Harm Reduction Strategies for a Public Health Crisis · 2019-07-25 · Suboxone.The prosecutions...
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Alice Bell, L.C.S.W. Overdose Prevention Project Prevention Point Pittsburgh [email protected] 412-247-3404 Harm Reduction Strategies for a Public Health Crisis
Transcript of Harm Reduction Strategies for a Public Health Crisis · 2019-07-25 · Suboxone.The prosecutions...
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Alice Bell, L.C.S.W.Overdose Prevention ProjectPrevention Point Pittsburgh
Harm Reduction Strategies for a Public Health Crisis
mailto:[email protected]
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Allegheny County, Pennsylvania Accidental Drug Overdose Deaths
1998-2018*
*Data from Allegheny County Medical Examiners Annual Reports.
Chart1
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
Total Overdose Deaths
104
101
140
189
220
224
208
220
252
254
233
222
224
259
286
276
307
424
650
737
432
Sheet1
Total Overdose Deaths
1998104
1999101
2000140
2001189
2002220
2003224
2004208
2005220
2006252
2007254
2008233
2009222
2010224
2011259
2012286
2013276
2014307
2015424
2016650
2017737
2018432
&C
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Allegheny County, Pennsylvania Accidental Drug Overdose Deaths
2000-2018
87% of cases include more than one drug
*Data from Allegheny County Medical Examiners Annual Reports. Includes all overdose deaths where these drugs were present at time ofdeath, alone or in combination with other substances..
2018: 77% of deaths involveFentanyl and/or analogues
Chart1
20002000200020002000
20012001200120012001
20022002200220022002
20032003200320032003
20042004200420042004
20052005200520052005
20062006200620062006
20072007200720072007
20082008200820082008
20092009200920092009
20102010201020102010
20112011201120112011
20122012201220122012
20132013201320132013
20142014201420142014
20152015201520152015
20162016201620162016
20172017201720172017
20182018201820182018
Heroin
Cocaine
Prescription Opioids
Fentanyl & Analogues
Total Overdose Deaths
80
42
15
0
140
121
59
30
4
189
118
63
52
5
220
82
72
85
15
224
77
89
80
15
208
77
105
92
9
220
40
129
142
31
252
33
91
188
23
254
62
92
158
16
233
59
77
137
16
222
50
87
140
19
224
92
83
132
5
259
138
67
99
14
286
145
67
112
8
276
157
82
114
59
307
244
124
152
130
424
330
221
168
422
650
288
277
123
600
737
196
185
100
333
432
Sheet1
HeroinCocainePrescription OpioidsFentanyl & AnaloguesTotal Overdose Deaths
20008042150140
200112159304189
200211863525220
200382728515224
200477898015208
200577105929220
20064012914231252
2007339118823254
2008629215816233
2009597713716222
2010508714019224
201192831325259
2012138679914286
2013145671128276
20141578211459307
2015244124152130424
2016330221168422650
2017288277123600737
2018196185100333432
&C
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Harm Reduction Services Providing Sterile Injection Equipment
to prevent HIV & Hep C since 1995. Testing for HIV and Hepatitis C Case Management, assistance to treatment Advocacy for Drug User Health Overdose Prevention & Response Training Naloxone Distribution since 2005. Wound Care Consultation Clinic Education on safer injection. Fentanyl test strips for drug checking All Services Free of Charge Anonymous/Confidential Low Threshold
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Hepatitis C, increased by more than eight-fold in the 10-county Southwestern Pennsylvania region —climbing from 335 cases in 2003 to 2,818 in 2014, driven by the spike in injection drug use and shared needles, creating an explosion of hepatitis C among younger injection drug users.
Sterile syringes cost about 7 to 10 cents each (about $185/year average) when purchased in bulk, compared to the cost of treating hepatitis C — which can range from $50,000 to $80,000.
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The mission of PAHRC is to promote the health, dignity, and human rights of individuals who use drugs and communities impacted by drug use. Recognizing that social inequity, criminalization, and stigma silence those affected most, we advocate for policies that improve the quality of life for people who use drugs, people in recovery, and their communities.
PAHRC is dedicated to advocating for, and with, individuals who are currently using substances to receive competent care and comprehensive services. Our immediate goal is to expand access to sterile injection equipment, naloxone, and other harm reduction oriented services throughout the Commonwealth of Pennsylvania. We welcome anyone who is interested in promoting evidence-based and humane responses to substance use to join us!
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Keeping people alive.
An emergency response to an emergency.
