OCRF

Aurora and Philomena are the founders of the Gwayakobimaadiziwin Bad River Needle Exchange, one of the only organizations in the US providing overdose prevention services to Native American communities.

This is their story, as Philomena told it to us when they first reached out to OCRF.

My very good friend Aurora and I have been working in our community to build a harm reduction and overdose prevention organization. It's been our labor of love since 2014. Our work is in and around the Bad River Indian Reservation, located in a fairly remote part of northern Wisconsin (we serve tribal members and non-tribal folks). We have been distributing naloxone since June 2015. Aurora's sister passed away that spring -- just weeks before we got the naloxone. Our work is inspired by the heartache of losing her sooner than what should have been...

After Nicole passed, we lost all qualms about distributing naloxone in a legal grey area -- it was on. We began training community members and giving them naloxone kits that were donated from other harm reduction programs, with as many kits as possible to our most at risk syringe exchange participants and their family members. We don't require our participants to report, but we are aware that our naloxone is being used to reverse overdoses and keep community members alive. (As overdose is evidence of a crime in Wisconsin, we know that many reversals go unreported and getting accurate data on naloxone use and overdose occurrences is tremendously difficult).

As we live in a rural area and many residents live at least 45 minutes away from the nearest EMT station, community naloxone distribution is essential to keeping people alive. In March 2018, our community had an emergency in which at least eleven overdoses occurred within a 48 hour period. Our rural emergency response services aren’t equipped to handle this scale of crisis alone. But as far as we know, all of those overdoses were reversed, with assistance from the naloxone we had distributed.

Our work also exists within a global context, where our people continue to suffer from the effects of colonization and attempted genocide: Native Americans across the country are dying of overdose at higher rates than other racial/political groups.

We are developing relationships with other tribal and community clinics in our region to encourage active efforts to reduce overdose deaths, within American Indian and rural communities. The work is guided by Anishinaabe values of sharing, love and respect; distributing what resources we have been able to secure in order to give people what they need. We have a modest amount of funding to cover our program's expenses, but as much of the Tribe's funding comes through the federal appropriations process, our funding is never secure. We are thrilled about the prospect of dedicated funding to support the work.

chi miigwetch (thank you very much),

Philomena

In July 2018, we awarded Aurora and Philomena a grant that will fund their overdose prevention work for at least the next 12 months. This is the first stable and dedicated source of funding for naloxone distribution they’ve ever had. With this funding Aurora and Philomena will also lay the basis for extending their live-saving work throughout the network of surrounding tribal communities.

Kim is the co-founder of Quad Cities Harm Reduction (QCHR), which provides harm reduction services to several Iowa and Illinois cities along the Mississippi River. QCHR was the first organization to perform community-based naloxone distribution in Iowa.

Here is Kim’s story, in her own words.

On May 25th, 2011 my world came to a crashing halt. My thirty-three-year-old son Andy died from an accidental heroin overdose. We knew he was in trouble, we knew he injected drugs, and most of all, we knew we were at risk of losing him…and then we did. I was a single mom working as a nurse, and I adored my kids. Now one was gone.

The damage done to a family when a child dies is staggering, especially when the death is caused by a drug overdose. The shame and stigma directed your way after losing a child to an overdose is quite debilitating. There were no neighbors with casseroles or offers to help, and very few condolences.

I was introduced to harm reduction when I sought support for my grief online. I discovered GRASP, Grief Recovery After a Substance Passing, and found other mothers to whom I could talk. GRASP literally saved my life. While pouring out my heart to these mothers I’d met, I was struck by their absolute certainty that our children’s deaths could have been prevented. Had we been able to access harm reduction tools, including naloxone, sterile needles, and safe spaces for them, maybe our kids would still be here.

