In an effort to reduce the harm caused by opioids within Columbia County, a new Harm Reduction Syringe Exchange program will be implemented on Wednesday, June 19, on Columbia Community Mental Health (CCMH) grounds.
The initial pilot project was funded by the Columbia Pacific CCO through a $9,000 grant, with additional funding sources yet to be determined. It is one of many prevention and intervention programs spearheaded by the Columbia County Opioid Task Force.
The force was developed in Spring of 2018 to combat the opioid crisis and other substances in Columbia County. Other task force projects have included increasing school-based education around controlled substances, providing free Naloxone to community members, providing safe medication disposal and storage, and building resilient families, according to Group Lead Claire Catt.
Why it’s necessary
According to federal statistics, Oregon ranked sixth out of all states in rates of illicit drug use in 2013 and 2014. In 2017, there were 344 overdose deaths involving opioids in Oregon, and opioid use disorder increased 11 percent from 2014 to 2018.
Further harm caused by opioids, which the new syringe exchange seeks to alleviate, is the number of communicable diseases spread through shared needle use. About one in 10 new HIV diagnoses in the United States are attributed to injection drug use. According to the Oregon Health Authority, injection drug use (IDU) hospital stays among HIV cases increased from 18 in 2008 to 108 in 2015, while the number of non-IDU HIV stays remained relatively unchanged.
In Clatsop County, where a similar exchange program was set up in October 2017 and whose model Columbia County will base their program on, the number of IDU related hospital stays among Clatsop residents increased from four to 53 between 2008 and 2015. Bacteremia/sepsis IDU stays also increased during that time.
The average cost to treat these stays per person per year among people who inject drugs increased from $48, 611 to $50,628. If the program works as it should, it means a reduced burden on taxpayers covering such medical costs. According to Clatsop County Public Health Director Mike McKnickle, they have already seen a dramatic drop in hospitalized cases of Endocarditis and Cellulitis among Clatsop residents since their syringe exchange began.
“Most of these people are on OHP, and when they go into the hospital, that costs all of us $50,000 to $80,000 because it’s a five to six day stay,” McKnickle said, adding instances of HIV and STDs due to IDU, “seems to be on a comeback due to the sharing of needles.”
Concerns have been raised that increasing access to clean needles may mean an increase in dirty needles left in public places, but McKnickle said that has not been the case in Clatsop County.
“We used to get tons of calls about dirty needles everywhere, and that’s gone way down. We don’t get any complaints about the Riverwalk anymore and to me, that’s a big victory,” McKnickle said. “We’re trying to make sure these folks have safe containers for disposal.”
How it works
The Harm Reduction Syringe Exchange program will run out of a white dodge van, the same used in Clatsop County, parked at the farthest end of the CCMH Creekside property along Gable Road, immediately after the entrance at 58646 Gable Road.
“The location of the exchange is a fair distance from the parking lot,” CCMH Executive Director Julia Jackson said. “We have exterior cameras in our parking lot and immediately outside our facilities. There would be absolutely no cross-over In walking or driving between the exchange traffic and regular client traffic at the main campus. The only cross-over would occur on the main Gable Road, if one were walking.”
The exchange works on a one-to-one ratio: if you bring in ten dirty needles, you will receive ten clean needles in return, as well as a proper sharps container for safe and appropriate disposal. The county will provide two nurses on site and have partnered with Jordan’s Hope For Recovery, who will bring two volunteers in a separate vehicle to offer naloxone (Narcan) training, doses of the life-saving drug, and outreach.
Outreach is perhaps the largest goal behind the program. Those involved are attempting to build relationships and trust with the addicts who use their services in an effort to guide them to resources that can help them battle substance abuse disorders.
“No one wants to be an injection drug user. No one wants to stick needles in their arm,” McKnickle said. “The current heroin crisis is a manifestation of the opioid crisis. When we decided opioids were a problem, we cut back on the pills and those who were addicted had to find another source. Most of them want to go into recovery, but their addiction is overriding that. We’re trying to be a familiar face because there’s so much stigma and shame associated with this. We’re trying to be there and offer those services.”
When someone arrives at the van, those running the program will introduce themselves and ask if they can take an anonymous survey to collect data like whether or not that person has health insurance, where they’re from, and if they’re ready to get clean.
“If they are, we work really hard to get them into the nearest facility,” McKnickle said. “We also offer Narcan training and provide them with a kit, so they can actually help themselves or someone they know who might suffer an overdose.”
According to Catt, the task force will review local data on a bi-monthly basis to learn the utilization rates to include the number of individuals accessing the program, number of needles accepted, number of needles distributed, number of Naloxone kits distributed, and the number of community partner referrals made. The data collection methodology will be identical to that of Clatsop County’s.
According to the Centers for Disease Control and Prevention, established Syringe Service Programs (SSP) have shown people who inject drugs are five times as likely to enter treatment for substance use disorder and more likely to reduce or stop injecting when they use an SSP. They have also been shown to reduce needlestick injuries among first responders by providing proper disposal, as one in three officers may be stuck with a needle during their career.
They also save lives.
“When I started this program in 2017 here, I told the board, ‘one life saved was worth the program.’ Since then, we’ve documented 64 reversals, so those are 64 lives saved,” McKnickle said.
The program has partnered with Jordan’s Hope for Recovery, whose founder and chair, Kerry Strickland, will be on site at the Harm Reduction Syringe Exchange. While the county handles the syringe exchange and supplies, Jordan’s Hope will handle the Naloxone training and outreach.
Jordan’s Hope for Recovery was born out of the loss of Strickland’s son to an overdose. They are dedicated to removing the stigma that comes with addiction and connecting those in need with recovery and support services.
“Something I feel is really important is educating the public. When you say ‘we brought in this many needles’ and focus on that, we forget why we’re there. There’s a humanitarian piece to it, too,” Strickland said. “We’ve reached out to people over 700 times since October 2017. We’ve had 60 overdose reversals, given out over 630 Naloxone kits and we’ve done some community training with that, too. It’s not all just a needle exchange. We’ve also made 13 intake calls to facilities right on site.”
For questions or upcoming dates, contact the CCMH prevention coordinator at 503-397-4651. For more information about Jordan’s Hope for Recovery, visit jordanshope.org.