ID: HR19-1425

Presenting author: Liz Evans

Presenting author biography:

Liz Evans is the Executive Director of syringe exchange programs Washington Heights CORNER Project and New York Harm Reduction Educators. Liz is also the founder of Insite, North America’s first sanctioned safe injection site, and has been involved with creating/ operating multiple initiatives to support the well-being of drug users.

What Can Be Done Now: How Harm Reduction Programs Can Navigate the Grey to Establish Effective Overdose Prevention Tools

Liz Evans, Kailin See, Sam Santoscoy, Christine Fitzsimmons, Jesse Reid

In the harm reduction field, we are often stymied by the professionalization of what CORNER Project outreach worker Clara calls “the business of saving lives.” This approach unfortunately over-complicates frontline work, impeding us from receiving the necessary tools to prevent fatal overdose. There is a grey space service-providers can utilize; however, it is often not identified or effectively managed.

As a New York Syringe Exchange Program, CORNER Project regularly faces these issues and has adapted novel interventions to aid overdose prevention efforts for program participants-- the majority of whom use heroin-- and successfully respond to participant overdoses. Learning objectives in this workshop will include an overview of these interventions and how they can be established as a basic standard of practice in harm reduction programs. Agency materials will be provided for interested audience members.

As a primary prevention tool, CORNER Project created a “bad batch alerts” system in March 2017 to warn local drug users about dangerous drug batches in the area. Since the initiation of this system, alerts have been improved via observation and participant feedback so that users better understand the risks associated with reported batches and can make informed decisions regarding their use.

As a primary intervention to improve overdose response, CORNER Project has operated a Monitored Bathroom Project for over a decade. Through implementing universal protocols with 3-minute check-ins and response procedures, these bathrooms were used by approximately 25,000 drug users in the past two years with zero fatalities. Given respiratory depression is the primary outcome of depressant-related overdose, CORNER Project implemented an oxygen treatment protocol in 2017 and now administers oxygen as a primary overdose intervention tool. Using onsite equipment including airways, oxygen tank, and ambu-bag, trained staff can reverse overdoses before naloxone becomes necessary and significantly decrease the possibility of brain damage via deoxygenation.