reality is that the money is being utilized in a way that serves it’s initial purpose. $5.6 million is already set aside in the city budget to combat AIDS. The $100,000 for the safe heroin injection site study is coming from that bulk of finances.
So while surely some would not be all for spending the tax-payers dollar on researching “legal drug dens” the truth is the money is going somewhere that could make a huge difference to the effect of what tax-payers originally intended it for.
The safe heroin injection study
According to a council memo, as far as the actual study itself, the researchers will review data that pertains to:
- Health conditions and disease transmission related to heroin and other injected drugs
- Evaluate existing supervised injection facilities
- Assess legal issues
- Input from select “city officials and community experts”
This isn’t the first radical idea on this side of the country. Seattle is also considering safe heroin injection sites. Earlier this year, Boston opened a facility where addicts can use under safe medical observation. However these people have to inject drugs elsewhere. This doesn’t seem like as good of a plan, because it’s basically asking for addicts to use and drive. Still, it is some kind of innovation in a different direction.
Preventing of death and the spread of disease is vital. As the death rate escalates in relation to heroin addiction and infections caused by intravenous drug use, prevention is increasingly important. These programs may be controversial, but the cost of losing lives is a lot higher than spending some money looking into alternatives.
Beyond harm reduction, there is real recovery. Real recovery begins with effective and innovative treatment. If you or someone you love is struggling with substance abuse or addiction, please call now. You are not alone.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Harm reduction is one method of addressing the nation’s drug issue that may seem to some as a philosophy of enabling, while to others it makes sense to offer safe alternatives to individuals who abuse drugs because these strategies can prevent the spread of disease and the damage to the community. It was estimated that 2015 would be a big year for harm reduction, as many suspected that drug policy reform would reshape the landscape in the wake of the “failed war on drugs” while there were efforts being actively put forth to alleviate the suffering caused by the opiate epidemic.
Needle exchange programs are one way that harm reduction can be implemented in a community. Supplying clean needles and safe disposal sites for addicts to use keeps them from sharing needles infected with disease, and now one kind of needle exchange program is changing the game.
In Seattle the volunteers behind a needle exchange are now handing out meth pipes to drug users for free as well. So is this the same kind of harm reduction being utilized to keep people safer, or is this just negligence at an all-time high?
Meth Pipe Program
It seems some think harm reduction means catering to more than just needles. This strange meth pipe program was launched by a group called The People’s Harm Reduction Alliance about 2 months ago, and is offered 5 days per week off an alley next to a church in Seattle’s University District.
About 25 to 30 meth pipes are handed out each day, and according to the executive director of the alliance Shilo Murphy, the demand for the free meth pipes has been growing ever since. The theory behind the program is that by handing out the pipes, some drug users will rely less on needles, which in turn helps to cut down on the risk of certain diseases in the community. Murphy stated:
“People kept coming to our program and saying that they were getting syringes because they didn’t have access to a pipe.”
So in essence this program has tried to circumvent the whole needle issue by giving users access to another method of ingesting their drugs that put them at a much more decreased risk of infection.
Many former addicts are actively involved in these movements to try and help change things in the community. Some even say that this program also helps those who have never used needles, because it is still possible to spread diseases by sharing pipes if there are open wounds in the mouth present. Regg Thomas, a drug user for the past 20 years who currently works with the Urban Survivors Union stated:
“Whatever the reason is why both parties don’t have their own… They wind up sharing. Well, this program has prevented that because all it takes is a cut orally and you’ve transmitted a disease possibly,”
Whether the theory for the program actually works is still up for debate.
So we have seen how harm reduction can help, and I can even begin to understand how this might actually be a useful tactic for addressing a local drug issue, BUT according to state law handing out drug paraphernalia like the pipes is still illegal in Seattle. And Murphy said he knows that, but he disputes that so was syringe exchange 25 years ago. And yet Seattle has syringe exchange programs and it’s proven to be one of the biggest advantages they’ve had for fighting HIV infections through injection drug use in the state.
Even though it’s illegal under state law to give someone certain kinds of drug paraphernalia, police said they’re more concerned with what’s put into the pipes and not necessarily the pipes themselves.
