PORT ANGELES — Securing funding, providing adequate treatment through partner agencies, changing public perception and purchasing an adequate supply of naloxone remain obstacles the Clallam County Health and Human Services Syringe Service Program is working to overcome.
“Funding is huge,” said Christina Hurst, public health programs manager for Clallam County Health and Human Services.
Hurst, speaking to about 28 people at a Jan. 12 meeting of the Port Angeles Business Association, said the program has been scrambling for funding sources ever since the state Department of Health, after 11 years, discontinued funding.
The Department of Health discontinued funding syringe programs to non-metropolitan areas Dec. 31, 2011, Hurst said.
“Syringe programs are a victim of their own success due to funds being tied to HIV cases,” she said.
“Funding has now moved towards [pre-exposure prophylaxis] and medication as prevention to reduce viral load for new infections.”
Pre-exposure prophylaxis is when people at very high risk for HIV take HIV medicines daily to lower their chances of getting infected, according to the Centers for Disease Control.
“When we had funding from the Washington State Department of Health, we were doing awesome,” Hurst said.
“We had all the supplies we needed. We had everything we needed.”
“We have a shortage of drug treatment in our community,” Hurst said. “We need a lot more drug treatment.”
When addicts seek treatment, “they should have a bed waiting for them at that moment,” she said.
“That is how we are going to make a dent in this epidemic.”
There also is a need for better access to medication-assisted treatment, Hurst said, “meaning we need to begin using drugs like Suboxone to help people taper down and withdraw off of heroin.”
Suboxone, which contains buprenorphine as well as the opioid antagonist naloxone, is a prescription medicine indicated for treatment of opioid dependence in tandem with counseling and psychosocial support.
“Suboxone is looking to have better results than methadone and people don’t need to be on it as long,” Hurst said.
“One of our big issues is public perception,” Hurst said. “This is always going to be a debatable program. People are not going to like it. People tell me I am enabling addicts.”
But, addicts “are going to get needles and they are going to use them regardless if they get them from me or if they get them from somebody else,” Hurst said.
“They are going to find a way to get [the drug] in their veins.”
Hurst spoke of the importance of supplying opioid addicts and first responders with naloxone.
Naloxone is an opioid antagonist that works by reversing the depression of the central nervous system and respiratory system caused by opiates, and can counteract overdoses long enough to summon medical help.
“You can give the person an injection of naloxone and it blocks the receptor cells in their brain to prevent overdose from shutting down the respiratory system,” Hurst said.
“That is what an overdose does. You stop breathing, you die.”
Naloxone is offered to clients of the exchange, who also receive sterile syringes.
However, naloxone is given only after the client signs a contract stating they will seek medical care after naloxone is used, Hurst said.
“We don’t just hand it out,” she said. “They will not get refills from us if we don’t see that they are following the agreements that they have made with us.”
Currently, the exchange is able to provide naloxone auto-injectors to clients thanks to a pair of grants from Kaléo, a pharmaceutical company headquartered in Richmond, Va.
“We have received two grants for 100 cartons each,” Hurst said.
“Each carton contains two doses of EVZIO and one trainer,” she said.
EVZIO is a take-home, hand-held, single-use naloxone auto-injector that may be used wherever an opioid overdose occurs, according to Kaléo.
The digital trainer does not contain a needle or medication, and is used as a demonstration device.
When a person accidentally overdoses on opiates, a family member, friend or other caregiver can administer EVZIO.
“We encourage [the drug user] to teach their family members how to use it, and the other people they inject with how to use it, to save each other’s lives, and we are seeing that happen,” Hurst said.
But the grant expires in April, Hurst said, leaving the exchange looking for alternative sources of naloxone.
“We got [our] second grant in November, and our grant runs out at the end of April and we will be purchasing naloxone from there on out,” Hurst said.
“We haven’t decided how we are going to do that yet.”
Hurst said the exchange will try to obtain another grant through Kaléo, “but so many people apply we suspect two grants will be our limit.”
Fortunately, the 2016 Clallam County budget includes $20,000 for naloxone purchase, Hurst said.
The walk-in needle exchange clinic is located at 111 E. Third St. It is open Tuesdays from 12:30 p.m. to 3 p.m.
For more information, call 360-417-2274.
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Reporter Chris McDaniel can be reached at 360-452-2345, ext. 5074, or cmcdaniel@peninsuladailynews.com.
