Transcript Harm Reduction and Sterile Syringe Access

Overview of Harm Reduction
and Sterile Syringe Access
Anna Benyo
Syringe Access Policy Coordinator
Harm Reduction Coalition
New Jersey Syringe Access Informational Forum
February 28th 2007
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
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.
Key Principles of Harm Reduction
 Designs & promotes public health interventions
that minimize the harmful affects of drug use.
 Understands drug use as a complex, multifaceted issue that encompasses behaviors from
severe abuse to total abstinence.
 Meets people where they are in the course of
their drug use
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
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.
Harm Reduction Practice Calls For
 Non-judgmental, non-coercive provision of
services
 Low-threshold program models
 Resources to people who use drugs
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
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
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.
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
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.
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.
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 nation’s 2nd leading cause of
accidental deaths.
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.
Sterile Syringe Access Programs
 Nearly 200 syringe exchange programs currently
operate in 38 states, Puerto Rico, Washington DC.
 Access includes: syringe exchange programs, overthe-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
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)
Opportunities and Challenges:
the good news and bad news
GOOD:
New 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.
Harm Reduction Coalition (HRC)
Education, Training, Technical Assistance, and
Capacity 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
HRC’s 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)
Contact Information
For training information:
Rebecca Stryjewski
212.213.6376 ext 18
[email protected]
For questions about citations or syringe access:
Anna Benyo
Syringe Access Policy Coordinator
212.213.6376 ext 49
[email protected]
Thanks to Drug Policy Alliance New Jersey,
Roseanne Scotti, and Meagan Johnson