Making a Real Difference
It isn’t all about the bureaucracy for those involved in this movement. It seems this is more about making a real difference and less about placating to the drug users to enable them. Murphy said this is the first program of its kind in the nation, and he believes it has not just reduced risk behaviors, but it has helped get various users tested for Hepatitis C.
But Murphy does not stop with handing someone a pipe and telling them have fun. The program lets drug users pick up wound care kits and get crucial information about treatment options. Murphy insisted:
“By engaging them, we gave people self-worth… Give back people’s desire to live better in life and live better in society,”
It seems that even though it is technically outside the realm of the law, this program could actually inspire similar changes as far as officials and organizations stepping up to keep citizens safer and more informed as drug addicts instead of labeling them all criminals and locking them up.
I have to say, harm reduction programs to me always seem like an awful idea at first because I believe in abstinence and a program of recovery, but these programs aren’t ever meant to be permanent solutions, only temporary effective vehicles to get individuals the help they need and provide safe and educational support for them until they are willing to get the help. It may sound like it is enabling, and it some ways I guess it is, but it’s saving lives and at least offering an opportunity most would never know about. Maybe harm reduction has more potential than we are currently using.
Enabling addicts to keep using is not a good personal decision, but at the same time putting in place a system to keep the community safe from the spread of disease or more dangerous circumstances is important, especially if it gets people the help they need. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
Author: Justin Mckibben
Earlier this year in March we reported on how Indiana is facing a public health crisis as HIV infection cases skyrocketed as a result of the drug epidemic in the area. Initially when the reports came in the number of confirmed HIV cases in Scott County, Indiana was 26, which is already big enough just 3 months into the year. Now at 5 months that number stands at a staggering 150 for a population of 4,200 in the twin towns of Austin and Scottsburg.
One institution providing mental health care to Scott County reported that so far this year they have admitted 22 patients to a medically monitored detox, which is mind-blowing considering only 16 were admitted last year TOTAL.
While some are sure that the lift on the needle exchange ban would help the issue, it seems that the progressive idea to save lives is being suffocated by local law enforcement.
Lifting the Ban
Indiana Governor Mike Pence declared a state of emergency at the end of March after the CDC persuaded Pence to lift the syringe and needle ban, extending it on April 20 for another 30 days to combat the growing HIV outbreak.
It had been illegal to possess the paraphernalia needed to use drugs in the state, and now the exchange program that was put in place to meet the rising number of HIV cases has been beset by interference from local law enforcement.
Heavy Hand Hurting the Cause
Addicts and community activists have reported to having needles and syringes confiscated by police. It seems law enforcement officials in Indiana remain committed to enforcing the anti-paraphernalia laws in spite of the legislation.
This is extremely detrimental to the cause. Without access to clean needles, addicts are sharing needles up to a staggering 300 times according to Brittany Combs who is a public health nurse for Scott County. The process of getting clean needles to the community is further disrupted by red tape and a fear of the police.
Typically a needle distribution program in urban areas allows addicts to hand out clean needles to their peers. But to get new needles in Scott County, drug users are expected to register at the exchange. Sherriff Dan McClain is more commited to scare tactics than anything it seems, stating:
“If they’ve got one needle and they’re not in the program, they’re going to jail,”
McClain has confidence that arresting those who do not carry a registration card will scare addicts into joining up, but is that just further pushing people away from a program that’s supposed to be helping them. Forcing them to basically register themselves as a documented drug addict under fear of arrest seems a little heavy-handed.
Sheriff McClain was interviewed a while back when Opana was taking over, and then he was just reinforcing stigma with statements like,
“Most of them sleep until noon, get up, and try to find a way to get another pill.”
He insisted that addicts are unable to break the chain of poverty because of their habits. Maybe having a guy who sees addiction as a disease that only affects those he considers poor and lazy isn’t such a good idea.
Knowledge is Power
Education about HIV and AIDS is probably the biggest problem. Education about needle hygiene was never on a list of priorities for the old fashioned, tough-on-crime Republican governor of Indiana. Now in a rural area devastated by unemployment and drug dependency characterized by prescription pain medication use, it seems this is a huge Achilles heel.
Opana, which when crushed and diluted, is a painkiller that is known for a potent high when injected. It had taken over as the number one oxymorphone when OxyContin was reformulated to stop abuse, and it fueled a lot of the new HIV outbreak in the area.
