who use drugs in order to assist them in reducing harm while in the cycle of addiction

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1 August 16, 2016

2 } Accepts that illicit drug use is part of our world, and chooses to minimize its harmful effects rather than ignore or condemn them } Calls for the provision of services to people who use drugs in order to assist them in reducing harm while in the cycle of addiction } Does not minimize or ignore the real and tragic harm and danger associated with illicit drug use

3 } Providing needles to injecting drug users will increase the number of users and the amount of illicit drugs used } An injecting drug user who goes to a syringe exchange program is five times more likely to go into a rehabilitation program Myth Reality

4 } Injecting drug users don t mind sharing dirty needles } New York experienced an 80% decrease, and Washington DC experienced a 60% decrease in new HIV infections after implementing syringe exchange programs Myth Reality

5 } Syringe Exchange Programs send the wrong message about illegal drug use } The impact of Syringe Exchange Programs is that they deter rather than promote drug use Myth Reality

6 } Individual Opportunity for Intervention 78% of injecting drug users never see a medical or mental health provider Required services (directly or by referral): HIV and viral hepatitis prevention education; safe injecting practices education; education on reduction of sexual risk behaviors; drug abuse treatment services; HIV and/or hepatitis screening; Hepatitis A and Hepatitis B vaccinations; screening for sexually transmitted infections; housing services for the homeless, for victims of domestic violence, or other similar housing services

7 } Average cost of a liver transplant - $300,000 Recurrence of Hepatitis C 40% of the transplants } Average cost for a life time of care for someone with HIV infection - $600,000 } Hepatitis C medication therapy ranges from $63,000 to $94,500

8 } In one year (November 18, 2014 to November 1, 2015) 181 newly identified cases of HIV (an additional 13 identified since) 92.3% also had Hepatitis C (167 people) Contact investigation identified 536 people who needed to be tested } HIV cost of care: $108,600,000 } Hepatitis C: $10,521,000 to $15,781,500

9 } Community - Risk reduction for exposure June 25, 2016 Hanford Sentinel Local law enforcement is seeing heroin use on the rise in Kings County Safe recovery and disposal of used syringes and sharps waste } Law Enforcement Decreased risk of needle stick injury San Diego 30% experienced a needle stick injury Connecticut needle stick injuries decreased by two thirds

10 Syringe exchange programs are a cornerstone of prevention efforts to protect the health and safety of police officers, fire fighters and other civil servants, and the public by helping to reduce transmission of blood-borne disease. Since implementation in the late 80 s, new HIV infections among IDUs have declined overall by 80% amfar, The Foundation for AIDS Research

11 } Shasta County Population 170,000 25,000 pounds of syringes removed last year } Fresno County Top 25 for new HIV infections from injecting drug use On track to remove1,000,000 syringes this year } San Luis Obispo people using the program On track to dispense 80,000 to 100,000 syringes this year

12 } H&S Code Section allows CDPH to authorize SEPs in locations where the conditions exist for the rapid spread of viral hepatitis, HIV or other potentially deadly diseases } AB1743 Allows pharmacies to sell hypodermic needles and syringes to adults age 18 and older without a prescription Allows adults to possess needles and syringes for personal use if they are provided by a pharmacy, doctor, or by an authorized syringe exchange program Removes limits on the number of syringes that can be sold or provided. } Starting January 1, 2015, pharmacy law changed to remove limits on the number of syringes that adults can purchase or possess. There are now no limits on the number of syringes an adult can have or buy

13 } American Medical Association } American Public Health Association } American Bar Association } American Civil Liberties Union

14 } Complete and submit application Operating Requirements: Syringe Dispensing Plan, Syringe Collection and Sharps Waste Disposal Plan, and Service Delivery Plan } Posted to the CDPH/OA website for public comment for 90 days } CDPH/OA contacts local law enforcement, local Health Officer, } CDPH/OA has 30 days to make a decision } Two year certification

15 } Locations Weekly for 2 hours at KCDPH Monthly for one hour at the outlying clinics } Times Scheduled during normal work hours } Staffing Intervention and Prevention staff Volunteers from Champions Alternative Recovery Programs at the Hanford location

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