St. Ann's Corner of Harm Reduction sits on a busy part of Westchester Avenue in Bronx, in the shadow of…
St. Ann’s Corner of Harm Reduction sits on a busy part of Westchester Avenue in Bronx, in the shadow of an elevated train track. Within the facility, borrowers can get away from the cold, have a hot meal and sit in a lounger watching TV or chatting with friends. In a corner, people can pump iron or make pull-ups in a temporary gym.
The organization also offers a dummy-free space for people who use drugs to pick up sterile syringes, alcohol pipes, doses of opioid overdose drug naloxone and other products that help them reduce the risks associated with intravenous drug use.
St. Ann works around the injury reduction model advocated by advocates is a pragmatic approach to prevent overdose and spread of diseases by accepting that some people are making drugs and it is better to keep them alive and healthy than requiring them to “just say no. “Harm reduction is not a silver bullet, and it should not be. Instead, it focuses on meeting people using drugs wherever they are and trying to keep them as safe as possible, “says Van Asher, Program Manager at St. Ann & # 39; s.
“Just say no” has not worked, said Asher. “It did not work in the 80’s, and it does not work now.”
The sterile syringes and other products like St. Ann has gone out has long been a staple for job reduction. When Bronx and many of the rest of the country began to see an increase in fentanyl death, a powerful synthetic opioid 50 to 1
00 times stronger than morphine, St. Ann sits at the forefront of a new way to help those who use drugs try to avoid overdoses.
At the beginning of 2017, Asher heard about a pilot project at Insite – a so-called safe consumption site in Vancouver, Canada, which allows people to inject drugs in the presence of trained staff – who suggested that a brand of urine strips intended to test hospital patients For fentanyl also could be used to test for its presence in samples of addictive drugs including heroin and cocaine. Intrigued by the prospect of a new tool to add his arsenal of piracy tactics, he ordered some strips that are about $ 1 a pop from the Canadian company BTNX.
Asher is one of several street-level activists who fight fentanyl deaths across the country. He has three goals: collecting data on the spread of fentanyl, which allows people to test their own drugs and take the necessary precautions and initiate dialogue with people using drugs in an effort to help them develop ways to stay safe as possible.
“We need to start talking to people about how to use something safely when there is fentanyl in it,” he said.
Van Asher, a program director at St. Ann’s corner of Harm Reduction in Bronx.
A few recent scientific studies seem to support Insite findings suggesting that urine strips would be useful in detecting fentanyl and helping people make safer choices . In February, a research group at Johns Hopkins University summarized a study which found that compared to two types of more sophisticated laboratory equipment – which would be of little use to a daily practitioner – BTNX urine strips had the lowest detection limit and highest sensitivity, which means they are very accurate in tracking traces of fentanyl. The team is still trying to publish its study in a medical journal, but they released the summary first because of what they thought was urgent of the matter, according to Susan Sherman a Johns Hopkins professor and one of the leading researchers in the study.
The study also consulted people using drugs and found them very susceptible to the idea of testing their drugs. 86% of respondents said they would use the test and 70% said they
While the strips are more useful immediately useful for those using drugs than the machines, they only provide a simple “yes” or ” no “answer if the drugs contain fentanyl or any of three of its analogues. The strips can not indicate which or how many of these substances may be present.
Still, Sherman said strips represent a positive step towards more informed consumption, one of a number of services to help those who use drugs alive at a time when overdose deaths continue to take a toll on communities across the country.
“What’s more, we need to understand that there is a crisis and that we have to answer all the tools in the toolbox,” she said in an interview. “It takes many different points of contact for people who use drugs, engaging them at different points along the path before they can be stable enough or have the will to stop using.”
Another study published in October by the North Carolina-based Research Triangle Institute, was even more encouraging. It was found that people using streetopiopies are five times more likely to participate in safer injection methods if their drug tests positive for fentanyl.
“The reason is that fentanyl test strips can be a new technique to prevent overdose of opioids by allowing people to check street drugs for fentanyl and modify consumption behavior accordingly,” wrote Jon Zibbell, a public health researcher at RTI who worked with study.
The tire is still not officially approved for use outside the clinical environment, but BTNX has taken its role as an important supplier of harmful clinics. The company sent representatives to a new conference in New Orleans organized by the Harm Reduction Coalition, and its website contains information on injury reduction, including a pamphlet based on the results of recent studies Johns Hopkins and RTI.  “It Was In Every Bag And People Prefer It”
While Fentanyl has been in a lot of pressure in recent years, because its presence in street drugs has increased dramatically and it has played a role in celebrity ] death it’s not very new. A batch of heroin labeled ” Tango and Cash “, which was flawed with fentanyl disease and killed many people in New York City in 1991. It reared its head from 2005 to 2007 when fentanyl contamination killed more than 1,000 people in Illinois, New York and several other states.
As overdose has become the leading killer of people under 50 in the United States, the number of deaths attributed to fentanyl has increased sharply. In 2017, 72,000 people died in America from all drugs. Fentanyl and its analogues were present in nearly 30,000 of these, according to provisional data from the National Institute on Drug Abuse.
In New York, fentanyl represents an even greater threat. In 2017, which saw 1,487 drug overdose deaths throughout the city, fentanyl was linked to 57% of these deaths, making it the most common substance, according to a report published in September 19459006.
Illegal fentanyl – now produced in laboratories in Mexico, according to the Drug Enforcement Administration – was probably introduced in heroin supply because it is easier to do than heroin and because it increases the strength of the product. The amount of fentanyl in a given bag is not always the same, so someone who is used to a certain dose can inadvertently misjudge if they happen to buy a dose of just one touch more fentanyl than they can handle.
