WINTER 2023-24
Innovations
In Treatment and Recovery Artículos en Español páginas 28-32
How Well Are We Doing?
Health To Go Meeting the Challenge
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THE RESPONSE // WINTER 2023-24
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SALUD PARA LLEVAR
ARTÍCULOS GRATUITOS DE SALUD Y BIENESTAR DISPONIBLES AQUÍ MISMO, CUANDO LOS NECESITE.
The Response is published through funding from county and state dollars in concert with the Berks County Opioid Coalition under the guidance of the Council on Chemical Abuse. cocaberks.org • 610-376-8669
Artículos en Español páginas 28-32
EDITORIAL BOARD
T.J. Huckleberry Executive Officer, Berks County Medical Society Michael Rivera Commissioner, County of Berks Katheen Noll Executive Director, Council on Chemical Abuse Marcia Goodman-Hinnershitz Director of Planning & Resource Development, Council on Chemical Abuse Tracy Hoffmann Hoffmann Publishing Group Lee Olsen Olsen Design Group Architects Josephine Torres-Boykins
BERKS COUNTY’S OPIOID COALITION, SOS BERKS www.sosberks.com
SOS BERKS BERKS OPIOID COALITION LEADERSHIP
Michael Rivera and Kathleen Noll Coalition Co-chairs
COMMUNITY SAFETY COMMITTEE
John Adams and Yvonne Stroman Co-chairs
COMMUNITY AWARENESS COMMITTEE Laura Catalano, Chair
DATA COMMITTEE
Justin Loose and Kathleen Noll Co-chairs
PREVENTION EDUCATION COMMITTEE
CONTENTS
WINTER 2023-24
FEATURES 4 6 8
Innovations Letter from the Editor The Recovery Corner: A Windy Day
12 Berks County Opioid Settlement Funding: An Opportunity for Innovation
14 Drexel Students Intend to Bring Hope to the Homeless on the Streets of Reading
BERKS COUNTY OPIOID COALITION
17 Innovations in Higher Education: Kutztown University Offers Innovative Graduate Level Addiction Couseling Program
19 Health To Go: Health Supplies and Harm Reduction Tools at Your Fingertips 21 Meeting the Challenge: Innovations in Substance Use Disorder (SUD) Treatment
26 Naloxone (Narcan®) Distribution: The Evolution of an Innovation in Overdose Prevention
28 Los Estudiantes de Drexel Tienen la Intención de Llevar Esperanza a las Personas Sin Hogar en las Calles de Reading
Cory Trevena and Jaclyn Steed Co-chairs
30 Salud Para Llevar: Suministros de Salud y Herramientas de Reducción de
TREATMENT COMMITTEE
OPIOID COALITION VISION Identify opportunities to remediate the opioid crisis through the provision of evidence based/best practice strategies and resources.
Amanda Miller and Bernice Hines-Corbit, Co-chairs
The opinions expressed in this publication are for general information only and are not intended to provide specific legal, medical or other advice or recommendations for any individuals. All rights reserved. No portion of this publication may be reproduced electronically or in print without the expressed written consent of the publisher or editor.
Daños al Alcance de Su Mano
OPIOID COALITION MISSION The mission of the coalition is to determine the extent to which Berks County is being affected by the non-prescriptive use of opioids and the use of heroin through the examination of its devastating effects, both personal and societal, and to set recommendations that address the prevention, intervention, treatment and recovery supports of local residents that suffer from opioid addiction. 2669 Shillington Road, Box #438, Sinking Spring, PA 19608 | HoffPubs.com | (610) 685.0914 Designer | Kim Lewis
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READ THE RESPONSE ONLINE AT Response.HoffmannPublishing.com RECEIVE THE LATEST UPDATES BY FOLLOWING US ON SOCIAL MEDIA 3
FROM THE COALITION
Innovations By Co-Chairs Commissioner Michael Rivera and Kathleen Noll, Executive Director of the Council on Chemical Abuse
T
he theme for this edition of The Response is innovation. Innovation is not only creating something new, but it is also something better than what we currently have. To provide the most effective drug and alcohol services possible, it is vital for us to continue to innovate. However, it is equally important to consider evidence and evaluate our new ideas and approaches. Over the past several decades people who provide drug and alcohol services as well as researchers, scientists, doctors, and people in recovery and their families have contributed to the innovations we have seen in the field of drug and alcohol services.
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Drug and alcohol prevention services have evolved over time as approaches to preventing drug and alcohol use among youth were evaluated and new and innovative services were developed. During the 1930s to 1960s prevention messages were overly dramatized and often exaggerated the negative aspects of drug use. The approach was frequently, “oneshot” presentations that were given to young people to elicit fear about using drugs and alcohol. Through research and evaluation, it has been determined that scare tactics have little to no effect on a young person’s decision to use alcohol and drugs. Today prevention services are comprehensive, and programs presented to youth are based on research and evidence that they are effective in preventing drug and alcohol use among young people. Practices in intervening with a person with a substance use disorder have also advanced throughout the years. When some people think of an intervention with an individual who is using drugs and alcohol, they think of a confrontation with the individual using drugs. We have learned that this approach may be counterproductive for some people. Innovations have led to the development of new, non-confrontational intervention techniques that are designed to build motivation for change and educate about substance use disorder. The substance use disorder treatment field has also changed considerably. We now have validated client placement tools to recommend appropriate levels of treatment to people seeking services. Treatment is delivered using evidence-based protocols and is individualized and trauma-informed. Additionally, while methadone has been used to treat opioid use disorder for decades, there are newer FDAapproved medications to treat alcohol and opioid use disorders that have less restrictions on the way
they are prescribed. This gives people easier access to medications and allows the prescribing physician to discuss options with the patient. Services for people in recovery have also grown. We now recognize that there are many pathways to recovery. The use of Certified Recovery Specialists to help those new in recovery find the way that will lead to sustained recovery has been growing steadily over the last several years. Recovery Centers where people can get information and referrals and participate in activities are found in more and more communities. The SOS sub-committees have also been innovative in their approaches to prevention education, intervention, and supporting treatment and recovery services. The Prevention and Education sub-committee has provided community education to populations not traditionally reached including business leaders, first responders and pharmacists. The Community Safety sub-committee has been innovative in their approach to intervention. This subcommittee has developed a connection with Helping Harvest and is providing Narcan®, Medication Lock Boxes, Medication Disposal Bags and information about how people can access treatment and recovery services at numerous locations. The Healthcare and Treatment sub-committee developed a new “No Wrong Door” policy and worked with substance use disorder treatment providers to help get clients access to appropriate treatment. Innovations in drug and alcohol services have culminated in being able to provide effective prevention, intervention, treatment, and recovery services. However, the work is not done. We will continue to rely on innovations and research to insure people receive the best services available.
