The opioid crisis presents a vital problem that needs to be addressed as a public health crisis because it increases the risk of the transmission of infectious diseases like HIV and Hepatitis C (CDC, 2018). In 2017, more than 70,000 people died from drug overdoses and of those deaths almost 68% involved a prescription or illicit opioid (CDC, 2018). According to the National Institute on Drug Abuse, rural areas include some of the most vulnerable populations for injection drug use related HIV outbreaks and may have the greatest unmet need for risk reduction services (NIDA, 2016). The Syringe Exchange program we propose will serve northern Florida specifically Alachua County and surrounding counties. We aim to increase accessibility to syringe exchange services in rural areas of the state of Florida and due to this we have strategically chosen Alachua County because of its geographic location. We also believe that our program will be successful in and near these counties due to their high rates of HIV and AIDS infections have been consistently higher than the state average and much higher than the national average. Our program will incorporate a trauma informed approach, to successfully reduce health risk behaviors associated with injection drug use and ultimately decrease the rates of infectious conditions, like HIV and Hepatitis C. Participants will receive one clean syringe for every used syringe they turn in. Participants will also be educated on harm reductions practices, overdose prevention, and the importance of routine testing. We will provide participants for the program free STD testing, and finally we will link them care and services we cannot provide.
The link between exposure to trauma and substance abuse has well established, in the National Survey of Adolescents, teens who experienced physical or sexual abuse/assault were three times more likely to report past or current substance abuse than those without a history of trauma (Kilpatrick, Sanders, & Smith, 2003). Khoury and colleagues, studied the relationship between adverse childhood experiences and subsequent substance abuse and confirmed findings of previous studies that showed a strong relationship leading to poor mental health outcomes (Khoury et al., 2010). We anticipate working with a population that have higher risk factors for adverse childhood experiences, and it is imperative the we incorporate a trauma informed approach. The CDC’s socio-ecological model will be used as a guide with a focus on impacting behavioral change at the individual and community levels. It is important to us that the community can take ownership of the program, and people who inject drugs (PWID) in Alachua and surrounding counties can feel supported by the program beyond the intervention period. Therefore, we will create a community coalition that will include officials, partners, stakeholders, and residents of the community. We will also work with local police departments to ensure program participants feel free from criminal persecution and will seek program services. In doing this we will create a physical environment that provides safety and stability. We will also use the principle of trustworthiness and transparency by actively engaging with and communicating with program personnel and program participants. Finally, we will empower program participants to use their voice and choice to make better lifestyle choices and decrease participation in risky health behaviors
REFERENCES:
Centers for Disease Control and Prevention. (2018, December 19). Understanding the Epidemic. https://www.cdc.gov/drugoverdose/epidemic/index.html
Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010). Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population. Depression and anxiety, 27(12), 1077–1086. https://doi.org/10.1002/da.20751
Kilpatrick DG, Saunders BE, Smith DW. 2003. Youth Victimization: Prevalence and Implications [Electronic]. U.S. Department of Justice, Office of Justice Program, National Institute of Justice;. Available at: http://www.ncjrs.gov/pdffiles1/nij/194972.pdf.
National Institute on Drug Abuse. (2016, December 1). Syringe-Exchange Programs Are Part of Effective HIV Prevention. Retrieved October 6, 2019, from https://www.drugabuse.gov/abou...ctive-hiv-prevention
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