But illegal drugs are not regulated, and fentanyl is much stronger than heroin. It is virtually impossible to identify one or the other by eyeballing them – a bag sold on the street can be significantly more powerful than the next, which may be a contributing factor to a possible lethal overdose.
For a person who uses drugs, one has an idea of what exists in your drugs can make the difference between life and death. Heroin and fentanyl are both opioids which, when taken in large doses, suppress heart rate and respiratory distress. This can starve the brain of the acid, kill the person or cause serious brain damage. An overdose is a contest against time to administer naloxone, which is designed to revive the victim by blocking the brain’s opioid receptors from absorbing the drugs.
Fentanyl absorbs in a person’s system faster than morphine or heroin, and as a result, people overdoed are knocked flat much faster. It makes it even more important that anyone who can use fentanyl takes precautionary measures such as using a friend and having naloxone at hand, according to Shawn Westfahl, a pestilent working with vulnerable populations in Philadelphia.
Westfahl was first educated as a street doctor in 2011 and said that he performed his first overdose overdose at Zuccotti Park in New York City during the direct action Occupy Wall Street. Since then, he says he has administered naloxone tens of times, which has given him a close up of the spread of fentanyl in the northeast. Westfahl said that he first began to hear about fentanyl in 2016, first as a dangerous transgression to be avoided. But when the drug began to dominate the local street opioid market, it changed
“At that time it was like” look, there is fentanyl here and it puts people out, “he said.” But eventually it came to the point where fentanyl Everywhere, it was in every bag, and people prefer it. “
According to several people familiar with opioan use in the northeast, fentanyl has become so widespread that many people are now looking for it, including some who started injecting drugs well after fentanyl began to replace or significantly increase heroin sold on the street. But even if someone prefers the fast, more intense fentanyl content of heroin, the mechanism of overdose remains the same and the ability to know if the more potent drug is present can mean the difference between life and death for people like James. James showed Mic how he usually prepares a shot of heroin and tests the drugs before using.
With a glass envelope slightly bigger than a stamp, James, who asked for his surname not to be published, poured a small pile of off-white powder into a stove, a sterile vessel used to mix drugs similar to one soft cap. James measured about 15 cubic centimeters of water in a sterile syringe, sprayed it in the stove and mixed the heroine short of a flame before putting a filter into the mixture, took it back into the syringe and cut the needle so that he could use the latter privately.
Then James dug the strip into the water and waited for about 15 or 20 seconds when a little bluish dye began to creep up the face of the band. Slowly, there is a single line indicating the presence of fentanyl.
The result is not a surprise for James. In New York, at least, every bag as tested has been positive for fentanyl, an occurrence backed by Asher’s bark test in Bronx. Still, he probably knows that the baptism he is going to shoot for a minute contains fentanyl, James said he can take precautions to avoid overdose. He may inject the slower
James said that he has never experienced an overdose, partly because he has been able to test drugs as long as he has injected them, which he said he just started several months ago.
. The time Asher began experimenting with fentanyl test strips, others began in the world reduction as well. Tino Fuentes, who previously treated drugs and used heroin, and now works as an independent malicious advocate, rolled the strips into his daily search of people using Bronx drugs. has adequately developed a reputation for her drug testing that other harm reduction sites across the country began to teach him how to use strips.
Christopher Moraff, a journalist and former opio user who started covering the drug scene in Philadelphia as an extension of his focus on crime , learned about the strips from Fuentes and began to carry out extensive tests of samples from the open drug markets in the Kensington area. Over time, he also began using morphine strips that test the presence of heroin and can say that he allows him to identify if a sample contained both heroin and fentanyl or only one or the other. Over time, fentanyl appeared in almost every test sample, and began to focus on bottles of sprickkokain, to verify rumors that fentanyl appeared in the city’s coke supply. No dice to date he told Mic .
But even as strips began to catch across the country, organizations like St. Ann to a large extent prevented from using public funds to pay for them. It began to change in 2018 with the city’s governments in Philadelphia San Francisco and Burlington, Vermont giving the green light for city-funded groups interested in the distribution of strips.
“Philly does a really good job,” Moraff said. “With each reform, we get closer to the final goal, which is safer for all.”
To June, St. Anns, partially funded by New York City, forbidden to use public funds to buy test strips, so Asher bought them with other grants and resources, he said. But this summer, the city quietly gave up to the 14 spray access programs such as the fund, including St. Ann, to start buying and distributing strips, told a departmental woman Mic .
Officials with the Department of Health and Mental Health were initially careful to give the thumbs up for an off-label use of strips. However, as other cities began to see their potential, and especially after reading the increasing scientific support of the strips as a single method of encouraging safer use, the agency, Denise Paone, was charged with monitoring the research and monitoring in the Department’s Alcohol and Drug Use, said in an interview.
“We had anxiety within the framework of supporting and financing test strips because there was insufficient scientific evidence,” said Paone. “We encourage organizations to use them as an engagement tool.”
Like many who work with pest control, Asher has its own story of drugs. As a young punk who lived in a trick on the Lower East Side, he said he lived a wild life, fought police and landlords and did a lot of drugs. He was never great in opioids, but his experience of “very crack and much meth” and his frustration of what he described as the government’s apathy against deaths of overdoses and HIV in marginalized societies led him to hurt the reduction work.
“It bothered me that a group of people who had never met me said it would be ok if I died,” he said as he drove from St. Ann to nearby Patterson Park, where his team went upstairs working on a new weekday. “So did this work make the best possible” screw you “I could join a group of people who said that
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