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LETTER FROM THE EDITOR
We’re a Long Way from ‘Just Hang Up’
S
o, a few days ago, I was driving home from football practice with my youngest son. A few minutes into the drive my wife called me, and I answered the bluetooth speaker phone in the car. Our discussion (which was no doubt about dinner and who was going to make it) concluded and I said, “Ok, I am hanging up. Talk to you soon.” And… this is when my normal post-football practice car conversation turned into Disney’s Carousel of Progress. Because my son pipes up from the back seat and asks, “Dad, how come you say you are going to hang up the phone? You either press a button on the screen or charge it, but you don’t hang it anywhere.”
T.J. Huckleberry Executive Officer Berks County Medical Society
At that moment, I realized that my son has never lived in a world where a phone was in a physical location and not in a pocket. He attributes phones as a place to access movies, a flashlight, games, search engines, music, and cameras. Where all of us remember the years before smartphones, where we lugged camcorders and cameras on vacation, and waited 5 minutes for our Gateway computers to access the internet; our children only understand instant gratification. So, for the rest of the car ride I explained, as best I could, that phones used to be on our walls and that they had to be physically hung up. And that in the not-so-distant past, when cell phones did not exist, we had phone booths and needed change to pay for the call if we needed to make a call outside of the house. I shared with him that all those digital apps on my phone were once very real and very expensive devices. Well, my son was understandably quiet as he processed my oral history of communication, but as we pulled into our driveway, he said, “Dad, what a time to be alive.”…which I later found out, he heard from an Xfinity commercial, that he no doubt watched on a phone. This edition of The Response celebrates innovation. Innovation has always been one of my favorite words because it brings hope. To innovate, by its very definition, is to improve. It’s the idea that someone sees something and wants to make it better and does. These articles are filled with stories about people who have done just that. As we focus this issue on Innovations, The Response will be introducing with its own innovations. While not as dramatic as the invention of the smartphone, these innovations speak to our commitment to moving forward. First, we will be expanding our reach to Spanish readers by including articles in both English and Spanish. Our journey has been built on partnerships. The “Recovery Corner,” a new feature of The Response, recognizes the power of the voices of recovery; we have created as a place for sharing stories of strength and hope. With education being a key pillar in our efforts, each issue will now feature the work of our partners in education. We will continue to utilize multiple platforms to bring The Response to our readers through both the print publication and an online version. We embrace Innovation as a guiding principle, looking forward to continued opportunities to enhance our “Response.” In the prevention and recovery community, we too have come a long way since phones were hung on walls. It took hard work, passion, hope, and, of course, innovation. It makes me think what the next twenty years will bring and it makes me thankful for where we are now. What a time to be alive.
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FEATURE THE RECOVERY CORNER
As we navigate through the challenges of the opioid crisis, our greatest hope rests in the lived experiences of persons who use drugs and persons in recovery. The Response will now include “The Recovery Corner” as a regular feature where individuals will share their perspectives on the paths to recovery.
A Windy Day L
et me introduce myself. My name is Frances, and I identify as being in long-term recovery. My holidays continue to be awkward for me. My experiences and sober journey belong to me. We all take different paths to finding sobriety. I believe social media reels and images have many people thinking and asking how a person gets there. Let me share a snapshot of my story with you.
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THE RESPONSE // WINTER FALL 2023 2023-24
The other week, I celebrated the fall season with my family, and it was a windy day. I shy away from crowded venues in my personal life despite decades of living sober. I still use self-talk in experiencing life and situations that I feel hesitant to embrace. What motivates me is my family and my grandson, who is seven, to try new things. I do remain sober for me, learning to love myself and being self-compassionate. When I began my sober journey, my daughter was very young. A friend of mine leaned into an uncomfortable situation and asked me what I was doing and that I could lose everything. I remember all the details of that day. I quietly left the room, and it was the starting point for my self-discovery. To this day, he is my soul brother, and we keep in touch over the years. I love him and his family. What a blessing for me to hear, but really listen to what he was telling me. I was going down a dangerous path of self-destruction. Not too many people knew my path in my use of drugs. When people ask how did they get there? I can only relate to how I got there. I can share that I would visit street corners purchasing my drug of choice, and I would have runners bring drugs to me. It’s a culture that swallows you whole when you are loving your drug of choice.
up with excuses and calls me on it. I use self-talk to get through the holidays. On that windy day, I watched my grandson and his cousins climb layers of hay. It was a gorgeous sight for me, taking everything in, and it was indeed my best to come. Imagine that decades on my journey and on a windy October day, my best presented itself. I experienced what they say in recovery: that the best is yet to come. I thank my daughter for encouraging me to go with the family. I can speak to when an individual finds support unexpectedly. My daughter, her family, and their friends are so kind, loving, and supportive. As life really throws us difficult situations, I give them credit for picking me off the floor over six years ago when I could have remained in an emotional puddle. I needed support at a sticky time in my life. I got through the emotional valleys and stayed true to myself. I am known as Mae Mae and cry with emotions over almost everything. Yes, I am tearing up as I type. I am very much a flawed individual, and each day is truly a day at a time. I have been doing affirmations every day for six years with my one cup of coffee. I, with intentions, try to bring my best self forward each day, and if it gets easy, then I am slacking. What I can share is that I experienced my best on that windy day.
I did a remarkable job of hiding my substance use disorder and my fondness for using and having a drug vacation and disappearing from everything in my mind. I do not pretend to know why I used it despite knowing the risk. It was my compulsive act of loving something that was not good for me and the people around me. Decades later, I hear people share how they did not know that their loved ones were using or sick with the disease.