Steps to inform the population about the risk of HIV infection have come from the media through local health officials, featuring a campaign to educate not only IV drug users but reach out to other high-risk groups.
State Health Commissioner Jerome Adams says truck drivers passing through Scott County, who frequent prostitutes, are in particular danger of HIV, so included in the efforts has been the “You Are Not Alone” campaign that is running on TV and radio, online, and on social media.
Austin High School homecoming queen Holli Reynolds has launched her own awareness campaign. The 18 year old wrote of the epidemic in her editorial for the school paper:
“Scott County is making national and world headlines for all of the wrong reasons. Austin has been dealing with poverty and a drug problem for over 50 years, but recently the problem has escalated and taken an ugly turn with the massive HIV outbreak in the community.”
“Stand Up” is a club Reynolds started with other students to talk to kids in grades 2-8 raising awareness about HIV and AIDS while dismissing the myths.
Jerome Adams also addressed many of those misconceptions in an editorial in early May, pointing out the re-surfacing prejudices of decades ago. He reasserted the difference between HIV and AIDS, and even deals with issues of transmission.
With so much going on to combat the increasing number of HIV cases, there is some hope that while the community becomes more informed that the needle exchange programs will be permitted to make more of a difference.
The focus now should shift to treating those living with the virus, and doing more to treat those in active addiction who can still prevent further spread of infection. Drug use puts people at risk for all kinds of health issues that can mean a life of suffering or even death, but there is help for those who are in the throes of addiction. It is never too late. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
Author: Justin Mckibben
This past February there was news from state health officials that changed all optimism regarding the decline in prescription drug abuse and heroin in southeastern Indiana, informing us that at least 26 people in the region were diagnosed with HIV in just a 3 month period, and most of them contracted it after injecting drugs.
The first case that has been considered part of the outbreak in southeastern Indiana was diagnosed in early December according to the deputy commissioner and director for health outcomes at the Indiana State Department of Health Dr. Jennifer Walthall. By January 23rd the total of newly diagnosed HIV cases had already spiked to 11 in a region that typically experiences less than 5 new cases annually. There have been around 90 cases reported thus far, the most in Indiana’s history.
The HIV outbreak among intravenous drug users in this part of the state prompted local health care officials to take a harm reduction approach more seriously, and they began work to start a needle-exchange program. With addicts using and sharing needles to inject drugs, a lot of infections are easily passed around, and hopefully this program can change that.
What is Needle Exchange?
Just a little background on what this all means, a needle and syringe program (NSP) or syringe-exchange program (SEP) is a social service that allows injecting drug users (IDUs) to attain hypodermic needles and related paraphernalia at little or no cost, but often requiring users to turn in used syringes for new ones.
Needle exchange programs are built on the philosophy of harm reduction, and the idea is to reduce the risk factors of spreading diseases such as HIV/AIDS and hepatitis.
A comprehensive 2004 study by the World Health Organization (WHO), which was later supported by the American Medical Associate (AMA) found a determined that needle exchange programs substantially reduce the spread of HIV among IV users, and do so without evidence of exacerbating injecting drug use, and they have proven to be cost effective and efficient.
Breaking the Ban in Indiana
Last week the ball got rolling when Republican Governor Mike Pence signed an emergency executive order in an attempt to control Indiana’s most intense HIV outbreak the population has ever seen. The executive order actually suspended Indiana’s ban on needle-exchange programs for the next 30 days. The ban has only been localized to Scott County, just 30 miles north of Louisville, Ky.
According to the local news sources in Jerome Adams, Indiana’s Health Commissioner, Governor Pence has clearly expressed that he does not support needle exchange as anti-drug policy on an ongoing basis. However those reports suggest that Pence has been adamant about his concern over this recent HIV outbreak, and has taken a critical step to end it.
While Pence voices his concerns about such programs, it doesn’t hurt to look at the evidence from several NIH funded studies that consistently reveal a 33% decrease in the frequency of HIV cases where people participate in needle exchange programs.
A Trial Run
30 days is 30 days, and while to some it may not seem like much, 30 days can be plenty to make a dent in an addiction issue when properly utilized. The 30 day needle-exchange program is based in the Community Outreach Center located in Austin, Indiana. Strategically officials chose this location based on the fact that this may very well be ground-zero in terms of where the most HIV cases have been reported, with 84 confirmed cases of HIV.
