We Know What to Do:Harm Reduction and Human Rights                in North Carolina
“[T]he question is not whether we know what to  do, but whether we will do it. Whether wewill fulfill those obligations; w...
 Access   to clean needles prevents  • HIV transmission  • Hepatitis C infection Providing          clean needles and “w...
 Providingclean needles is part of the harm reduction approach. Thegoal of programs and policies based on harm reduction...
 An example would be comprehensive sex education for youth and young adultsRisky behavior – unprotected sex w/o birth con...
 Lower   HIV risk Lower hepatitis C transmission Prevent accidental overdose Provide a gateway to health care and  tre...
 Thereis no evidence that clean needles increases drug use or drug-related crimes. However  harm reduction programs can ...
Harm reduction information: North Carolina Harm Reduction Coalition  • www.nchrc.net Project   Lazarus  • www.projectlaz...
 The   Southern US ranks the highest in  • Number of people living with HIV  • Number of people dying of AIDS  • Rates of...
A  person can purchase needles at  pharmaciesBUT Itis a class A misdemeanor to possess or  distribute syringes or other ...
 Medicaid  • Covers some dependence treatments, but limited   eligibility Patient   refusal  • Many health programs and ...
 Drugoverdose is the second leading cause of injury death How many North Carolinians died in 2009 due to overdose? Prev...
 Federal   ban lifted in 2009  • State law restricts the access of these programs Cost   effectiveness  • ER care for ov...
 Universal   Declaration of Human Rights International   human rights law  • Appropriate health care  • Racial dispariti...
 Needle   stick injuries  • 30% of police officers experience a needle stick  • 27% experience 2 or more injuries Why? ...
 There      is anecdotal evidence that this can happen.      to carry condoms  reduced Afraid condom usage Similarprac...
Government of North Carolina Legalize the possession and distribution of sterile  syringes. Enact a 911 “Good Samaritan”...
City and County Governments   Work with state health officials and harm reduction    experts to implement and support syr...
State Public Health Officials   Promote harm reduction education and information    throughout the state.   Promote syri...
We Know What to Do:Harm Reduction and Human Rights in North                Carolina http://www.hrw.org/news/2011/09/13/we-...
Melicia Laroco-Molter, MPHMelicia.laroco@gmail.comTonya Del SoldatoPeaceogreen@gmail.com
Human rights watch scpg presentation 11.10.11
Human rights watch scpg presentation 11.10.11
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Human rights watch scpg presentation 11.10.11

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This is a presentation I made to the NC Statewide Community Planning Group, HIV Group. The Human Rights Watch performed a study entitled "We Know What to Do: Harm Reduction and Human Rights in North Carolina."

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  • In Seattle, for example, participants in a syringe exchange program werefive times more likely to enter drug treatment than non-participants
  • Project Lazarusaddress the alarmingly high rate of unintentional drug overdose death in Wilkes County,North Carolina.Why so high?-“moonshine” activity during the prohibition era cultivated a tradition ofsubstance use at the margins of the law-The primary industries in Wilkes County includelogging, textiles, manufacturing, and chicken and cattle farming – pain management Rx opiodsProvides NaloxoneEducation and trainingPain management referralsTreatment referralsProject Lazarus’ efforts have helped to reduce overdose rates in Wilkes County by 42percent, and emergency room admissions for overdose have dropped by 15 percent.
  • One in five persons with AIDS acquired the disease through injection drug use4% of NC’s new HIV cases in 2009 can be traced back to injection drug useEst. 50,000 IDUs in NC
  • North Carolina has an estimated 35,000 people with HIV/AIDS
  • Non-elderly and non-disabled adults without children are regularly excluded
  • What is the first? Motor vehicle accidents1000, nearly half under 40
  • All persons have the right to adequate means to protect their health and well being, andgovernments must protect these rights without discriminationeveryone has the right to appropriate health care, including drug usersand people living with HIV/AIDS and hepatitisUS is also obligated to address racial disparities in the public health and to ensure thatminority communities have equal access to HIV prevention, care, and treatmentLaws and policies that “are likely to result in bodily harm,unnecessary morbidity and preventable mortality” are considered violations of the right tothe highest attainable standard of healthCondoms and needles – reduce HIVTherapy – Reduce illicit opioid useReduce OdsPrevent HIV and HCVMedication adherenceThat treaty has been interpreted to require thatgovernments ensure, at a minimum, a range of harm reduction interventions includingsyringe programs, opioid substitution therapy, overdose prevention, and harm reductionservices for youth, prisoners and other vulnerable groups
  • Human rights watch scpg presentation 11.10.11