Perhaps I can give this holiday thing a better try. It’s time for me to shed my awkwardness and embrace my today. Recovery is a life of more, and I am in an excellent place to experience more this holiday season. I am experiencing goodness, and that may be another article in the future that I write. My heart goes out to my brothers, sisters, and families impacted by substance use disorders. And wow, the best is truly yet to come.
Now we are approaching the holidays. My blessing is that my daughter doesn’t know much about my journey because she knows her mother is present. What motivated me to do my best in being a mother is that I didn’t want to screw things up. I needed to stay sober for me. I am blessed that was my first lesson. Today, my daughter would share that I shy away from holiday celebrations. I genuinely have no clue why. She is and has always been my holiday spirit. I believe she knows when I try to come
Hugs and Love,
Frances
9
Where your journey starts and healing begins LICENSED BY DEPARTMENT OF DRUG & ALCOHOL Programs: Outpatient Drug and Alcohol Intensive Outpatient Program Maternal Dependency Program (IOP) Partial Hospitalization Program (PHP)
1150 Berkshire Blvd, Suite 210 Wyomissing, PA 19610 • 147 N. 5th Street, 2nd Floor, Reading, PA. 19601 P 610-750-6015 • F 610-750-6108 • Referrals can be sent to intakes@peaceandharmonyhouse.com peaceandharmonyhouse.com • We accept walk ins in both offices Monday - Friday 8am-2pm Medicaid Insurance, Capital Blue Cross and Blue Cross Blueshield Insurance Accepted
THE RECOVERY CORNER
Addict Me/Clean Me Addict Me In my addiction I was a thrill-seeker – I was always strong but no addiction made me weaker. In my addiction myself I did hate I used to be honest, soon lies I would create. In my addiction I drifted away from my family and friends I didn’t want to apologize and make any amends. In my addiction I only thought of one thing And to me it was the joy that it would bring. In my addiction I would go to work everyday But couldn’t wait to go home and take the stress away. In my addiction I used people to get high But I want to get clean and to my addict self say good-bye.
Clean Me So now I am clean, 206 already – Not only do I feel strong, but I feel steady. Instead of thrill-seeking, I am seeking thrills. Instead of spending money on drugs I will spend it on bills. I will try to be more honest, no more lies will I tell. I no longer want to be sick – I want to be healthy and well. I will get closer to my family and friends. I will apologize to my family and friends. The clean me will still go to work every day. The clean me wouldn’t take drugs to take the pain away. The clean me wants to laugh and have fun. The clean me wants to feel the rain and see the sun. ‘Cause in my addiction there was only a dark space. I will remain clean when I leave this place. So there will be no more Dr. Jekyll and Mr. Hyde. I will be a clean person with so much pride. So here’s what I want to say. I hated the addict I was – but I like the new me today. Kelly All content of the Recovery Corner represents the perspectives of the authors. 11
FEATURE
Berks County Opioid Settlement Funding
An Opportunity for Innovation B
erks County Opioid Settlement Funding is utilized to address gaps in services, while also maintaining and enhancing established programs and activities. This includes supporting additional services that complement and/or enhance existing programs. The funds are also used to provide sustainability for proven and effective services for expiring grant programs.
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Opioid Settlement Funding has offered a unique opportunity to implement and enhance innovative programs in Berks County. There are specific programs that utilize novel approaches to strengthen our local response to the opioid crisis.
Equine Therapy: Bethany Christian Services will be implementing an equine therapy program for pregnant and post-partum women. This project will enable pregnant/post-partum women struggling with addiction in Berks County to process and heal from past trauma through a modality that has been successful for many who have not responded to traditional therapy. The Masimo Bridge™: White Deer Run will be implementing
the use of the Masimo Bridge™, an FDA-authorized medical device which increases successful completion of withdrawal from opioids and increases the successful transition from illicit opioid use to a prescribed and medically managed Medication Assisted Treatment (MAT) program.
Medical Fellow Program: Caron Treatment Services offers an
Addiction Medicine Fellowship Program which provides specialty training in substance use disorders. Participating physicians learn innovative, evidence-based treatment modalities and therapies from addiction experts. This fellowship program helps to grow the number of physicians expert in addiction medicine.
Recovery Works: Berks Connections will provide workforce
development services to individuals in recovery from an opioid use disorder (OUD). The program will guide individuals by offering employment readiness training, individualized employment plans and assistance with job search and placement.
We Can All Use a Soft Landing Sometimes.
Are you or someone you know pregnant and using? We can help. SOFT LANDING SUPPORT PROGRAM
Call 484-628-9050 Email SoftLanding@towerhealth.org www.bewellberks.org/soft-landing-program
Danny’s Ride: Through the provision of transportation to
treatment and recovery support services, this program removes a barrier for individuals without transportation resources. The program utilizes existing local ride sharing resources to assist those who lack appropriate transportation. These programs represent just a few of the creative programs that are supported through Berks County Opioid Settlement funding. For a complete list of programs as well as instructions on how to apply for funding, visit the Council on Chemical Abuse website at: Berks Opioid Settlement Fund: Request for Funding Process - Council on Chemical Abuse | Your Bridge to Addiction Resources (cocaberks.org).
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FEATURE
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Drexel students intend to bring hope to the Unhoused on the streets of Reading By David A. Kostival
T
he opioid crisis gets a lot of negative media attention whenever there are incidents of tragic overdoses. But there are also positive and hopeful stories which arise from the opioid crisis narrative. One such bright spot in Berks County is the newly formed Drexel University Street Outreach Program. The program has emerged from the coordinated efforts of three doctoral candidates in the class of 2026 at the Drexel University College of Medicine at Tower Health. Carter Van, 23, Windsor, Ontario, Canada, said the project was started by partnering with the Naloxone Outreach Project. The intention is to get the program started before the end of the year, according to Van. “The idea is that we’re going to be regularly stationing a table at the New Journey Soup Kitchen where we will interact with the local homeless population and try to get a better understanding of their needs,” Van said. “As we build relationships with the community there, we can tailor the supplies that we order to better fit their needs.” The soup kitchen is part of the New Journey Community Outreach, Inc., which formed in 2014 when the New Journey United Methodist Church merged with West Lawn Methodist Church. The non-profit is housed in what is known as “the yellow church” at 138 South 6th St., Reading. Marquis Winston, 26, Killeen, Texas, emphasized the necessity to establish communication with the homeless population. He explained it is based on a program known as “Street Medicine,” which provides medical care for the homeless. “We want to establish relationships with them so they can feel comfortable enough to tell us what they actually need instead of us guessing,” Winston said.