As part of this trial run, there are some regulations in place to keep a controled grasp on the program. Each individual will be able to receive:
- 1 week worth of clean syringes
- Access to free HIV screenings
- Hepatitis A and B vaccinations
- Drug treatment referrals
Health Commissioner Adams reiterated that one should not feel ashamed to seek help as this is now an issue of public health. But with the governor seemingly unsupportive of this program, it may seem like needle exchange in southeastern isn’t being used to its fullest potential. The executive order is able to be extended if needed, and if it proves to make a difference then hopefully this program will get the time it needs to help curb the epidemic, as well as provide the drug users in the area with adequate information to get drug treatment.
Harm reduction has been speculated to be a huge part of the new wave in the war on drugs in America, and while it may not be an indefinite solution, it can surely save lives and improve the quality of others in an effort to get more people the treatment they need for the recovery they deserve. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135
Author: Justin Mckibben
While treating a condition such as Hepatitis B can prolong the life of an individual, and that be a worthy cause, it is essential to prevent the spread of the infections. Today for the first time the World Health Organization (WHO) issued some advice on how to address the spread of Hepatitis B (Hep B). In this statement WHO made several recommendations, and one of the primary focuses of this was to point of the importance of using “smart” needles to prevent the spread of the infection.
According to one of the WHO spokeswomen who reported on this,
“Safety engineered syringes also called ‘smart syringes’ have a feature that prevent from reuse of the devices. There are different mechanisms.”
Some of the mechanisms in the “smart” syringes are actually very clever in terms of function and how they are used to treat individuals without the option to reuse. Some of the features include:
- One mechanism is a metal clip which blocks the plunger after the injection is given which prevents one from being able to pull back the piston.
- Presence of a weak point at the end of the plunger which breaks after the injection is given.
- Other “smart” syringes have a needle stick protection feature, which consists of a plastic cover that can be pushed over the needle after it is used.
The WHO had previous touched on the importance of this kind of harm reduction, warning that the reuse of needles is one of the major causes of spreading disease, citing a recent study that indicated that according to the data collected:
- 7 million people with Hep B virus were infected by dirty needles
- 315,000 people with HIV were infected by dirty needles
The Money in this Modification
At the moment there are about 70 firms for deliver technology that are currently working to develop the so called “smart” needles according to the WHO organization. With that in mind its safe to safe that national healthcare programs should be taking every opportunity to utilize this innovation to further prevent exposure to contagious diseases.
One reason this has not yet become the way of the medicine world universally may be the price-tag on this technology. The “smart” needle costs between $0.03 and $0.04, almost double what the more standard needles typically sell for.
Given the fact that this technology could make a vast and drastic impact on the healthcare situation, especially given the rise in heroin abuse in America and the prominence of HIV and other contractible illnesses being spread through needle sharing, the WHO also suggested that smart needle manufacturers donate the newer technologies to healthcare programs with the idea that donations will increase the demand for these products, and the manufacturers will be able to cut down the cost of production, which will in turn lower the price for “smart” needles in the future.
The spokeswoman for the WHO was sure to emphasize how imperative it is that a genuine effort be made for preventing further Hep B infections. She even went as far as to predict that in preventing infections it generates savings. The WHO apparently determined through a cost effectiveness analysis that each dollar invested in safe injection programs creates a saving in the long run of $14.00.
In short, “safe” needles are one advancement in the field of medicine and treatment that can be taken advantage of in order to drastically limit the spread of infectious diseases.
As far as the effects on harm reduction, it seems like this would be the next step beyond needle exchange programs and other clean needle dispensaries, because it takes an extra measure to ensure that once the syringe has been used, someone using it to inject illicit substances cant reuse of share contaminated needles.
When it comes to harm reduction, how much better can it get than having access to a needle that self-destructs after each use? How much of an impact could this really have on the heroin epidemic?
New technology like “smart” needles can be a huge step in the right direction toward battling the epidemic of opiate addiction, and how we are able to address diseases like HIV and Hepatitis in the future. So many people fall victim to the disease like addiction, and worse is they don’t get the treatment they need, either because they don’t know that is available, or they never take the action to get help. If you of someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135