Heroin Harm Reduction Strategies in the US

Heroin Harm step-down Strategies in the USThe Northern Kentucky (NKY) Independent wellness Department represents quaternity different counties in Kentucky Boone, Campbell, Grant, and Kenton. This region is often referred to as District 8 and it is made up of 381,153 Kentuckians. In 2008, a startling 18% of individuals in the region were diagnosed with depression and 9.8 % of individuals were living be pitiful the poverty level. Yet, the most printing press issue in this district is the diacetylmorphine epidemic and its association with HCV. match to the NKY Drug Strike Force, three of the four counties in District 8 ar the most problematic in the Northern Kentucky Area using District.Boone, Kenton, and Campbell counties represent 60% of Kentuckys heroin prosecutions for trafficking and possession. Data shows between 2008 and 2012 the heroin court cases in these three counties increased from 257 cases to 1339 an shocking 500% surge. These terrific statistics influenced the NKI HD to partner with mixed organizations to form the NKCRHE. Although a comprehensive community exclusively-embracing plan is now under development through the Response Team, at that place argon major govern psychic, social, and scotch factors to consider before reducing and fillet the epidemic.Social FactorsThe Heroin Impact Response Team sees scrape is the main(a) reason for the silence associated with heroin in NKY. Stigma is defined as a mark of disgrace with a particular circumstance, quality or person. This mark rear be alienating and oppressive to individuals and can dealer to prejudice and discrimination. People with a history of drug ingestion atomic number 18 highly specktized and often become egresscasts in society. Some groups argue this stigma helps pull down the drug problem in communities beca call it shows societys admonition of drug use. However, this argument is flawed because it does non consider that stigma can lead to shame and can lead people to hide their unsatisfactory and undesirable behaviors. Hiding and silencing drug use not only leads to delays in seeking help, save also leads to barriers in retrieval and reintegration into society.NKY is a primordial example of silence resulting from stigma. Between 2010 and 2012, the number of heroin overdoses in NKY threefold from 31 to 61 and the rates of HCV were more than double Kentuckys rate.Despite this alarming statistic, until October 2012, communities in NKY were silent about the epidemic. The map below shows NKY is rooted in a historically conservative state, and thus NKYs social and heathenish environment strongly reflect conservative ideologies. These ideologies promote the silence, because speaking out would constitute condemnation, it would depict the family-unit as inadequate, and the community as a barbarian waste land.Finally, families in NKY are speaking out about the epidemic. They are sharing their personal stories and those of their lost loved ones. Throu gh advocacy and education, they are working to break down the barriers associated with the stigma of drug use. Yet stigma is a muscular barrier, and education and community participation may not be enough to reduce the social barriers associated with heroin use. An additional powerful approach may be to remove certain legislative and administrative restrictions that reinforce stigmatization. The removal of these restrictions can lead to drug-user harm reduction strategies and programs, which could be considered the first steps to stop the spread of HCV and the first steps to recovery. semipolitical FactorsOne of the most effective harm reduction strategies to consider is uninventive Needle and Syringe Programs (NSPs). In 2004, the World Health Organization (WHO) released a comprehend on the effectiveness NSPs in which they confirmed studies in the report presented a compelling case that NSPs substantially and cost effectively reduce the spread of HIV (and other infectious disease s) and do so without inference of exacerbating injective drug use at either the individual or societal level (World Health Organization, 2004). Not surprisingly, the CDC, the National Institute of Health (NIH) and most of the medical and scientific community are advocates of NSPs because the scientific entropy supports the efficacy of these programs. In addition, these types of programs are seen as the first steps to recovery because they provide abusers the opportunity to seek help and obtain necessary chief(a) health careAlthough the federal government does not ban the use of NSPs, since the late 1980s federal funding for NSPs was prohibited in the linked States. In 2009, President Barack Obama removed this ban and allowed states to use federal silver for Syringe Exchange Programs (SEPs). The ban, unfortunately, was reinstated in 2011 due to a change in the federal spending package for 2012. As a result of the political controversy, this type of harm reduction strategy will b e laborious to promote in NKY because despite the scientific data, Kentucky legislation continues to prohibit the use of NSPs. The controversy arises from the common misconception that NSPs promote drug use, encourages abusers to stay addicted to drugs, and fosters sorry behavior. Others argue these types of programs are a costly waste because they do not stop addiction. Scientific data, however, shows both of these arguments are invalid. The efficacy of the programs is evident in various studies and the cost benefit analysis shows that a full-coverage program that exchanges all used syringes in the United States would cost or so $423 million but avert 1.3 billion in medical care and treatment beThe development of an exchange program is not explicitly prohibited in the Kentucky statutes, however the Kentucky Revised Statute 218A.500(3) addresses the prohibition of distribution of drug gear It is unlawful for any person to deliver, possess with intent to deliver, or pay with i ntent to deliver, drug paraphernalia, knowing, or under circumstances where one moderately should know, that it will be used to plant, propagate, cultivate, grow, harvest, manufacture, compoundinject, ingest, inhale, or otherwise bring out into the human body a controlled substance (Kentucky Legislative Research Commission, 2010). In 1992, Dr. John Poundstone wrote a letter to the Kentucky Attorney General requesting an opinion on NSPs in the state of Kentucky. The Kentucky Attorney General advised urban-county health departments could be guilty of criminal offence and liability if they were to pursue development of a needle exchange programEconomic FactorsIf successful in ever-changing Kentucky legislation to allow harm reduction strategies such as SNPs, the coterminous issue NKY will encounter is the economical component. In 2005, the Substance laugh at and kind Health Services Administration (SAMHSA) reported an estimated $1.9 billion was fatigued on mental health and subst ance abuse (MHSA) treatment in Kentucky which is approximately 1.5% of all the MHSA treatment in the United States (Substance Abuse and Mental Health Administration, 2012). However, the most pressing economic problem in NKY is the low federal and state funds distributed to the region for drug abuse and mental health in fact, Northern Kentucky receives the lowest funds of the 14 regions in the state.Since federal funding cannot be used for NSPs the NKY region would be only dependent on state and local funds. Yet, NKY receives only 8.16% of the states general funds for MHSA despite making up more than 10% of Kentuckys general population. To make matters worse, NKY Health Department continuously faces compute cuts and the reduction in funds results in an uneven distribution of monies for various programs. In 2012-2013 the health department faced a 5% cliff in revenue due to cuts in state, federal and Medicaid funding kind 1 shows this represented approximately $739,247.Figure 2 sho ws the decrease in revenue resulted in a 7% decrease in expenditures, approximately $1,050,043. These cuts make it difficult for the health department to address the heroin and familial disease issues in a more robust manner. Notwithstanding these economic setbacks, the heroin and HCV epidemic has spiraled out of control and has become a daimon that can only be tamed by organizations coming together to address the issue.