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North Carolina Harm Reduction Coalition. North Carolina Harm Reduction Coalition (NCHRC) is North Carolina’s only comprehensive harm reduction program.

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Presentation on theme: "North Carolina Harm Reduction Coalition. North Carolina Harm Reduction Coalition (NCHRC) is North Carolina’s only comprehensive harm reduction program."— Presentation transcript:

1 North Carolina Harm Reduction Coalition

2 North Carolina Harm Reduction Coalition (NCHRC) is North Carolina’s only comprehensive harm reduction program. NCHRC engages in grassroots advocacy, resource development, coalition building and direct services for law enforcement and those made vulnerable by drug use, sex work, overdose, immigration status, gender, STIs, HIV and hepatitis. NORTH CAROLINA HARM REDUCTION COALITION 2

3 Harm Reduction Syringe Access and Injection Drug Use (IDU) Crack Use Overdose Prevention Ethics 4 Pillars OVERVIEW NORTH CAROLINA HARM REDUCTION COALITION 3

4 Harm reduction is a way of preventing disease and promoting health that “meets people where they are” rather than making judgments about where they should be in terms of their personal health and lifestyle. This is based of the behavioral health theory “stages of change.” HARM REDUCTION NORTH CAROLINA HARM REDUCTION COALITION 4

5 Accepting that not everyone is ready or able to stop risky or illegal behavior, harm reduction focuses on promoting scientifically proven ways of mitigating health risks associated with drug use and other high risk behaviors, including condom distribution, access to sterile syringes, medications for opioid dependence such as methadone and buprenorphine, and overdose prevention. HARM REDUCTION NORTH CAROLINA HARM REDUCTION COALITION 5

6 Diabetics (680, ,000) HIV+ (35,000) HBV/HCV+ (+/-750,000, of which 120,000 know their status) Cancer Patients People taking hormone replacement therapy Multiple Axis 3 Issues IDUs +/- 50,000 IDUs IDUs are injecting: Pills, hormones, vitamins + street drugs ISSUE SPOTLIGHT: WHO NEEDS/USES SYRINGES NORTH CAROLINA HARM REDUCTION COALITION 6

7 Doctor (Get a prescription) Friends/Associates The Underground Syringe Exchange Legal Syringe Exchange in Another State/District (DC/NYC) Pharmacies (Pharmacists have right in NC to decide who gets one) Drug Dealer Discarded syringe at a known IDU site Acquire them from health care sites (sympathetic staff or steal them) Biohazard Containers WHERE DO PEOPLE GET THEIR SYRINGES IN NORTH CAROLINA NORTH CAROLINA HARM REDUCTION COALITION 7

8 Cookers Cottons Tourniquets, shoelaces, belts Water Crack/meth pipes Choy Other drug use equipment WHAT ELSE ARE WE WORRIED ABOUT WITH IDUS? NORTH CAROLINA HARM REDUCTION COALITION 8

9 HIV/AIDS - ($340,000-$620,000 per infection) 35,000 people have HIV/AIDS in NC HBV/HCV ($80, ,000 per infection) Up to 750,000 people have HBV or HCV in NC Law Enforcement Needlesticks (33% get a needlestick, 28% get multiple) Health Care Provider Needlesticks every 30 seconds someone gets a stick, some require PEP, which costs >$4,500 Overdose (#4 cause of death in NC), which cost >$6,000 per case When people reuse syringes they get abscesses that cost >$2,000 per case PROBLEM WITH A LACK OF SYRINGE ACCESS NORTH CAROLINA HARM REDUCTION COALITION 9

10 Access to Treatment Access to Methadone/Bupe Access to Overdose Prevention Education Access to Narcan Access to HIV/Hep B +C Services Access to housing, medical services, food, jobs, etc. Stigma WHAT ELSE ARE WE WORRIED ABOUT WITH IDUS? NORTH CAROLINA HARM REDUCTION COALITION 10

11 2009 STUDY FROM RTI: Racial differences in acquisition of syringes from pharmacies under conditions of legal but restricted sales Elizabeth C. Costenbadera, ∗, William A. Zule, Curtis C. Coomes Result: In our study sample, African-American IDUs were one-fifth as likely as white IDUs to report pharmacies as their primary source of syringes in NC. SYRINGE ACCESS ISSUES IN THE TRIANGLE NORTH CAROLINA HARM REDUCTION COALITION 11

12 THE PROBLEM WITH SHARING SYRINGES NORTH CAROLINA HARM REDUCTION COALITION 12

13 According to the DEA Crack is used by 2% of NC A lot of crack users get exposed to HCV by sharing their crack pipes Difficult to work with population Operate “after hours” High risk for STIs Harm reduction programs prevent crack users from getting HIV, HCV and STIs HCV can be prevented by providing rubber tips (or spark plug covers) on pipes or by promoting rubber band use Harm Reduction Programs refer crack users to drug treatment CRACK USE NORTH CAROLINA HARM REDUCTION COALITION 13

14 #4 cause of death for year olds in NC NC Doctors wrote 17million known scripts for NC’s 9 million residents in 2010 HARM REDUCTION Overdose can be prevented by providing overdose prevention training, as well as community initiatives to anyone who use prescription or illegal drugs or is likely to do so (people in drug tx, corrections, seniors, etc) Overdose can be prevented with the passing of Good Samaritan laws that protect people who call 911 Overdose can be prevented by having doctors use controlled substance registry OVERDOSE 14 NORTH CAROLINA HARM REDUCTION COALITION

15 Does harm reduction promote drug use? No, in fact in communities with harm reduction programs the following occur: Drug use goes down Amount of people who access drug treatment goes up Crime goes down Average age of first drug use goes up Increase in HIV, HCV & STI testing HIV and Hepatitis incidence goes down Decrease in overdose rates SOURCE: NIH & CDC ETHICS NORTH CAROLINA HARM REDUCTION COALITION 15

16 Drug use is not going to end and is a part of human culture whether we agree with it or not. Thus a comprehensive approach is necessary to decrease the negative health outcomes The 4 Pillars Solution Drug Prevention, Harm Reduction, Drug Treatment and Law Enforcement need to work together, not against each other to fight this the negative impacts of drug use This has worked to much success in Vancouver, Switzerland and New Mexico. NCHRC currently operates using this framework as its operating principle 4 PILLARS NORTH CAROLINA HARM REDUCTION COALITION 16

17 Robert Childs, MPH Executive Director NCHRC, PO BOX 13761, Durham, NC, NORTH CAROLINA HARM REDUCTION COALITION 17


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