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2005
2019
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Prevention Point Pittsburgh NaloxoneCUMULATIVE DATA - July 2005- Dec 2018
Third Party Implemented
Chart1
20052005
20062006
20072007
20082008
20092009
20102010
20112011
20122012
20132013
20142014
20152015
20162016
20172017
20182018
96% of Naloxone RescuesPerformed By Individual Who Use Opioids
Total Number of Individuals Who Received Naloxone
Total Number of Overdose Reversals
50
8
175
51
299
135
426
249
532
354
639
472
747
569
887
775
1023
1000
1175
1167
2040
1398
2749
1847
3453
2480
4319
3016
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Total Number of Individuals Who Received NaloxoneTotal Number of Overdose Reversals
2005508
200617551
2007299135
2008426249
2009532354
2010639472
2011747569
2012887775
201310231000
201411751167
201520401398
201627491847
201734532480
201843193016
&C
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Ideally naloxone in first aid kit of every lay and professional first responder: in police cars, ambulances, homeless shelters, SUD Tx programs, schools, community centers and home first aid kits. The Surgeon General has recommended that EVERYONE carry naloxone.
However, NUMBER ONE priority: Put naloxone in the hands of those most likely on the scene and first to respond, individuals who use opioids, themselves.
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2005- 2012: Prevention Point only source of Naloxone for lay people
2008: PPP founding member of national network NOPE, later renamed the Opioid Safety and Naloxone Network, with over 700 members nationwide.
2012-2013: Available by individual prescription in a in a few medical practices.
PPP testified before FDA re: naloxone access, 2012, 2015, 2016, 2017, 2018.
2016: PPP, County Jail, County Pharmacy Standing Order, a few doctors and treatment providers. About 7,000 doses distributed overall.
2017 – Some Hospital ED’s, Health Dept., more SUD Tx programs dispensing take-home naloxone. Statewide Standing Order for Pharmacies. PPP began distributing fentanyl test strips. 2018 – EMS Leave Behind.
2018 over 29,000 doses distributed in a variety of settings.
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Estimated Number of Naloxone Doses Distributed Allegheny County 2016-2018
Chart1
2015
2016
2017
2018
Column1
950
7212
13122
29611
Sheet1
Column1
2015950
20167,212
201713,122
201829,611
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Overview of Medication Assisted Treatment Methadone, Buprenorphine and Naltrexone Alexander Y. Walley, MD, MSc, Associate Professor of Medicine, Director, Addiction Medicine Fellowship Boston University School of Medicine/ Boston Medical Center Medical Director, Opioid Overdose Prevention Pilot Program Massachusetts Department of Public Health Medication Assisted Treatment Summit Massachusetts Medical Society Monday, October 31, 2016
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The idea: If you know they're about to inject, snort, smoke or swallow fentanyl, you'll take smaller doses, avoid using alone, and make sure you have naloxone handy in case of overdose.
Even when someone assumes they have fentanyl, the experience of testing the drugs and seeing positive confirmation that it's fentanyl has an impact.
It encourages people to use more safely.
Fentanyl Test Strips
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Addiction clinics in and around Pittsburgh have become a legal battleground over the past year, with federal prosecutors charging 13 people for fraudulently prescribing a common addiction medication, Suboxone.The prosecutions were funded by a federal program formed in August 2017 to combat prescription fraud. The program has subsidized at least 113 charges in 12 federal districts so far, and the vast majority have involved dangerously addictive painkillers, such as OxyContin, which kill more than 13,000 people per year. But in Western Pennsylvania, most of the charges brought by the program’s prosecutors involve the addiction treatment Suboxone, which uses a mild opioid to help people taper off of more potent ones.
…health experts worry that cracking down on these cases could scare off reputable doctors from getting approved to prescribe Suboxone — effectively leading to a shortage of one of the few effective treatments for opioid addiction.
June 13, 2018
“Effective immediately, the Crittenden County State’s Attorney’s Office will decline to prosecute any citationsor arrests for Misdemeanor Possession of Buprenorphine and related compounds such as Suboxone.
These drugs are intended to be life-saving and an integral part of Medication-Assisted Treatment (MAT). They block the craving for heroin or other opioids, which in return reduces crime, the likelihood of fatal overdoses and recidivism.”
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There is only so much you can do if you also want to avoid
serious change.
-Scott Burris, Director, Public Health Law Research Center, Temple University Beasley School of Law
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Alice Bell, L.C.S.W.Overdose Prevention ProjectPrevention Point Pittsburgh
mailto:[email protected]
Slide Number 1Slide Number 2Slide Number 3Prevention Point �Pittsburgh Slide Number 5Slide Number 6Naloxone��NALOXONE HCL (Narcan® or Ezvio®) Slide Number 8Slide Number 9Slide Number 10Slide Number 11Slide Number 12��PPP Advocacy for Increasing Access to Naloxone Since 2002��Slide Number 14Slide Number 15Slide Number 16Slide Number 17Slide Number 18Slide Number 19Slide Number 20Slide Number 21Slide Number 22
