9th - Harm Reduction Coalition

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9th National Harm Reduction Conference FROM PUBLIC HEALTH TO SOCIAL JUSTICE Feffer, Richard, Independent, Seattle, WA rich@hepeducation.org Crisis on The Inside: Hepatitis in Prison and Jail While the national rate of chronic Hepatitis C (HCV) infection stands at about 2%, it is estimated that as many as 40% of incarcerated persons in the U.S. are infected with HCV. Most HCV infected persons, as many as 75%, are unaware of their infection. The astounding prevalence of HCV in correctional settings creates particular issues for inmates of our penal institutions. Specific issues include access to hepatitis testing and vaccines, HCV transmission and prevention in prison, eligibility for and access to the latest HCV treatment, and HCV/HIV co-infection. Prison is a high-risk setting for hepatitis, and educational and medical resources are often limited in prison facilities. These concerns particularly affect injection drug users and racial/ethnic minority populations, who are disproportionately affected by HCV and disproportionately incarcerated. This roundtable discussion will provide in-depth information on issues related to HCV in prison and will discuss current initiatives and programs aimed at educating prison populations and increasing access to quality healthcare and treatment for all incarcerated people, including the Hepatitis Education Project’s prison and jails outreach programs. Participants from related health and advocacy organizations will be encouraged to participate and share ideas, issues, and initiatives. Rich Feffer has a background in sociology, criminology, and community development. He currently runs hepatitis education, outreach, and advocacy programs at Seattle’s King County Jail and all Washington State Prison facilities for the Hepatitis Education Project (HEP). He also works with HEP to facilitate the National Hepatitis Prison Coalition. Rich has a master’s degree in community development from Illinois State University. Figallo, Claudia, UCSF - Alliance Health Project, Daly City, CA claudia.mph@gmail.com Drugs and Creativity: A Support Group for Active Drug Users Many drug treatment agencies utilize individual and group support based on talking therapies using techniques such as Motivational Interviewing, Cognitive Behavioral Therapy and psychotherapy among many. There are multiple other ways to explore emotions and inner conflict particularly when it relates to drug use. Creative Arts are an effective way to help active and former drug users explore their relationship to drugs and their drug using behavior. The UCSF-Alliance Health Project currently runs a Creative Arts group for active drug users to explore themes such as sexuality, relationships, triggers, emotions and goals. The groups uses images, pens, paper, music, poetry and movement to help participants express their concerns and get support from others about how to address multiple issues. Some participants may find it difficult to speak up in group settings or meetings and the Creative Arts groups provides a safe setting to express oneself without having to speak. This presentation will provide specific information on the history of the Creative Arts group, how themes are planned, the structure of the group, managing active drug users in a group setting and will also provide specific examples and quotes from participants. This workshop will be particularly useful to those working in harm reduction community agencies. These support groups can be useful in building community, creating alliances, exploring alternative ways of expression and providing participants with a different outlet to their concerns. Drug User Led Peer Support Groups The UCSF-Alliance Health Project has been providing peer support groups for people with HIV for over 25 years. The Groups Program trains community members to facilitate support groups during an experiential weekend, based on a peer-group model. Providing active drug users with the training and resources they need in order to serve as facilitators of peer support groups can result in safe, non-judgmental groups which serve as emotional and social support for participants, as well as a forum where members can share information and referrals. This presentation will provide specific information on peer group basics and key facilitation skills which can be taught to drug users so that members can run groups, with and without staff support in community agencies, hotels and day programs. The presentation will cover topics such as creating safety, encouraging group interaction and managing conflict and differences among group members. Participants will learn the 40
9th National Harm Reduction Conference FROM PUBLIC HEALTH TO SOCIAL JUSTICE basics of the Alliance Health Project peer group model and how to pass on these skills to drug user groups to create safe peer-led groups for the purpose of social and informational support. Also, it will provide suggestions on how to set up different types of groups such as drop-in groups and groups with specific themes. Claudia Figallo, MPH has been advocating and supporting drug user health through harm reduction for over 10 years. She assists drug users in exploring their using practices and make wiser choices about their health. Claudia works as a substance abuse counselor and group facilitator at the UCSF-Alliance Health Project, trains community members to lead peer led groups and is a Board Member for the Harm Reduction Therapy Center in San Francisco. She has a post-graduate diploma in Drama and Movement. Fitzpatrick, Tom, The People’s Harm Reduction Alliance, Seattle, WA tomsfitzpatrick@gmail.com Implementing Peer Control: From Philosophy to Policy Services designed and implemented by peers are the most effective at protecting the health and fundamental rights of drug users. To make good on this commitment, we have made increasing drug user participation at all levels of our organization a priority. In our presentation Shilo Murphy and Tom Fitzpatrick will share the successes PHRA has enjoyed as a result of our inclusionary policies and also discuss the challenges we’ve encountered in the process of implementing peer control. We will emphasize how PHRA’s experiences might be applied to other programs and make specific suggestions as to how other organizations might take practical steps to increase user participation. Specific topics will include (1) making the transition from an exclusionary to an inclusionary harm reduction organization, (2) defining who is a peer, (3) codifying peer control, (4) protecting individual privacy, and (5) managing staff in an organization that distinguishes between users and non-users. Tom Fitzpatrick has worked at UDNEP for the past six years and is a co-founder and board president of PHRA. In 2010 Tom worked with newly-formed harm reduction programs in China through a Fulbright research grant. Shilo Murphy has worked at Seattle’s U. District Needle Exchange Program (UDNEP) for the past 16 years and is a co-founder and executive director of PHRA. Shilo is also president of the Urban Survivors Union. Most importantly, he is a proud drug user. Flynn, Neil, SANE, Sacramento, CA franza@frontiernet.net Buprenorphine therapy has something for almost everybody: Opiate dependent people and their families, service providers and, yes, even law enforcement. So why isn’t it more popular In our experience with approximately 400 clients, buprenorphine maintenance and detox therapy offers opiate-dependent people unique advantages over methadone or using just to ‘stay well’. These include: freedom from rigid methadone program rules (monthly, not daily, visits; more autonomy; etc.); virtually no withdrawal symptoms on maintenance; little or no opiate craving while on therapy, allowing return to work without the constant distraction of drug-seeking; normalization of cognition and mood improvement; increased involvement with family and friends; decreased involvement with law enforcement; respite from the hustle, during which users can make more informed choices about their long term goals; detox if/ when desired; safety from overdose and low long-term toxicity; lower cost than street use of pills or heroin; and surprisingly good pain relief. Of those who have received buprenorphine treatment at our clinic, retention in therapy has been >50% at one year and clients report very positive assessments of buprenorphine therapy. Despite these advantages, buprenorphine remains grossly underutilized. Although we targeted street injectors, the majority of our patients are pill users. Using clinical vignettes and data we will explore these findings and remaining barriers to realizing buprenorphine’s full potential. 41
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