With this knowledge, I began to turn my grief into advocacy. Iowa did not have a naloxone access bill. In 2012, we began to advocate for one at our state capitol, and to seek allies to support naloxone training and distribution. In 2015, we founded Quad Cities Harm Reduction (QCHR), our 501(c)3, non-profit organization. Finally, in 2016, after four grueling years, our naloxone access law was passed. As we attempted to build support for training and distribution in our community, we continued to get push-back from many stakeholders. Stigma, shame, and a focus on abstinence were sadly still the rule of the day.

My friend, Michael Gayman, introduced me to some folks who operate a local food pantry and community services organization called The Center. They listened as I explained how a simple harm reduction tool, such as naloxone, could save the lives of people who use drugs. Our message was well received, and they invited QCHR to be a partner organization. As a result, we have been able to reach those directly impacted by drug use at a fixed site in Davenport, as well as through our street outreach.

In addition to distributing naloxone, QCHR now provides HIV and Hepatitis C testing through an MOU with our county health department, all free of charge. Unfortunately, Iowa has yet to approve needle exchanges. We are working to change this. We also distribute food, clothing, backpacks, and other items necessary for survival, including, importantly, love and acceptance to those who use drugs.

I am deeply grateful to The Center and the community for the support they’ve shown to me, to QCHR, and to those individuals we are helping to serve. We, at QCHR, believe strongly that harm reduction is a human right and that everyone is entitled to safety and compassion. Love is love. Every life is worth saving.

OCRF is providing Kim with a grant to cover QCHR’s naloxone expense for at least the next 12 months. We also plan to work with QCHR to build its data collection capabilities, and to identify opportunities for the organization to expand the geographic reach of its naloxone distribution program.

(Fourth photo on the left is Kim bringing a shipment of naloxone to Iowa on her boat across the flooded Mississippi River.)

Mark Jenkins is an individual in long-term recovery from addiction, a service connected disabled Veteran of the United States Air Force, and the Founder / Executive Director of the Greater Hartford Harm Reduction Coalition (GHHRC). He has worked in the fields of harm reduction and public health for the past twenty years, serving the most vulnerable members of central Connecticut communities. Mark started in the field as an AIDS Risk Reduction Outreach Worker (ARROW) for the Perception programs in Willimantic. In his subsequent work with Community Renewal Team, the Hispanic Health Council, and AIDS Project Hartford, he further cultivated progressive strategies for reaching and delivering services to Connecticut’s most difficult-to-reach populations.

Mark founded GHHRC in 2014. As of 2018, GHHRC operates in a service area that extends across Central Connecticut—from Enfield on the Massachusetts border, through the Hartford and New Britain metropolitan areas in the center of the state, to New Haven on the coast. Throughout these communities, GHHRC provides its participants with access to: naloxone and overdose prevention education; direct service referrals to treatment by social, medical, and behavioral service providers; syringe access and exchange; and HIV/HCV counseling and testing.

In August 2018, OCRF presented Mark with a grant that will finance the expansion of GHHRC’s community-based naloxone distribution program for at least the next 12 months.

On Valentine’s Day 2016, Chris officially launched the Indiana Recovery Alliance Syringe Service Program (IRA) to provide sterile injection equipment and overdose reversal medication directly to the community of Monroe County. By 2018, the IRA had gone from riding bikes and paying out of pocket to being the largest syringe service and overdose protection program in Indiana.

IRA follows best practices, does not limit the type and number of supplies that can be taken, and provides community members with free supplies of naloxone. Members also pick up sterile syringes and drop off used syringes for safe disposal. The alliance focuses on helping people help each other.

According to Abert, many people still do not call 911 to respond to an overdose for fear of stigma and recrimination. As a result, people who use drugs (or their friends and family) frequently find themselves as first responders in the event of an opioid overdose. By distributing naloxone, IRA has empowered community members to facilitate more than 2.100 opiate overdose reversals in Indiana since 2015. 

At the root of the IRA’s effectiveness is its caring, compassionate, member-centered approach. Nearly all of IRA’s staff, board and volunteers have their own lived experience with drugs, or with people who use drugs. The alliance provides a stigma-free environment in which contributors recognize members as having identities apart from their drug use. 