Tom Parker, 26, Boston, Massachusetts, president of the Naloxone Outreach Project at Drexel, said the street outreach is another way to get Narcan® out to those who need it in the community. Parker explained the street team for the Naloxone Outreach Program would go out with backpacks full of Narcan kits and directly deliver them to anyone who wanted one. “We found that we gave entire Narcan kits out to anyone who wanted them,” Parker said. “The street outreach is going to be a way that we regularly go out and deliver just the Narcan spray directly to people, in addition to all the other supplies.” While the street outreach is facilitated by the three medical students, Parker said it is affiliated with Drexel. “There’s a community service program called Health Outreach Project,” Parker explained. “The Naloxone outreach and street outreach are both under the umbrella of the community service outreach program.” The new street outreach is also being assisted by the Berks Coalition to End Homelessness. Parker said the students are being mentored by Mike Knoll, street outreach/jobs program coordinator for the non-profit. Winston said the basic goal of the program is to establish a presence in the community and to let people in need know it is a resource for them. “Drexel Medical School has a lot of resources, and we just want to be able to give our resources the best way possible to the community,” Winston said. “The programs that are already in Reading have laid the groundwork. They’re doing what they can to end homelessness and we are just trying to collaborate and learn from them and from the individuals that we’re helping.” Parker stressed it is also a way for students to get involved. “Students can regularly volunteer and actually help out in the community,” Parker said. “We spend a lot of time in class talking about the social continued on next page 15
FEATURE
determinants of health and learning how homelessness affects health. But it’s important for students to get out in the community and directly talk to people about what they are experiencing. “I think it’s also important to make us better doctors too, because it kind of gets in our minds as to why we went into healthcare, which is to help people,” Parker added. Parker explained the program will be instrumental as a regular way to distribute Narcan. “This way we can deliberately hand out Narcan to people and tell them how to use it,” Parker said. “If we can prevent one overdose, then in my mind, it’s worth it.” The Narcan kits are being provided by the Council on Chemical Abuse. Parker explained the Narcan kits have instructions in English and Spanish. “Whenever we give out a kit, we explain what Narcan is actually used for, how to use it, how to recognize an overdose and make sure the person actually understands what they’re asking for,” Parker emphasized. “It’s not just a free bag of something. They need to understand Narcan and why it’s important.” Van said the plan is to set a table up at the end of the food distribution line where the homeless will be able to pick up supplies. “Once we get out there and start having conversations with them, we can
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engage with them and be able to provide specific items rather than just general supplies like basic toiletries,” Van predicted. Van added that the program will be beneficial to the medical students. “It’s very much a two-way relationship in terms of the benefit,” Van explained. “As Med students we are learning more about the struggles that the homeless are going through by interacting with them face to face.” Winston hopes the program will expand to other consistent locations in the city. “I feel like the longer that we’re out there, the longer we will have to establish these relationships and we can start guiding them towards other resources in Berks County,” Winston said. Van believes the program has potential for growth. “I think the beauty of this is that it’s a longitudinal thing and it’s something that generationally, each year the new Med students that come in will build on top of what their predecessors built,” Van said. Parker added that the program is about hope. “I want us to give them hope and be able to connect them to other resources to help get them back to their feet,” Parker said.
PARTNERS IN EDUCATION As the opioid epidemic has impacted every sector of our community, stakeholders have stepped forward to do their part to pro-actively strengthen or put in place programs and policies that address substance use disorders. Our partners in education, including schools and institutions of higher education, have been committed to ensuring that students receive timely and age-appropriate education and training as well as linkages to intervention and treatment resources. In each issue of The Response, we will highlight a Partner in Education and their work in addressing this challenging health crisis. This issue we focus on the Kutztown University Innovative Graduate Level Addiction Counseling Program.
INNOVATIONS IN HIGHER EDUCATION Kutztown University Offers
Innovative Graduate Level
Addiction Counseling Program
By Dr. Scott Tracy, Kutztown University Associate Professor of Counselor Education
I
n response to the overwhelming need for highly trained addiction counselors, Kutztown University (KU) began a graduate level addiction counseling program for the first time in the Fall of 2022. The KU program is the first of its kind in Eastern Pennsylvania and one of only three in the Commonwealth. The program consists of 60-semester hours, along with a 100-hour practicum experience and a 600-hour field clinical internship. The program is offered by the Department of Counselor Education, and it is created to meet the standards that are required by the Council for the Accreditation of Counseling and Related Educational Programs (CACREP). Integrated into the coursework are assessment and treatment standards of the American Society for Addiction Medicine (ASAM), which is the current approved Pennsylvania placement and treatment plan continued on next page
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FEATURE model. The addiction counseling program additionally meets the educational requirements for Pennsylvania licensure as a Licensed Professional Counselor (LPC). The program also offers graduates the ability to become a Nationally Certified Counselor through the National Counselor Examination (NCE). After completing the program in Addiction Counseling, graduates will meet the educational requirements of the Pennsylvania Certification Board for certification as a Certified Advanced Alcohol and Drug Counselor (CAADC). Throughout the program there is an emphasis on developing knowledge and skills that align with the standards of the Department of Drug & Alcohol Prevention in Pennsylvania which integrates with the ASAM criteria. The focus of the program prepares graduates with evidence-based approaches that can be clinically applied in many settings such as community mental health agencies, hospitals, drug and alcohol treatment programs, private practice, public schools, and colleges/universities. The Addiction Counseling Program is created to address the national need for nearly 60,000 future jobs in addiction counseling. Core courses include training in professional orientation and ethics in addiction treatment, intercultural issues in counseling, fundamental helping skills, counseling theory, group counseling, career counseling and issues across the life span. Advanced specialty courses include chemical dependency treatment, approaches in for healing in the addicted family, psychological trauma and addiction, psychopharmacology and the assessment and management of behavioral/process addictions. Topics in all courses emphasize the importance of family, social networks, and community systems in treatment and recovery process. Through the program students obtain a comprehensive academic knowledge base, develop effective counseling skills, and engage in personal and professional growth activities that qualify them to become highly skilled practitioners, advocates, and leaders within the addiction treatment field. The overall mission and core tenets of the program are to guide the students in obtaining personal awareness of self as a counselor, building knowledge of counseling, addiction, and co-occurring disorders, and to gain
the skills in counseling delivery across the life span with diverse populations. KU works with many community partners to offer real world clinical experiences to students. KU has recognized the need for all counselors to have conceptual knowledge of addiction as a brain-based disorder along with initial assessment and treatment protocols. A course titled Problems of Addiction is now a required course for all graduate counseling programs. The addiction specialization courses may be taken by students in the school, clinical mental health, and marriage, couple, and family counseling programs who want to gain more broad-based knowledge of addictive disorders. The addiction counseling program also works with the KU campus alcohol and other drug programs office (AOD) that offers early screening and prevention services to the entire KU learning community. Currently, AOD in partnership with the Department of Counselor Education is operating a funded grant from the Pennsylvania Liquor Control Board titled “Embracing Cultural Communities.” The grant’s goal is to provide supportive services and prevention programming to reduce alcohol consumption within many culturally diverse communities on KU’s campus. Alcohol related incidents continue to plague institutions of higher education and this innovative KU program helps to address that issue locally. The grant also offers KU graduate students experience in working with harm-reduction models in college populations. In related drug and alcohol prevention initiatives, KU recently dedicated residence hall space for students who embrace sober living. Named Freedom Place, students living in that learning community pledge to engage in a sober lifestyle and participate in drug and alcohol prevention advocacy as a service project to the University. All KU’s program are supervised by doctoral level, licensed faculty members who work collaboratively with campus and community partners to make the KU Counselor Education experience unique.
