Friends and Fellow Harm Reductionists:
Here are the minutes of our meeting which I am posting on Nancy's behalf.
Minutes from Networking Meeting of Health Care Providers in Harm Reduction
Harm Reduction Conference – Oakland, CA 11-06
Facilitator: Sharon Stancliff
Minutes: Nancy Murphy
On Friday Nov 10, 2006 a meeting of approximately 30 people was held to discuss how to begin the formation and continuation of a group called
Health Care Providers in Harm Reduction.
The main focus of the meeting was to establish the group and ongoing communication and then to determine longer term goals and when/where/how the group might meet again after the first goal is accomplished.
Melinda Campopino and Ro Guilano (hope I have the spelling correct) agreed to take the email list and create a blog for the group. The details of how this will work, how others might join, who will be insiders/outsiders, how to post, etc will be sent to the group by the above.
Sharon Stancliff was to speak to folks at HRC about having this blog be a link on the HRC webpage.
It was agreed that all who were at the meeting would make an effort to invite a friend to join the group and make 2 postings to the blog and work to keep the momentum of the meeting and group going.
Topics of Interest to the Group:
How the group could use their collective knowledge to be a resource and mutual support for each other/others.
How the group might be of use around issues of teaching, training, placements, precepting, curriculum development and consultation (to name a few).
Possibly have an area called: “Stories from the Field”.
Possibly have an are area for posting papers, resources, etc.
Possibly have links to other resources – such as information on HRC. website or other related materials / areas.
Upcoming and related conferences – 2007 conferences: methamphetamine conference (salt lake city); international harm reduction conference (Poland); drug policy alliance (new orleans).
Be prepared to get postings to the blog from those who will have a difference of opinion.
If you know anyone who was at the meeting and has NOT received an electronic invitation to post on the blog please tell them to visit the blog and leave a comment so I can track them down and get them on board.
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1 comment:
Hi all, I am pasting in a letter to HHS that the Harm Reduction Coalition is seeking organizational sign ons for. Maybe you saw it at the conference. If you want to sign on e mail me.
Welcome to the blog!
Mike Leavitt
Secretary of Health and Human Services
The U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Dear Secretary Leavitt,
The current outbreak of fatal overdoses due to heroin contaminated with clandestinely manufactured fentanyl has killed over 750 people in at least 8 states, including nearly 200 in Chicago, 150 in Detroit and nearly 100 in Philadelphia. Most of these deaths occurred since April. There is every reason to believe that the number of deaths is vastly under-reported, as many jurisdictions near these epicenters may lack resources, coordination, or expertise to monitor overdose trends and conduct toxicology tests to identify fentanyl in opioid overdoses.
This wave of overdose deaths poses an acute public health emergency and immediate threat to the lives of opiate users, while highlighting persistent weaknesses in health officials’ response to the major, on-going problem of heroin overdose. Opiate overdoses must be recognized as an epidemic whose proportions have been increasing over the past decade. For example, overdoses kill more New York City residents than do suicide or homicide, and overdose is a leading cause of death in several cities across the country, including San Francisco and Portland, Oregon. The Federal Government must seize this opportunity to craft and coordinate more intensive and effective responses to both the underlying problem of heroin and other opioid overdose and the urgencies of this devastating outbreak of fentanyl-related overdoses.
Efforts to respond to the high rates of heroin and other opioid overdose deaths have been hampered by a significant lack of epidemiological data. In many jurisdictions, opioid overdoses are not reportable, and no federal agency is responsible for tracking and documenting the incidence of fatal and non-fatal overdoses. Better surveillance would provide a vital tool to detect emerging trends and sudden increases while guiding long-term prevention efforts.
Similarly, virtually no information is available regarding the presence of fentanyl in heroin sold in different cities and states. Throughout the country, law enforcement officials, in particular the Drug Enforcement Agency, has access to street drugs collected in the course of their work. However, to our knowledge the specific information found regarding the purity of heroin and nature of contaminants (such as fentanyl) is not routinely shared with public health officials to guide overdose prevention efforts.
Several jurisdictions in the United States have developed overdose prevention programs that include education, instruction in mouth-to-mouth resuscitation and the provision of naloxone for use by lay persons. There is clear evidence that these programs are feasible and safe and evidence that these programs are associated with significant decreases in overdose deaths is growing rapidly. Some states have passed laws to allay questions of legality and liability associated with the prescribing of naloxone.
We call upon the Federal government to develop and implement a coordinated response to the fentanyl-related overdose epidemic and lay the groundwork for long-term efforts and strategies to reduce overdose deaths. Specifically:
1. We call upon the Centers for Disease Control and Prevention to design and pilot epidemiological systems and standards that will yield a more accurate picture of fatal and nonfatal opioid overdoses in the United States and are capable of early detection of emerging trends and threats. The appropriate tests for fentanyl need to be used routinely and results need to be available rapidly.
2. We call upon the National Institute of Drug Abuse to make emergency funds available as supplemental awards to existing research projects that can answer urgent questions:
· What are the circumstances of fentanyl-related overdose deaths? Are the risk factors similar to typical heroin overdoses or are there other factors that may be helpful in prevention?
· Are current recommendations for the dosing of the opioid overdose antidote, naloxone, sufficient for fentanyl-related overdoses, or should they be altered?
· How are drug users responding to the presence of fentanyl and what prevention messages are helpful?
3. We call upon the Substance Abuse and Mental Health Services Administration to disseminate rapidly information about existing overdose prevention programs as models, to fund training and technical assistance on implementing overdose prevention programs, and to develop a Treatment Improvement Protocol on overdose prevention.
4. We call upon the Drug Enforcement Administration to share information with the CDC and work together to notify the public of dangerous levels of purity and presence of fentanyl and other hazardous contaminants in local drug supplies before they result in increased overdose fatalities.
5. We call upon the Department of Health and Human Services to work with these agencies as well as with the with the Food and Drug Administration and the Drug Enforcement Administration to prepare a national description of the fentanyl-related overdose epidemics for Congress. This report should:
· Identify all parts of the United States that have been involved, including a state-by-state review of fentanyl-related overdoses and deaths
· Describe the patterns of other drugs involved in fentanyl overdoses
· Include laboratory tests of drug samples recovered by law enforcement
· Describe prevention measures that have been used for this fentanyl-related epidemic
· Recommend surveillance systems that will assure early detection of future epidemics of overdoses and overdose deaths associated with new drugs or changes in illicit drug use so that preventive measures can be implemented early to save lives.
· This report should also address the ongoing epidemic of non-fentanyl related opioid overdoses:
· Describe the coordination of public health, law enforcement, substance abuse treatment, and drug enforcement agencies in understanding and responding to this epidemic.
· Recommendations for prevention measures including:
o improving drug user response to overdose including the use of naloxone (a highly effective antidote to opioid overdose) by users and their loved ones
o improving police and emergency medical services responses to overdoses
o substance abuse treatment availability
In closing, we urge that Federal agencies, working in consultation and collaboration with state and local government along with community groups and health and service providers, respond quickly and decisively to end the current overdose epidemic and craft a long-term strategy to reduce overdose mortality.
Sincerely,
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