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

3

4

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!!!