For more information about Addiction Counseling at Kutztown University,
contact Dr. Scott Tracy, Associate Professor of Counselor Education and clinical
coordinator of the clinical mental health and addiction counseling programs at Kutztown University at stracy@Kutztown Universitytztown.edu.
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HEALTH TO GO FREE HEALTH AND WELLNESS ITEMS AVAILABLE RIGHT HERE, WHEN YOU NEED THEM.
SALUD PARA LLEVAR
ARTÍCULOS GRATUITOS DE SALUD Y BIENESTAR DISPONIBLES AQUÍ MISMO, CUANDO LOS NECESITE.
Health Supplies and Harm Reduction Tools at Your Fingertips
Jennifer Murphy, Ph.D. Associate Professor of Criminal Justice, Penn State Berks
O
verdose deaths continue to rise in Berks County and are exacerbated by the adulteration of drugs with highly dangerous substances like fentanyl and xylazine. Innovative solutions to the overdose crisis are needed more than ever to help people who are at highest risk for drug overdose obtain naloxone, the opioid overdose-reversing drug. continued on next page 19
One such innovation, an interactive health kiosk, will soon be available to Berks County residents. The “Health To Go” kiosk will administer health and wellness items, including the lifesaving naloxone nasal spray, free of charge and anonymously. The kiosk, also described as a “smart” vending machine, will be open to the public by the end of the year and will be located in the lobby of the Reading YMCA, 631 Washington Street. Its large, interactive touch screen will display the available items, along with local resources to help people access health care, drug treatment, and other social services. A team of researchers at Penn State University has partnered with S.O.S. Berks to design and implement the machine in Reading. They will also evaluate its effectiveness in providing harm reduction supplies to residents and reducing overdose deaths. The pilot grant, awarded by Penn State’s College of Medicine, funds the startup costs for two interactive health kiosks in Pennsylvania and their operation for one year. The other machine will be located near the Emergency Department entrance of the University of Pittsburg Medical Center in downtown Harrisburg. Dr. Alice Zhang, a family medicine physician at Penn State Health and one of the co-Principal Investigators on the project, saw the kiosk as a way to reach people who might not otherwise seek healthcare. “My desire to help those who may not necessarily see a primary care provider, whether it is due to cost, time constraints, or not being ready to connect to care, combined with the rising numbers of overdoses that spiked during the COVID-19 pandemic, motivated me to implement the Health To Go kiosks. It seemed the perfect opportunity to deliver free health items to the community, while connecting them to care by listing available resources and services on the interactive touchscreen.” The Reading location was chosen due to the concentration of overdose calls in the area and because of the growing racial and ethnic disparity in overdose deaths. In Pennsylvania, the opioid overdose death rate among black and Hispanic individuals is higher than white individuals and continues to increase at a disproportionate rate, according to the Centers for Disease Control and Prevention. The YMCA in downtown Reading offered to host the machine in their first floor lobby, near the other vending machines. Individuals will be able to access the kiosk 24 hours a day and do not need to be members of the YMCA to enter the building. Ken Borkey, Jr., Chief Operations Officer of the YMCA of Reading and Berks
County, discusses why they wanted to collaborate on the project: “We are proud to partner with S.O.S. Berks and Penn State to host the naloxone vending machine at the Reading YMCA facility. Our location, at the heart of the community, is ideal for this life-saving initiative. The Y is committed to the well-being and health of our community members, and this initiative aligns perfectly with our larger mission of providing support and resources to enhance the overall health and safety of our community.” The interactive kiosk will have a large touchscreen where users will be able to obtain various health and wellness items, including naloxone, safer sex kits, medication disposal bags, menstruation products, pregnancy tests, hand sanitizer, wound care kits, and HIV tests. It will also dispense fentanyl test strips, so people can detect whether fentanyl is present in their drug supply. Fentanyl has been detected in nearly 67% of overdose deaths that have occurred in Berks County in 2022. Given that the Pennsylvania legislature just decriminalized the use of fentanyl test strips earlier this year, they are a relatively new tool for people and can provide life-saving information about the content of the drug supply. In addition to the items, users will be able to use the kiosk to access information about local organizations that address health and social needs, including drug treatment, health care, mental health, housing, and other social services. Because the kiosk is in a public location, and people can access the items and information anonymously at no cost, it has the potential to decrease stigma surrounding drug use and drug treatment. While agencies in Berks County, including the Council on Chemical Abuse, provide education and distribute naloxone, a large proportion of the drug-using population is still not carrying naloxone. “These smart kiosks, designed specifically for harm reduction and health promotion, may be most effective by reducing the stigma associated with accessing traditional prevention methods,” declares Dr. Aleksandra Zgierska, professor of family and community medicine at Penn State Health and the other co-Principal Investigator of the project. All of the text on the kiosk, including the information on resources, will be offered in both Spanish and English. Due to the machine’s interactive capacity, new items and resources can be added if they are shown to be in demand by the community. S.O.S. Berks and Penn State are finalizing the specifications of the machine’s items and resources. They anticipate that the machine will be up and running in early 2024.
