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Advocating for Harm Reduction Across a Diverse District

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  1. Advocating for Harm Reduction Across a Diverse District April 9, 2019 Kentucky Harm Reduction Summit Lynne M. Saddler, MD, MPH District Director of Health

  2. 8001 Veterans Memorial Drive Florence, Kentucky 41042

  3. Public Health in Northern Kentucky The Northern Kentucky Health Department is the public agency charged with performing mandated public health services and addressing priority community health needs. We prevent disease, promote wellness and protect against health threats.

  4. Situation Analysis

  5. Complicated Population with Complex Needs Timeline: • 2012 – Awareness of problem – Hepatitis C, overdose deaths & ER visits • 2013 – NKY HIRT plan – our focus on harm reduction • 2015 – state heroin law allows syringe exchanges • 2016 – Grant Co. syringe exchange • 2016 – Naloxone Distribution System starts • 2017 – HIV increase starts in Campbell & Kenton • 2018 – Mobile syringe exchanges in Newport & Covington • 2018 – Hepatitis A outbreak

  6. Heroin Use in NKY In NKY the increase in IV drug use (particularly heroin) has led to an increase in: • Drug overdoses and untimely deaths • Emergency room visits and hospitalizations • Babies born to women with drug addiction • Arrests and incarceration, drug possession, trafficking and other criminal activity • Impact on businesses and economicdevelopment • Communicable diseases (e.g. hepatitis C and HIV)

  7. Diseases Associated with IV Drug Use • Hepatitis C – viral infection of the liver that can proceed to liver failure and death if untreated. Medication costs to treat=$84,000. • In 2014, KY’s Medicaid program spent more than $50 million to treat 800 people infected with hepatitis C. • HIV –chronic disease with a lifetime cost of over $300,000 to treat.

  8. Hepatitis C in N KY

  9. Scott County, Indiana • “I don’t think there’s anything that makes Scott County, Indiana, different from any other rural county in America. It just happened to be the first.” • Jennifer Walthall • Indiana Deputy Health Commissioner

  10. CDC Map of HIV Vulnerable Counties

  11. HIV Cluster Investigation • Since 2017, the number of HIV infections among people who inject drugs (PWID) have been increasing in Northern Ky and Hamilton County, Ohio. • Injection drug use is now the leading risk factor for HIV infection in Northern Kentucky, surpassing sexual transmission. • At the same time, Hamilton County, Ohio, began experiencing the same increase of HIV among PWID.

  12. Building Support

  13. What is a Syringe Access Exchange Program? Health care access: • Testing for HIV, hepatitis, sexually transmitted diseases, pregnancy • Vaccinations (e.g. Hepatitis A & B) • Naloxone (overdose prevention) • Enrollment in health care coverage • Counseling and education – connect to treatment • Other health department services and referrals to other health care providers

  14. Services at the Health Center and Mobile Unit

  15. Building Support Among Partner Organizations • Tapped into regional heroin response partners and sought resolutions of support • Provided presentations to 60 organizations, reaching more than 1,600 people • Engaged community organizations, non-profits and business community • Local hospital system became strong advocate

  16. Building Support Among Governing Bodies • Presentations to county officials in all four counties in district • Gained approvals from 3 of 4 county governments • Presentations to officials in nine cities • Gained approvals from 3 cities

  17. Building Support Among Community Groups • Partnerships with local neighborhood associations • Open houses at proposed sites • Presentations with police and fire officials

  18. Building Support through Mass Media • National and local media placements • Provided key messages to partners commonlyinterviewed • Shared media coverage with Health Department employees

  19. Building Support through Social Media • Utilized Health Department’s Facebook and Twitter accounts to share updates and key messages • Supplement with paid Facebook ads as needed

  20. Building Support through Social Media • Developed videos as another tool to share detailed information • General advocacy • Program operations https://www.youtube.com/watch?v=OOCoPkzEKpM https://www.youtube.com/watch?v=mJDM42uS79o

  21. After 3 Years of Advocacy…Where Are We?

  22. Status of the Program

  23. Grant County Health CenterWilliamstown, KY

  24. Mobile UnitsCovington and Newport, KY Located in the parking lots of St. Elizabeth Covington and St. Elizabeth Urgent Care Newport

  25. Progress*Data through 3/30/19

  26. What participants say about Grant County SAEP • I’m glad I came” • “I am tired of this life. I just want to get better and be who I used to be.” • “You guys offer so much more than needles” • “I didn’t expect this to be so professional” • “I really want to quit. I’m embarrassed to be here but I am glad I came” • “Nobody has treated me this nice before”

  27. Questions?