[email protected] (616) 456-9063 - bcbsm.com...physicians desk reference cdc mmwr, june 18,...
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A 501c3 non-profit founded in 1998
Mission: Improve Health, Reduce Risk, Prevent HIV
We utilize a Harm Reduction philosophy◦ The space in between prevention & treatment
◦ Meeting people where they are at
◦ Providing a range of options
◦ Client centered
◦ Low threshold approach
◦ Pre-recovery supports
Health Issues: HIV, Hepatitis C, and Overdose
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Overdose Prevention
Rapid HIV/Hepatitis C Testing
Risk Reduction Counseling
Syringe Access
HIV Linkage To Care & Case Management
Recovery Coaching/Access To Treatment
Support Groups
Red Project provides comprehensive programming along the continuum of care
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0
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2
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1999 2001 2003 2005 2007 2009 2011
Dea
ths/ 1
00
,00
0 liv
ing
Year
Michigan Mortality Rates
Narcotic Overdose
Viral Hepatitis
HIV/AIDS related
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0
20
40
60
80
100
120
1994199519961997199819992000200120022003200420052006200720082009201020112012201320142015
Death
s
Year
Kent County Drug Deaths
by drug of first mention
Total
Total Opioid ODs
Narcotic Analgesic
Heroin/Morphine
Methadone
Linear (Total)
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How did we get here today?
The ‘90s◦ Pain as a vital sign & patient satisfaction as a
measure of doctor performance
◦ Opioid availability increases, as does overdose
c. 2008-current◦ Opioid overdose epidemic is recognized
◦ Prescription opioids become less available
◦ Effective treatment options not widely available
◦ Heroin use (82% begin w prescription opioids) and overdose begins to increase
Lessons- Reactionary vs Proactive, & a focus on Comprehensive Care
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American Medical Association
American Society of Addiction Medicine
Office of National Drug Control Policy
US Conference of Mayors
National Coalition Against Prescription Drug Abuse
American Public Health Association
United Nations Office on Drugs and Crime
National Alliance of State and Territorial AIDS Directors
And SAMHSA: Opioid Overdose Toolkit◦ http://store.samhsa.gov/product/Opioid-Overdose-Prevention-
Toolkit/SMA13-4742?WT.mc_id=EB_20131212_SAMHSAStore
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CDC MMWR, June 18, 2015 Nationally there were 136 local overdose
prevention programs that distribute Naloxone◦ From 1996-2014
Trained 152,283 people 26,463 reported reversals
Multiple Models For Successful Programming◦ Syringe Access/Harm Reduction-Chicago Recovery
Alliance, etc◦ Point of Prescription/Medical Model-Project Lazarus◦ State Health Department- Massachusetts, etc
The Take Away:◦ Finding ways to put tools in hands to save lives…
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Clean Works Program- October 2008
Cherry St Health Methadone Clinic- 2012
Network 180 and SUD Treatment- 2013◦ SA Turning Point, Arbor Circle IOP, Our Hope, Jellema
House, Freedom House, Cherry St Health Methadone Clinic, Degage Open Door Women’s Shelter, Network 180 Access Center, etc
Results (as of 12/31/2016)◦ 4,000+ individuals trained which has led to 465+ reported
reversals
The Future◦ Increased collaboration/partnerships
◦ Multiple points of distribution
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Direct Client Service Delivery◦ Allegan, Ottawa, Muskegon, lake, Mason, and
Oceana counties
Technical Assistance/Program Start-Up◦ Region 10 PIHP- 4 County Region Flint to Port
Huron
◦ SWMBH- Kalamazoo and 8 Counties in SW MI
◦ Lansing and Montcalm Counties
Law Enforcement Training
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Local Task Force Creation◦ This epidemic is bigger than what the capacity of a
few scattered not-for-profits can handle- it requires a community response
Local Law Enforcement Training
Integration into the medical community- co-prescription along with opioids
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Red Project 2016-18 Steelcase grant
Emergency Departments
◦ Metro Health
◦ Mercy Health St Mary’s
Increased Pharmacy Access
◦ Spartan Nash
◦ Meijer
◦ Cherry Health Heart of The City
◦ Mercy Health St Mary’s
Providers
◦ The Dettmann Center
◦ Spectrum Health: CMC, CIM, Sharp Clinic
◦ Cherry Health Westside Health Clinic
◦ Exalta Health
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http://www.michigan.gov/naloxone
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www.prescribetoprevent.org
http://redproject.org/learn/naloxonetraining/◦ Specific to:
◦ Those prescribed opioids
◦ Individuals abusing opioids
◦ Those in Recovery
◦ And Law Enforcement
For pharmacies, info about MI’s standing order:
www.Michigan.gov/naloxone
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Massachusetts provides overdose education and naloxone distribution on a statewide level, supported through their health department
Walley et al. BMJ 2013; 346: f174. found that:◦ 0 kits per 100,000 people resulted in a 0% change
◦ 1-100 kits/100,000 people resulted in a 27% reduction in community overdose mortality rates
◦ >100 kits/100,000 resulted in a 46% reduction
Decreasing overdose mortality is dependent on increasing naloxone kit distribution
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The more the betterA Dose-Dependent Effect On Community Level Fatality
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Treatment With an Evidence Base:◦ Medication Assisted Treatment:
Methadone
Buprenorphine
Naltrexone
Factors Affecting Treatment:◦ Access
◦ Stigma
◦ Social Context
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The Chicago Recovery Alliance and Dan Bigg
Network 180/CMH of Ottawa County/Health West/SWMBH/Region 10 PIHP
Our Physicians◦ Dr Vernon Proctor
◦ Dr Sandra Dettmann
◦ Dr Cara Poland
◦ Dr Paul Trowbridge
Our Staff
Our Clients◦ They do the real work
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CDC: Injury Prevention and Control
MDHHS
Kent County Medical Examiner
MAPS
Physicians Desk Reference
CDC MMWR, June 18, 2015-Community-Based OpioidOverdose Prevention Programs Providing Naloxone – United States, 2010
The Grand Rapids Red Project
Walley et al. BMJ 2013; 346: f174.
North Carolina Harm Reduction Coalition
Coffin et al. AIM 2013; 158: 1-9.
Chicago Recovery Alliance