By Nacogdoches Miller

Sun Intern

For several hours each Friday, the Clark County Health Department closes its doors to the general public to protect the identities of those seeking help, caught in the grip of addiction.

The staff at Clark County’s Harm Reduction program, which operates from 1 to 4 p.m. each Friday at 400 Professional Ave., works to educate communities — both affected and unaffected by opioids — and tackle issues amid the opioid epidemic.

The comprehensive program includes the needle exchange program, an educational proponent, advice and resources for recovery and referrals for other health care needs.

The staff not only works to end the casualties of drug use, but they also fight the stigma surrounding programs like theirs because some people in the community claim they encourage drug use rather than try to stop it, Jennifer Burchett, a clinical nurse administrator at the Clark County Health Department, said.

However, Burchett said she has never had a new client walk through the door looking to become an addict — they are looking for help.

“(I’ve never had a client come in and say,) ‘I’m here for the first time today, I’ve never used, and I’m going to start today because I got needles here,” Burchett said. “No one ever saw their life bringing them to this place.”

Jennifer Gulley, a program coordinator for the harm reduction program, said there was a noticeable reluctance among clients when the program started in 2016. Some were even waiting to see if it was a police operation before they would stop by, she said.

However, word-of-mouth helped the program grow, especially once a few people braved the uncertainty and began to tell others. 

Gulley said the program also makes anonymity a top priority, allowing staff to work closely with program participants as well as its various community partners. Each patient receives an identification card created on site, unique to them and only usable in the program. No personal information is required or asked.

This process keeps the clients’ identity separate from their medical files, ensuring they receive needed treatment while also remaining anonymous.

“We are never collecting personally definable information,” Gulley said. “When a person does need additional services, they make an appointment at the clinic.”

Almost at its three-year mark, the program has helped to vaccinate numerous people who otherwise would not have been. The vaccination aspect of the program helps moderate the spread of diseases — such as hepatitis and HIV —  and prevent outbreaks — such as the HIV outbreak experienced in Austin, Indiana, in 2015 which linked back to Perry County — because diseases don’t stop at county lines.

“That is the primary reason we do the syringe exchange,” Gulley said.

In addition to its information and vaccination tenets of the program, the harm reduction program also has the needle exchange, rapid HIV testing and a referral process for hepatitis and sexually transmitted diseases testing. These additional services further help the program keep its participants at a lower-risk of spreading diseases.

“Among those who share or maybe say they don’t share needles, they don’t understand the risk to them with sharing other equipment,” Gulley said.   

The program’s harm reduction education service includes teaching safer use practices, not sharing when using or in the company of others, overdose prevention, the signs associated with overdoses and how to respond to an overdose.

The staff also discusses resources with patients, such as housing and health care, which Gulley said is the benefit of having a peer specialist on site.

“There are a good number of people that want help,” Amber Fields-Hull, one of the on-site peer support specialists, said. “They’re overwhelmed though on how to do it.”

Fields-Hull said it’s even harder when you’re discussing long-term treatment, which she said is the best option.

But, before work can start on getting people into recovery, staff have to build trust first.

To do that, clients have to make the first step of coming in.

Gulley said clients come in looking for clean needles, but many leave with the hope they need to get clean.

“Primarily the value of the program is the prevention of the spread of disease,” Gulley said. “But, on the other hand, this program might be the only opportunity that we have to interact with individuals who are struggling with substance use in order to develop a trusting relationship so that we can move people toward long-term recovery. It offers an opportunity to explore the reasons they use and what their goals are.”

First-time visitors receive 21 syringes, a sharps container and other items they may need. Returning patients must return needles to acquire new ones.

According to the most recent reports from the health department, from Nov. 1, 2018, to May 10, 2019, 9,712 needles have been returned after 15,061 were distributed. Of 725 total visits, 153 received referrals, and 86.1 percent have tried to quit or are seeking recovery.   

A future goal of the program is to distribute Narcan, an overdose reversal drug, to patients as well. With overdoses on the rise in all areas affected by the epidemic, sometimes the speed of first responders isn’t enough.

Clark County Public Health Director Becky Kissick said the focus of the program is in its name: harm reduction. Although, a lot of people get caught up on the needle exchange part of it.

“That’s one tool in the toolbox,” Kissick said.

Gulley said part of harm reduction is also making the community safer, and evidence shows the program is working.

Gulley said law enforcement and local government officials say, since the program’s inception, they receive fewer reports of people finding needles

Sheriff Berl Perdue Jr. reinforces that statement for his department.

“We’ve seen a very significant decrease for found needles,” Perdue said.

Programs like these will always have doubters, but Kissick said that’s OK. The staff has spent time and will continue to spend time educating people until they understand what it is that harm reduction aims to do.

“It keeps syringes off the streets, from being thrown down in our parks and on our roadways,” Gulley said. “It’s reducing harm for our community and the risk to those who live and work here.”

For Gulley, her work with the program has been as rewarding as it has been humbling.

“Substance abuse has personally affected my family,” she said. “Unfortunately, as a family member, I was unable to give the necessary help my family needed. But I’m thankful there was someone else that was able to intervene. I hope through this program, I am able to help others in ways I couldn’t help my own family. So often these individuals have family relationships that are strained and they don’t have anyone to turn to. That not only impacts them, but everyone around them — their parents, their siblings, their children.”

The program has proven successful for many in the community.

In a letter to the program organizers, one client wrote about how the program has drastically changed her life.

“I went to the SEP to get needles and I met Amber Fields-Hull,” the client wrote. “…she began helping me take the necessary steps toward completing by DCBS case plan. These are the things I’ve accomplished so far: I attend Celebrate Recovery meeting twice a week. I’ve gotten married. I have a house, a vehicle. My husband has gained and maintained a steady, well-paying job. I’ve been sober six months and I’ve been passing random drug tests for DCBS since Dec. 4, 2018 … I definitely wouldn’t be where I am today and so close to reunification with my children had I not gone to the SEP.”

For Gulley, and the other organizers, seeing lives changed and the community become a safer place is the ultimate goal. And it’s a goal being accomplished.

“You can’t measure the impact fully of the benefits of one person getting their life back together,” Gulley said.