Grant helps make syringe exchange program viable

A $10,000 grant awarded by The Alaska Mental Health Trust Authority will keep The Exchange, Homer’s syringe exchange program, open and stocked with supplies for two years, said Ginny Espenshade, a co-founder of The Exchange.

The grant allows the facilitators of The Exchange to move their focus from maintaining enough supplies to working on a long-term sustainability for the program and starting prevention education.

“This grant was written to give us security that we will have enough supplies. This also will give The Exchange time to decide if we will start another nonprofit, stay under the existing coalition, or fit under an existing nonprofit,” Espenshade said. “Also, the same group needs to work on prevention education as well as helping people with treatment. I think getting this type of support lets us pivot now and work on the upstreams of the problem, trying to prevent people from getting into that situation in the first place.”

The Exchange’s budget for the grant money includes 10,000 syringes, 800 wound care kits, 2,000 tourniquets, 16,000 alcohol wipes, 8,000 bandages, and supplies for 48 hepatitis C tests and 48 HIV-AIDS tests. The program also provides feminine hygiene products and vouchers for showers and taxi rides to participants in need.

“(Providing) feminine hygiene products … fits in with trying to keep people healthy. It goes a little outside our original vision, but it fits our mission of reducing harm, infection and … the more they are treated with dignity and respect at The Exchange, it can have a ripple effect.”

The Exchange is a coalition of community members and agencies that provides clean syringes, other drug injection supplies, overdose kits and training, rapid HIV-AIDS and Hepatitis testing, information about rehabilitation treatment and disposal of used syringes to heroin and other opioid users in the Homer community.

The Exchange opens twice-per-month at the South Peninsula Hospital’s training and education facility on Pioneer Avenue.

Receiving The Alaska Mental Health Trust Authority’s Small Project Grant is the result of collaboration between The Exchange and the Homer community, Espenshade said. Since The Exchange is a coalition, rather than a non-profit entity, they needed a nonprofit to serve as a fiscal agent. The Homer Foundation agreed to act as The Exchange’s agent for the grant, and also waived their administrative fee for doing so.

“They are donating their administrative services, which is a big help,” Espenshade said.

The Small Project Grant awards one-time funding of up to $10,000 for projects that directly impact benefactors of the trust — Alaskans with mental illness, developmental disabilities, chronic alcoholism or other substance-related disorders, Alzheimer’s disease and related dementia, and traumatic brain injuries, said Alaska Mental Health Trust Authority Grants Administrator Lucas Lind. The trust looks for intervention programs that serve a problem and have strong community support as ideal recipients of the grant.

“(The Exchange) was an innovative project,” Lind said. “It was exciting to see the grassroots nature of it. … It’s clear to us a lot of hard work has gone into this and that really stood out in the application.”

The grant comes to The Exchange as Gov. Bill Walker declared Alaska’s opioid epidemic a public health crisis on Feb. 15. The declaration established a statewide Overdose Response Program and enables wide distribution of the opioid overdose intervention drug naloxone, according to a press release on the State of Alaska website.

In 2012, Alaska’s prescription opioid pain reliever overdose death rate was more than double the rate in the United States and Alaska’s heroin-associated overdose death rate was 50 percent higher than the national rate, according to the declaration of disaster emergency document. Between 2009 and 2015, the number of heroin-associated deaths in Alaska quadrupled.

Since The Exchange started as a pilot program in June, it has been funded by donations from private individuals in the Homer community and grants — $1,000 from The Awesome Foundation and $1,000 in supplies from North American Syringe Exchange Network. The Exchange purchases its supplies through NASEN, which offers syringes and other items at low cost with free shipping to syringe exchange programs, Espenshade said.

The Exchange served 75 individuals and distributed 2,615 clean syringes between June 21 and Dec. 20, 2016, according to records from participant enrollment forms. The program has also provided 19 naloxone kits and prescriptions and disposed of an estimated 710 used syringes. Participants often take more than one safer injection kit per visit to bring to friends who did not come to The Exchange.

Intravenous drug users who come to The Exchange range in age from 22-50 years, though 54 percent of participants are in their 20s.

A majority of 94 percent of answering participants reported that they usually sleep within the Homer zip code area, while 1 percent reported Anchor Point and 5 percent reported Anchorage as the primary place they sleep. At the time of their visit, 29 percent of participants disclosed that they were homeless.

Volunteers running The Exchange have worked to gain the trust of potential participants, some of whom fear the program might be a way for law enforcement to arrest drug users, Espenshade said. Though the Homer Police Department, along with The Homer Foundation, South Peninsula Hospital, Kachemak Bay Family Planning Clinic and Dr. Sarah Spencer, has been a partner in developing the syringe exchange program, the police keep their distance, Espenshade said.

“(The police) have done everything they can to stay out of the way to make sure that our participants know that this isn’t a way for law enforcement to crack down on users,” Espenshade said. “They asked for a training on (naloxone) from Dr. Spencer and a couple officers did bring someone back to life as a result of that training. They’re obviously not a visible partner, but their support is really important to that trust.”

Anna Frost is a Homer freelance writer.