For updates on the “Health To Go” kiosk visit: Health To Go Vending Machine - Coming Soon to Berks County - SOS Berks - Opioid Coalition. 20
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FEATURE
By Dr. David Loveland, Ph.D.
D
avid Loveland, Ph.D., is the Senior Director of Operations at the University of Pittsburgh Program Evaluation and Research Unit (PERU) within the School of Pharmacy. His research focuses on individuals with a SUD, including increasing access to effective treatment, creating a continuum of seamless care, and integrating community resources. Dr. Loveland worked for Community Care Behavioral Health (a UPMC Health-Plan division) for nine years prior to his arrival at PERU, where he focused on the implementation of evidence-based practices for SUD programs across Medicaid-funded programs in PA. His work at CCBH also involved the development of value-based payment protocols to increase access to effective SUD treatments, including medications for individuals with opioid use disorders (MOUD). continued on next page
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FEATURE
The field of SUD treatment is evolving in response to the changing needs of individuals with a SUD as well as the challenges created by the COVID-19 pandemic. Reaching more individuals with a SUD is the primary driver behind recent innovations. Less than 10% of individuals with a SUD seek or receive treatment in the U.S. each year and less than half complete a single episode of treatment, when they do engage (Center for Behavioral Health Statistics and Quality, 2022; Saloner et al., 2022; SAMHSA, 2022). Black and indigenous people of color (BIPOC) are less likely to access services than white, non-Hispanic individuals with the same SUD (Barnett et al., 2023; Martin et al., 2022). Providing care to individuals who are using multiple substances or have multiple treatment needs (e.g., depression, diabetes, trauma, or chronic pain) are also less likely to engage or stay in SUD treatment (Frost et al., 2023; Smart et al., 2023). Socioeconomic barriers, such as lack of insurance, transportation, childcare, time, or stable housing, as well as stigma prevent many individuals from seeking or staying engaged in treatment (Bielenberg et al., 2021; Pinedo et al., 2023; Simpson et al., 2022). Despite the limited number of individuals receiving SUD treatment in PA and across the U.S. each year, most encounter the healthcare system, criminal justice system, or both, multiple times within each year. A variety of treatment interventions has been designed to either intercept individuals during a crisis event or provide them with mobile treatment in their homes, 22
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neighborhoods, or other accessible locations. Some notable innovations include: • Telehealth treatment, including access to medications, via phone or video conferencing, to individuals in their homes. A growing body of research has found telehealth models of SUD treatment increase access and retention in treatment, reduce overdoses and suicide risk, and reduce the use of expensive medical services (e.g., emergency departments & hospitalizations) compared to office-based treatment (Frost et al., 2022; Gujral et al., 2023; Jones et al., 2023). Telehealth options can overcome most socioeconomic barriers as well as reduce the feelings of stigma when seeking SUD treatment. • Mobile vans; i.e., street medicine, which functions like a primary care clinic on wheels. Mobile clinics can be driven to neighborhoods with limited resources, where individuals with a SUD need medications for their opioid use disorder (OUD), harm reduction services (e.g., naloxone or fentanyl test strips), and access to medical care (e.g., wound care, medications for chronic health conditions, or COVID-19 vaccines) (Messmer et al., 2023). • Low-barrier or -threshold clinics, which provide rapid access to medications for an OUD or alcohol use disorder (AUD), case management and peer services to overcome socioeconomic barriers, and counseling tailored to the needs and time
limitations of participants (Collins et al., 2021; Lowenstein et al., 2023). Low-barrier programs bypass many of the bureaucratical requirements of traditional SUD providers (e.g., multiple appointments & assessments prior to access to medications or counseling) and provide individuals more time to eliminate the use of all substances without the risk of being removed from treatment. For example, many individuals seeking help for a SUD are willing to abstain from some but not all substances at the start of treatment and need time to learn how to avoid using all psychoactive substances. • Bridge clinics, which are often located in emergency departments with telehealth options, are providing rapid access to medications for people with an OUD or AUD during gaps in care (Kalmin et al., 2021). Bridge clinics are also classified as low-barrier programs, with a specific focus on providing brief prescriptions of buprenorphine or other medications to individuals who are either waiting to access treatment or during gaps care. • Recovery support services (RSS), which are peer-directed programs in the community. These grass roots organizations focus on helping individuals with a SUD receive ongoing culturally tailored social support, access to needed resources
(e.g., job training, housing support, or food/clothing) and guidance on how to achieve sustainable recovery from substances (Ashford et al., 2021). The PA Department of Drug and Alcohol Services (DDAP) recently funded nine regional recovery hubs covering all PA counties to help organize existing RSS organizations as well as develop new ones. RSS programs can help individuals before, during, after or in place of traditional SUD treatment programs. Financing these noted innovations is the primary challenge associated with dissemination (Alliance for Addiction Payment Reform, 2023; Harris et al., 2023; Wallis et al., 2023). Traditional SUD treatment providers are limited in the types of services they can provide due to how services are licensed to receive public funds, limitations in how fee-for-service (FFS) payments can be earned in non-medical settings, and the overwhelming volume of paperwork and data collection requirements needed to receive FFS payment. As an example, FFS funding, based on present fee rates, would be insufficient to cover the staff time in a lowbarrier clinic where individuals receive lower volume of billable contacts, more individualized care through telehealth services (as opposed to in-office, group therapy), and flexible medical care for medication treatment. Low-barrier programs are expensive to operate because they require the integration of medical, clinical continued on next page
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This project is made possible, in whole or in part, by funds received through the Berks County Opioid Settlement Agreement. 23
FEATURE and peer staff, though without the ability to earn enough income via FFS payment options or even bill FFS when bypassing most paperwork requirements.
randomised clinical trial. Lancet Psychiatry. 2021 Apr;8(4):287-300. doi: 10.1016/S2215-0366(20)30489-2. Epub 2021 Mar 10. PMID: 33713622; PMCID: PMC9875110.
