Harm Reduction in Chicago
The Power ofAny Positive Change!
Chicago Recovery Alliance
Low Threshold Treatment Options - All are Welcome
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Chicago Recovery AllianceSyringes Found in Humboldt Park
July 1993 - June 1996Note: Search method is 20 minute walking tour of consistent course
OutreachStarts
Date of Tour
Numberof
SyringesFound
Making a Safer ShotStarting Point?
More Accurate!
Candidates for Hepatitis A Vaccination
• High-risk populations * Users of illegal drugs.
Candidates for Hepatitis B Vaccination
• High-risk populations * Injection drug users.
Despite the long-standing existence of unambiguous recommendations for risk group vaccination, hepatitis B vaccination coverage remains low in most risk groups in most high-income countries. This low coverage may be attributed to a lack of perceived risk of hepatitis B and the absence of appropriate health care programmes targeting hepatitis B monitoring and vaccination for certain risk groups, particularly sex workers, injecting drug users, and prisoners…The VHPB also recognises that new strategies will have to be developed and implemented.
Hepatitis B vaccination: how to reach risk groups. Francois G, Hallauer J, Van Damme P.
Vaccine 2002 Nov 22;21(1-2):1-4
The Berkeley Free ClinicHealth Care for People Not Profit
http://www.berkeleyfreeclinic.org
Hepatitis Testing, Education and Vaccination (Hep-TEV)
Service is open only to people at risk for hepatitis. Hep-TEV provides anonymous or confidential testing and counseling for hepatitis A, B and C. The hepatitis clinic is open Saturdays between 3 and 5. Those interested should call between 1 and 2:30pm on Saturday for a same-day appointment at (800) 6-CLINIC.
Pneumococcal
Seasonal Flu
H1N1 Flu
Hep A/B Combined
Hep A and Hep B separatelyTetanus
Vaccination Experience to Date…Vaccination Experience to Date…
46,270 vaccinations completed over last decade (84% latest completion figures);
Some staff take longer than others to get up to speed -- more hands on training and on-site support;
Physician skilled in work with drug users critical to program success;
Could not happen without CDPH vaccine!
Enough Motivation to Address OD? Program
Opiate Overdose Prevention and Intervention
in Chicago
Use of a proven antidote to save lives where they are being lost
on the streets
CRA’s OD work dedicated to John Szyler as Any Positive Change
T I M E
Person's
Level of
Opiate
Activity
100% of Their OD Dose
One shot naloxone save...D E A T H
N O T B R E A T H I N GN O T R E S P O N S I V E
1
2
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CRA’s Opiate Overdose Prevention/Intervention Work…
All Testing Possible…
Rapid HIV ab – oral or finger stick
Syphilis + HCV ab
ALL TESTING POSSIBLE…
Chlamydia/Gonorrhea
CRA Annual Report 200911,021 visits
6,341 unique participants
3.06 million syringes exchanged
30.8% female, 1% trans
55% W, 31% AA, 9% PR, 4% Mex
32% 20-24, 25% 30-44, 23% 44+,
12% 25-29, 7% 13-19
Bridge to Life Improvements
- 300 new methadone treatment admissions in 40 days - Spring ‘00
MOSTMOST•Mobile Opiate Substitution Therapies
MOST Twenty Month Trial Ended July 2007. Lessons:-Successful engagement tool through any positive change
- All risk reduction tools INCREASED engagement and did not prevent or reduce relationships!!
- OD/Safer injection materials/work useful with constructive engagement/disengagement with peers both in and outside of treatment
- Regulations allow respectful engagement but system can be challenged by practice of this approach
- Resources needed for continuation/expansion
- IMPROVEMENT FOR ALL PROGRAMS!!!