Transcript Cincinnati Exchange Project

& SYRINGE ACCESS
ADAM REILLY PROJECT DIRECTOR
COMMUNITY PLANNING
COMMUNITY SUPPORT FOR HARM
REDUCTION
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Identified key individuals to champion harm
reduction in various sectors of the community
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People who take drugs
Family members
Law enforcement
Judicial and corrections system
Drug treatment and prevention
Health care system
City and county government
Business community
Private funders
ENGAGING THOSE WHO TAKE DRUGS IV
Conducting street outreach
 Outreach to those in treatment
 Conducted community assessment
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189 surveys completed
 67 participants in focus groups
 All individuals were currently using or had used in
the past year
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Community assessment was used as a way to
make national and international data on harm
reduction have a real connection to what was
going on at the time locally
GAINING LAW ENFORCEMENT SUPPORT
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Have worked closely and continue to do so with CPD
and Hamilton County Sheriff’s office
Outspoken support from city police Chief and county
Sheriff
Engage community liaison officers, those for
individual neighborhoods and those for specific
groups
Maintain relationships with district commanders and
liaison officers
Provide training to law enforcement on harm
reduction and Naloxone use
Local law enforcement understands how harm
reduction protects them and other first responders
BUSINESS AND FUNDING COMMUNITY
SUPPORT
Support from major local foundation, Interact for
Health, has been a catalyst for harm reduction in
Cincinnati
 Early support of such an approach has lead to
more support in the wider funding community
 Connections made with business leaders,
prominent individuals and families
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HAMILTON COUNTY ROE PLAN
Individuals from more than 30 organizations
joined forces in 2013
 During that time they were split into four main
categories
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Treatment/recovery
 Harm Reduction
 Prevention
 Supply reduction
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A more than 40 page detailed plan will be
released to the public in the coming weeks
 Plan has endorsement from key city and county
officials
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GETTING PEOPLE
THE TREATMENT
THEY NEED
Treatment Outcomes:
 More Hamilton
County residents
will achieve longterm recovery as a
result of addiction
treatment and
related services.
 Fewer Hamilton
County residents
will overdose on
opioids
TREATMENT
STRATEGIES
• Increase the capacity of all levels of addiction treatment
care, particularly for indigent and underinsured Hamilton
County residents.
• Enhance addiction treatment services through the
continued use of evidence-based counseling practices
and by making Medication Assisted Treatment (MAT)
more available in conjunction with treatment services.
• Increase the number of sober housing units available for
Hamilton County residents.
• Strengthen treatment providers’ collaborations with
mutual help groups such as Narcotics Anonymous,
Alcoholics Anonymous, and SMART Recovery.
• Make peer mentoring and support more available to
people in recovery and for providers of Medication
Assisted Treatment.
REDUCING
HARM
CAUSED BY THE
OPIOID
EPIDEMIC
Harm Reduction
Outcomes:
HARM REDUCTION
STRATEGIES
- Decrease the number of new Hepatitis C,
HIV, and other infections caused by
intravenous drug use
- Decrease the number of unintentional
overdoses due to opioid use
- Decrease the transmission of Hepatitis C,
HIV, and other infections through
accidental needle sticks.
• Increase community based
Naloxone distribution
• Expand syringe exchange
programs in Hamilton County
• Increase community support
and education efforts
• Increase access to healthcare
for intravenous drug users
• Provide overdose education
and prevention services
throughout Hamilton County.
PREVENTING
OPIOID MISUSE
Prevention
Outcomes:
• Fewer people
begin misusing
prescription
opiates
• Fewer people
begin using
heroin and other
illegal opioids
PREVENTION
STRATEGIES
• Provide information by educating the public and
professionals about heroin and prescription drug
issues.
• Build skills, connected to trust and communication
• Improve the safety of the physical environment
• Advocate for policies that increase the availability
of permanent drop boxes and education about SBIRT
and pain management practices.
CUTTING THE
SUPPLY OF
OPIOIDS IN
HAMILTON
COUNTY
Supply Reduction
Outcomes:
SUPPLY REDUCTION
STRATEGIES
• Reduce the supply of heroin in
Hamilton County
• Less diversion of prescription
opiates
• Enforce current laws
and regulations
• Collaborate with
others to educate the
public
• Explore the feasibility
of implementing harm
reduction measures on a
larger scale
PUTTING THE PLAN INTO ACTION
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Funding collaborative has been established
Comprised mostly of local private funders
 ROE admin team will pursue local, state, and federal
funds for portions of the plan as well
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Plan is a living document and will be updated
periodically
 Once fully implemented ROE will be able to show
the success of each strategy and how they work
together
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MISSION STATEMENT
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The Cincinnati Exchange Project is a local
advocacy organization that promotes education
and the harm reduction model. We advocate for
policy change that will enable local community
based organizations to conduct outreach, testing
and provide safe injection equipment to the
injection drug use community. Upholding every
individual’s right to health and well-being. These
efforts will increase their competence to protect
themselves, loved ones, and the community as a
whole.