Single County Authorities (SCAs), Medicaid managed care organizations (MCOs), Health Choices directors, and commercial insurance organizations in Pennsylvania are essential to disseminating these innovations. Medicaid is the largest public payer of SUD treatment across the U.S. (Saloner et al., 2022). Health Choices directors of Medicaid, SCAs and MCOs in PA are working with treatment providers and peerdirected organizations to develop funding options to expand the use of these innovations. SUD treatment providers, healthcare providers, and peer-driven organizations can reach more individuals with a SUD, if they can be integrated into a seamless continuum of care, financed through alternative payment options, and focused on outcomes in place of excessive paperwork requirements.
Frost MC, Hawkins EJ, Glass JE, Hallgren KA, Williams EC. Associations Between Distinct Co-occurring Substance Use Disorders and Receipt of Medications for Opioid Use Disorder in the Veterans Health Administration. J Addict Med. 2023 May-Jun 01;17(3):278285. doi: 10.1097/ADM.0000000000001095. PMID: 37267168; PMCID: PMC10110763.
Cited Literature Ashford RD, Brown A, Canode B, Sledd A, Potter JS, Bergman BG. Peer-based recovery support services delivered at recovery community organizations: Predictors of improvements in individual recovery capital. Addict Behav. 2021 Aug;119:106945. doi: 10.1016/j. addbeh.2021.106945. Epub 2021 Apr 6. PMID: 33872848. Barnett ML, Meara E, Lewinson T, Hardy B, Chyn D, Onsando M, Huskamp HA, Mehrotra A, Morden NE. Racial Inequality in Receipt of Medications for Opioid Use Disorder. N Engl J Med. 2023 May 11;388(19):1779-1789. doi: 10.1056/NEJMsa2212412. PMID: 37163624; PMCID: PMC10243223. Bielenberg J, Swisher G, Lembke A, Haug NA. A systematic review of stigma interventions for providers who treat patients with substance use disorders. J Subst Abuse Treat. 2021 Dec;131:108486. doi: 10.1016/j. jsat.2021.108486. Epub 2021 May 25. PMID: 34217033. Carise D, Love M, Zur J, McLellan AT, Kemp J. Results of a statewide evaluation of “paperwork burden” in addiction treatment. J Subst Abuse Treat. 2009 Jul;37(1):101-9. doi: 10.1016/j.jsat.2008.10.009. Epub 2009 Jan 15. PMID: 19150201; PMCID: PMC2736054. Center for Behavioral Health Statistics and Quality. (2022). Results from the 2021 National Survey on Drug Use and Health: Detailed tables. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2021-nsduh-detailed-tables: State level data; Table 5.1A. Collins SE, Duncan MH, Saxon AJ, Taylor EM, Mayberry N, Merrill JO, Hoffmann GE, Clifasefi SL, Ries RK. Combining behavioral harm-reduction treatment and extended-release naltrexone for people experiencing homelessness and alcohol use disorder in the USA: a 24
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Frost MC, Zhang L, Kim HM, Lin LA. Use of and Retention on Video, Telephone, and In-Person Buprenorphine Treatment for Opioid Use Disorder During the COVID-19 Pandemic. JAMA Netw Open. 2022 Oct 3;5(10):e2236298. doi: 10.1001/jamanetworkopen.2022.36298. PMID: 36223118. Gujral K, Van Campen J, Jacobs J, Kimerling R, Zulman DM, Blonigen D. Impact of VA’s video telehealth tablets on substance use disorder care during the COVID-19 pandemic. J Subst Use Addict Treat. 2023 Jul;150:209067. doi: 10.1016/j.josat.2023.209067. Epub 2023 May 8. PMID: 37164153; PMCID: PMC10164656. Harris LM, Marsh JC, Khachikian T, Serrett V, Kong Y, Guerrero EG. What can we learn from COVID-19 to improve opioid treatment? Expert providers respond. J Subst Use Addict Treat. 2023 Nov;154:209157. doi: 10.1016/j.josat.2023.209157. Epub 2023 Aug 29. PMID: 37652210. Jones CM, Shoff C, Blanco C, Losby JL, Ling SM, Compton WM. Association of Receipt of Opioid Use Disorder-Related Telehealth Services and Medications for Opioid Use Disorder With Fatal Drug Overdoses Among Medicare Beneficiaries Before and During the COVID-19 Pandemic. JAMA Psychiatry. 2023 May 1;80(5):508514. doi: 10.1001/jamapsychiatry.2023.0310. PMID: 36988913; PMCID: PMC10061313. Kalmin MM, Goodman-Meza D, Anderson E, Abid A, Speener M, Snyder H, Campbell A, Moulin A, Shoptaw S, Herring AA. Voting with their feet: Social factors linked with treatment for opioid use disorder using same-day buprenorphine delivered in California hospitals. Drug Alcohol Depend. 2021 May 1;222:108673. doi: 10.1016/j. drugalcdep.2021.108673. Epub 2021 Mar 18. PMID: 33773868; PMCID: PMC8058318. Lowenstein M, Abrams MP, Crowe M, Shimamoto K, Mazzella S, Botcheos D, Bertocchi J, Westfahl S, Chertok J, Garcia KP, Truchil R, Holliday-Davis M, Aronowitz S. “Come try it out. Get your foot in the door:” Exploring patient perspectives on low-barrier treatment for opioid use disorder. Drug Alcohol Depend. 2023 Jul 1;248:109915. doi: 10.1016/j.drugalcdep.2023.109915. Epub 2023 May 9. PMID: 37207615; PMCID: PMC10330675.