The alliance creates space for people who have been alienated and disenfranchised to be meaningfully involved in their communities, despite drug use that would typically bar them. It offers ways for people to join together and learn about disease prevention and public health.

OCRF has presented IRA with a grant for purchase of naloxone that will allow the organization to maximize its distribution channels across the entire State of Indiana for the next 12 months.

PHOTOGRAPHY BY Jasmin Shah

Tracey is the Founder of Project 4-14, which serves a region of Appalachian Ohio stretching from Columbus to the West Virginia border.

This is Tracey’s story in her own words.

“The conception of my group Project 4-14 was born from my own personal tragedy. On April 14, 2014, I became a widow when my husband, Jason, died from an accidental drug overdose. Jason was in a home with six other people. Nobody had naloxone and paramedics were not called right away. My husband became one of the 56 people who died in Ross County that year because of overdose. My goal is to prevent others from going through the heartbreak that my family did by advocating and educating others about substance use disorder. Providing naloxone to those who use opiates and people who love them will help saves lives.

Since I began my program in April of 2018, I have provided 470 kits to people in my community.  I have delivered kits to families and individuals who use drugs.  What I found is most people don’t know where to get naloxone or are too ashamed to contact the local health department.  I understand the need in my community for harm reduction strategies to expand overdose prevention in my town. The goal of Project 4-14 is to reduce opioid overdose deaths by providing as many kits as possible.”

OCRF is providing Tracey with a 12-month supply grant that serves as her first stable source of funding for naloxone. This grant will enable her to launch the first (and only) effort in Ohio to distribute IM naloxone to the State’s most at-risk populations.

New Orleans Trystereo Syringe Distribution was founded in November 2011 by Crow Lopez, Nora Maria Fuller, and Linda Flores-De Leon—all community activists, and each with a different background. At the beginning, Trystereo was a 24-hour-bicycle-delivery-service that delivered harm reduction supplies (including naloxone) and provided referrals to social/healthcare services to people who use drugs in Orleans Parish.

In the last 7 ½ years Trystereo has grown beyond all expectation. Since 2011, Trystereo has distributed more than 1,000,000 sterile syringes, disposed of over 200,000 used syringes, distributed hundreds of safer-smoking kits, trained 5,000 individuals in overdose prevention, distributed 10,000 doses of naloxone, and documented over 2,500 overdose reversals resulting from the naloxone it distributed.

Over the years, Trystereo has recorded many victories in bringing life-saving care to the people in New Orleans most impacted by opioid use. In November of 2017, Trystereo volunteers helped to pass legislation which led to the legalization of syringe access programs in Orleans Parish. Its volunteers also began wound-care trainings and distribution of wound-care kits in response to reports of medical treatment at traditional healthcare provider organizations which stigmatized drug-using clients with abscesses. Trystereo volunteers continue to host weekly drop-ins in the Central Business District and in the Lower Ninth Ward of New Orleans. These drop-ins are geared toward providing access to harm-reduction and overdose prevention supplies to folks without access to the call-line. Trystereo has started distributing Fentanyl test strips and training clients at the Lower Ninth Ward drop-in in the life-saving technique of rescue breathing.

In describing their work with people who use drugs in New Orleans and Southeastern Louisiana, Trystereo’s co-founders write,

Every week we hear of too many people in this community dying, and we feel it is our duty to train them in as many ways as we can. They definitely train us as well—for instance, by telling us about bad dope which caused overdoses, and about what to tell other clients to look out for. Many volunteers at Trystereo feel the relationships with our clients are symbiotic, in that we get back more than we give out.

Lack of funding has always prevented Trystereo from distributing as much naloxone as it could. With funding from OCRF, Trystereo will be able to supply ALL of the client demand for naloxone it encounters through its current distribution structure, for at least the next 12 months. This will mean a doubling of the amount of naloxone Trystereo distributes on an annual basis.