HOW CEP GOT STARTED
Coalition of interested parties started work in
2007; reps from drug treatment, health care, law
enforcement, and others (separate from ROE)
 Ohio is a home rule state
 Cincinnati Health Department declared a health
emergency on 2/28/2012
 Health emergency allows CEP to operate within
the city of Cincinnati only
 Gained support of CPD and Hamilton County
Sheriff’s office
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TURBULENT START TO CEP
Operations started in Springdale in February
2014 with an emergency order
 After 6 weeks of operations it was claimed that
CEP decreased business at surrounding
businesses by 20%
 All levels of Springdale government withdrew
support
 No incidents occurred and police or first
responders were never call for anything related
to CEP
 Next neighborhood we approach was Lower Price
Hill which ended up being a media nightmare!
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CEP OPERATIONS STABILIZE
Change over in city and county law enforcement
leadership
 Greater knowledge of issue in the general public
 Partnership with Episcopal church in Mt.
Auburn
 Large scale support for harm reduction in
Northside
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COMMUNITY BUILDING FOR CEP
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CEP operates in 2 Cincinnati neighborhoods
Mt. Auburn and Northside
 3rd site to start in late-April, this site will have a focus on
Transgender services
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To gain access and support CEP…
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Canvassed neighborhoods, talking to community members
and cleaning up trash and needles
Identified key neighborhood supporters/advocates
Met with community councils and business associations
Conducted community education sessions
Secured support from CPD and both district commanders
along with community liaison officers
Continue to build and maintain relationships with those in
each community
WHO MANAGES AND RUNS CEP
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Medical Director
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Project Director
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Adam Reilly
Project Manager
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Dr. Judith Feinberg, MD
Libby Harrison
Volunteers
Much of the community work CEP does is through
the work of our amazing volunteers!
www.cincyep.org or follow us on Facebook
www.facebook.com/cincinnatiexchangeproject
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WHAT SERVICES
ARE OFFERED
1-for-1 syringe exchange
 FREE rapid HIV, HCV, syphilis and pregnancy
testing
 Safer sex & injection equipment/education
 Community based Naloxone distribution
 Active referrals to detox and drug treatment
 Active referrals to other social services
 ACA enrollment through Free Store Foodbank
 A conduit for entering drug treatment
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WHAT’S THE CLIENT EXPERIENCE
Initial paper work (only done once)
 Agrees to participant’s rights and responsibilities
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No Drug use, drug dealing, weapons, or other illegal
activity
Given a participant code AREI5723
 All services are offered, but not required
 Initial visit may be 20 minutes, subsequent visits
may only be 5 minutes.
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WHAT CEP HAS SEEN AS OF 3/16/2014
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240 total clients
Exchanged 15,500 syringes
Distributed 200 Narcan Kits through Project DAWN
and 26 Evzio kits
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27 lives saved
7 deaths, nearly doubled since running our of Project
DAWN supply
15% given to second party, 85% to first party
10 organizations trained and supplied with Narcan
CBD unit trained and District 3 is in the process
Average age of client is 37, youngest 19, oldest is 67
Average length of use 8.4 years
10% of clients have been using less than 1 year
30% of clients have been using for more than 20 years
CEP RACIAL/ETHNIC BREAKDOWN
Sales
Asian
Native American
Hispanic
Middle Eastern
White
CEP EMPLOYMENT STATUS
Sales
Employed
Unemployed
Student
Disabled
Homemaker
CEP GENERAL DATA
56% have overdosed in lifetime
 71% report being HCV positive
 4.3% report being HIV positive
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NEXT STEPS AND EXPANSION
CEP is a data driven program, but can only
operate in communities that are welcoming
 We have plans to expand within the city and are
in talks with other jurisdictions in the region
 CEP needs communities to approach them, we
have found that when approached by community
members we have more success than the reverse
 We hope that data collected by CEP and the
successful operations for more than a year will
help to open more community member’s minds,
leading to greatly expanded services in the region
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MOBILE UNIT