Jul 14, 2017
President and CEO, Trillium Health, Rochester, NY
Testimony before the New York State Senate Joint Task Force on Heroin and Opioid Addiction Public Hearing
July 12, 2017
Erie Community College-City Campus; Minnie Gillette Auditorium; 121 Elicott Street Buffalo, NY
Good morning. I would like to thank the Chairs of the Joint Task Force; Senator Jacobs, Senator Amedore, Senator Akshar, and all members of the Task Force for the opportunity to be here today, and to share with you the work that we at Trillium Health are doing to combat the epidemic of heroin and opioid addiction. This epidemic in our communities and across the country has devastating effects on every sector of the population without regard to age, race, gender, social or economic standing. According to the Drug Policy Alliance, deaths from drug overdoses now surpass the number of deaths from motor vehicle accidents and homicides combined in New York State. Individuals, families and public and health policymakers are struggling to find options for treatment and prevention.
Trillium Health is a Federally Qualified Health Center that has been serving the Rochester community for over three decades. Our work includes helping to fight the opioid/heroin epidemic through efforts that focus on harm reduction and linkages to care. We meet people every day who are struggling with addiction. Through our harm reduction program located in the heart of downtown Rochester, we provide a place for safe disposal of used needles, distribution of clean needles, outreach, education, testing and support to reduce the transmission of infectious disease and other risks faced by injection drug users and to link those to care when they are ready.
As recently stated by Richard Wolitski, Director Office of HIV/AIDS United States Department of Health and Human Services, injecting drugs puts people at risk for blood-borne infections because used needles are brutally effective at transmitting a host of known and yet to be known infectious agents. It should be noted that in the early 1990s, more than 50% of all AIDS cases were related to injection drug use; by 2014, that statistic dropped to 3%, due, in part, to programs like our syringe exchange.
In May 2017, however, the Center for Disease Control (CDC) released new data showing that new Hepatitis C infections nearly tripled in the past five years, and HIV is on the rise largely as a result of opioid-related injection drug use. It is important that in our efforts we recognize this interconnection between the opioid epidemic, HIV and viral Hepatitis. And therefore, it is critical that we continue to expand access to integrated prevention services for people who inject opioid drugs. The CDC predicts that at least 220 US counties may be at risk for epidemic outbreaks of Hepatitis C and HIV if no preventive action is taken (largest reports of cases are in Kentucky, Tennessee and West Virginia, although, that’s not to say this couldn’t happen in New York State). In New York, we have been working toward Ending the HIV Epidemic by the year 2020—but all of our work done to date will be reversed if we do not address the infectious disease risks associated with the opioid epidemic itself.
This is where our work at Trillium Health fits into the response to the epidemic. Collection of used needles and distribution of clean needles minimizes the risk of infection and helps to protect community health. We provide information on buprenorphine, a medication to replace the need for opioids and link individuals for treatment to our clinic. And as a community based health center, we provide prevention, education, outreach and testing for HIV and Hepatitis C at our harm reduction site, and link individuals to our medical clinic and providers for care including antiretroviral medications to treat and prevent HIV, and substance use counseling, treatment and recovery. It is this type of integrated approach to better serve populations that face threats, occurring together rather than in isolation, that improves outcomes and optimizes the use of taxpayer dollars.
And our program is also saving lives. As part of our services we train and distribute Narcan that reverse overdoses. From 2015 through the first six months of 2017 we trained 2,079 individuals and distributed 2,011 kits. These numbers would have been greater, however, we were constrained due to a shortage of naloxone and a recall of atomizers.
In 2016, our harm reduction program prevented 98 overdoses and, in just the first six months of this year, 103 overdoses were prevented. That number is likely an underestimate since not all individuals who reverse an overdose report their reversal back to us.
Since the beginning of 2016, our harm reduction program has served over 2,300 people, provided 1,187 clients HIV testing – for a total of 1,313 encounters – and linked 322 people to care such as HCV testing and treatment, substance treatment and primary care.
These numbers show how vital harm reduction programs are in combating this epidemic. To continue the fight, our major asks to you this morning are:
- Continue efforts that destigmatize drug use health through education, training and media campaigns.
- Provide additional funding for integrated harm reduction services, including education, testing, prevention and treatment of HIV and Hepatitis C.
- Increase access to buprenorphine treatment at harm reduction sites to help with recovery and symptoms of withdrawal by supporting waivers from the Department of Health to make this possible for licensed facilities.
- Provide financial support for training for providers and other efforts.
- Provide more funding for opioid overdose prevention training and post-overdose services.
- Continue support for Governor Cuomo’s New York State Peer Worker Certification Program. Certified Peer Workers are employed by community based organizations and hospitals and are required to have “lived experience” related to HIV, Hepatitis C and/or harm reduction programs. Commissioner of Health Dr. Howard Zucker has stated “Peer workers are uniquely suited to work with people who need assistance accessing HIV, HCV or harm reduction services. These graduating peer workers will be able to provide the compassion and understanding that encourages at-risk individuals to take steps to protect themselves or to get tested and linked to care.”
Trillium Health continues to be a leader in the fight against heroin and opioid addiction. I welcome the opportunity here today to share our insights with this Task Force as you work to develop legislative recommendations and funding to combat this public health crisis.