    1. 1. We Know What to Do:Harm Reduction and Human Rights in North Carolina
    2. 2. “[T]he question is not whether we know what to do, but whether we will do it. Whether wewill fulfill those obligations; whether we will marshal our resources and the political will toconfront a tragedy that is preventable.”
    3. 3.  Access to clean needles prevents • HIV transmission • Hepatitis C infection Providing clean needles and “works” is an evidenced-based approach used in the US and globally.
    4. 4.  Providingclean needles is part of the harm reduction approach. Thegoal of programs and policies based on harm reduction is to make risky behaviors less risky. Harm reduction makes injection drug use the only mode of HIV transmission to show long-term, consistent decline.
    5. 5.  An example would be comprehensive sex education for youth and young adultsRisky behavior – unprotected sex w/o birth controlRisks – pregnancy, STIs including HIVPrevention – education, proper condom use, access to another form of birth controlResult – possibility of engaging in sexual activity, but with tools to prevent risks
    6. 6.  Lower HIV risk Lower hepatitis C transmission Prevent accidental overdose Provide a gateway to health care and treatment Reduce law enforcement needle stick injuries Reduce the number of contaminated needles in the community
    7. 7.  Thereis no evidence that clean needles increases drug use or drug-related crimes. However harm reduction programs can provide a link to drug treatment and other health services.
    8. 8. Harm reduction information: North Carolina Harm Reduction Coalition • www.nchrc.net Project Lazarus • www.projectlazarus.org Harm Reduction Coalition • www.harmreduction.org Harm Reduction Journal • www.harmreductionjournal.com
    9. 9.  The Southern US ranks the highest in • Number of people living with HIV • Number of people dying of AIDS • Rates of new infections North Carolina has an estimated 35,000 people with HIV/AIDS The rate of new infections in NC is 41% over the national average One in three people diagnosed with HIV already have AIDS
    10. 10. A person can purchase needles at pharmaciesBUT Itis a class A misdemeanor to possess or distribute syringes or other paraphernalia that may be used for injection of illegal substances
    11. 11.  Medicaid • Covers some dependence treatments, but limited eligibility Patient refusal • Many health programs and services refuse drug users Health of drug users • Multiple health problems – drug dependence, mental illness, HIV, HCV…
    12. 12.  Drugoverdose is the second leading cause of injury death How many North Carolinians died in 2009 due to overdose? Preventioncan be taught via harm reduction programs
    13. 13.  Federal ban lifted in 2009 • State law restricts the access of these programs Cost effectiveness • ER care for overdose - $20million a year in NC • Each prevented overdose saves $20,000 to $30,000 in medical expenses and lost productivity
    14. 14.  Universal Declaration of Human Rights International human rights law • Appropriate health care • Racial disparities • Drug dependence is a disability International Covenant on Economic, Social and Cultural Rights
    15. 15.  Needle stick injuries • 30% of police officers experience a needle stick • 27% experience 2 or more injuries Why? Needle decriminalization • In Connecticut, there was a 66% drop in injury • Similar reductions shown in international prison settings
    16. 16.  There is anecdotal evidence that this can happen. to carry condoms  reduced Afraid condom usage Similarpractices documented in places like Miami and Washington, DC
    17. 17. Government of North Carolina Legalize the possession and distribution of sterile syringes. Enact a 911 “Good Samaritan” or “Medical Amnesty” law to protect those who seek help for an overdose victim from arrest for drug offenses. Ensure that police and prosecutors do not use condoms as evidence of prostitution. Ensure access to affordable drug treatment that includes opioid substitution therapy and provides harm reduction education and information.
    18. 18. City and County Governments Work with state health officials and harm reduction experts to implement and support syringe access programs. Ensure that safe disposal of used syringes and police protocols for safely handling syringes are part of these programs. Work with police departments to ensure that individuals are not arrested, harassed, searched, detained or otherwise punished based on their possession of syringes or condoms.
    19. 19. State Public Health Officials Promote harm reduction education and information throughout the state. Promote syringe decriminalization and apply for federal funding to support syringe distribution programs. Work with harm reduction experts to promote increased access to Naloxone to prevent overdose among drug users by authorizing and supporting its distribution through trained peer counselors and other outreach workers.
    20. 20. We Know What to Do:Harm Reduction and Human Rights in North Carolina http://www.hrw.org/news/2011/09/13/we- know-what-do
    21. 21. Melicia Laroco-Molter, MPHMelicia.laroco@gmail.comTonya Del SoldatoPeaceogreen@gmail.com
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