Martin CE, Parlier-Ahmad AB, Beck L, Scialli A, Terplan M. Need for and Receipt of Substance Use Disorder Treatment Among Adults, by Gender, in the United States. Public Health Rep. 2022 SepOct;137(5):955-963. doi: 10.1177/00333549211041554. Epub 2021 Sep 21. PMID: 34546835; PMCID: PMC9379831. Messmer SE, Elmes AT, Jimenez AD, Murphy AL, Guzman M, Watson DP, Poorman E, Mayer S, Infante AF, Keller EG, Whitfield K, Jarrett JB. Outcomes of a mobile medical unit for low-threshold buprenorphine access targeting opioid overdose hot spots in Chicago. J Subst Use Addict Treat. 2023 Jul;150:209054. doi: 10.1016/j.josat.2023.209054. Epub 2023 Apr 23. PMID: 37088399; PMCID: PMC10330226. Pinedo M, Castro Y, Gilbert PA, Caetano R, Zemore SE. Improving assessment of alcohol treatment barriers among Latino and White adults with an alcohol use disorder: Development of the barriers to specialty alcohol treatment scale. Drug Alcohol Depend. 2023 Apr 28;248:109895. doi: 10.1016/j.drugalcdep.2023.109895. Epub ahead of print. PMID: 37156194. Saloner B, Li W, Bandara SN, McGinty EE, Barry CL. Trends In The Use Of Treatment For Substance Use Disorders, 2010-19. Health Aff (Millwood). 2022 May;41(5):696-702. doi: 10.1377/ hlthaff.2021.01767. PMID: 35500189; PMCID: PMC10161241. Simpson SA, Hordes M, Blum J, Rinehart D, Al-Tayyib A. Barriers to Engagement in Opioid Use Disorder Treatment After Buprenorphine Induction. J Addict Med. 2022 Jul-Aug 01;16(4):479-482. doi: 10.1097/ADM.0000000000000943. Epub 2021 Dec 23. PMID: 34954744; PMCID: PMC9549700. Smart R, Kim JY, Kennedy S, Tang L, Allen L, Crane D, Mack A, Mohamoud S, Pauly N, Perez R, Donohue J. Association of polysubstance use disorder with treatment quality among Medicaid beneficiaries with opioid use disorder. J Subst Abuse Treat. 2023 Jan;144:108921. doi: 10.1016/j.jsat.2022.108921. Epub 2022 Oct 27. PMID: 36327615. Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2020. Admissions to and Discharges from Publicly Funded Substance Use Treatment Facilities. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2022: table 9.1. Wallis R, Signorelli M, Linn H, Bias T, Allen L, Davis SM. Lessons learned from employing Medicaid-funded peer recovery support specialists in residential substance use treatment settings: An exploratory analysis. J Subst Use Addict Treat. 2023 Nov;154:209136. doi: 10.1016/j.josat.2023.209136. Epub 2023 Aug 5. PMID: 37544511.
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WWW.CARON.ORG 25
FEATURE
NALOXONE (NARCAN®)
DISTRIBUTION
The Evolution of an Innovation in Overdose Prevention 26
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Number of Narcan Kits Distributed August 2015 - October 2023 Total Distributed: 12,994 Kits
N
aloxone (Narcan®) was first distributed in Berks County in 2015 as a critical tool in curbing overdose deaths. Referred to as the “opioid overdose reversal drug,” the drug blocks the actions on the brain and respiratory systems of opioid drugs such as heroin, morphine, and fentanyl. When this innovative approach was first introduced to the community for use by non-medical professionals, there was a degree of hesitancy accompanied by stigma. With community education and training, the use of Naloxone (Narcan®) has become a widely accepted practice and the requests for this lifesaving drug by both professionals and lay persons continues to grow. Through its Naloxone Expansion Project, funded by the Pennsylvania Commission on Crime and Delinquency, the Council on Chemical Abuse is broadening its distribution to non-traditional first responders including street outreach programs, persons in recovery, persons who use drugs, family members, and health and social services agencies. Naloxone (Narcan®) will also be distributed in the “Health to Go” kiosk (vending machine) to be located in the Reading YMCA lobby. With this expanded distribution effort, Naloxone (Narcan®) will evolve from an innovation to a normalized health product to prevent opioid overdoses. 27
FEATURE
Los estudiantes de Drexel tienen la intención de llevar esperanza a las personas sin hogar en las calles de Reading Por David A. Kostival
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a crisis de los opioides recibe mucha atención negativa en las redes cada vez que hay incidentes de sobredosis trágicas. Pero también hay historias positivas y esperanzadoras que surgen de la narrativa de la crisis de los opioides. Uno de esos puntos brillantes en el condado de Berks es el recién formado Programa de Alcance Callejero de la Universidad de Drexel. El programa surgió de los esfuerzos coordinados de tres candidatos a doctorado de la clase de 2026 en la Facultad de Medicina de la Universidad de Drexel en Tower Health. Carter Van, de 23 años, de Windsor, Ontario, Canadá, dijo que el proyecto se inició al asociarse con el Proyecto de Alcance de la Naloxona. La intención es que el programa comience antes de fin de año, según Van. “La idea es que vamos a colocar regularmente una mesa en el Comedor Comunitario New Journey donde interactuaremos con la población local sin hogar y trataremos de comprender mejor sus necesidades,”
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dijo Van. “A medida que construimos relaciones con la comunidad allí, podemos adaptar los suministros que pedimos para que se ajusten mejor a sus necesidades.” El comedor de beneficencia es parte de New Journey Community Outreach, Inc., que se formó en 2014 cuando la Iglesia Metodista Unida New Journey se fusionó con la Iglesia Metodista West Lawn. La organización sin fines de lucro se encuentra en lo que se conoce como “la iglesia amarilla” en 138 South 6th St., Reading. Marquis Winston, de 26 años, de Killeen, Texas, enfatizó la necesidad de establecer comunicación con la población sin hogar. Explicó que se basa en un programa conocido como “Medicina Callejera”, que brinda atención médica a las personas sin hogar. “Queremos establecer relaciones con ellos para que se sientan lo suficientemente cómodos como para decirnos lo que realmente necesitan en lugar de que nosotros adivinemos,” dijo Winston.
Tom Parker, de 26 años, de Boston, Massachusetts, presidente del Proyecto de Alcance de Naloxona en Drexel, dijo que el alcance en las calles es otra forma de hacer llegar Narcan a quienes lo necesitan en la comunidad. Parker explicó que el equipo de calle del Programa de Alcance de la Naloxona salía con mochilas llenas de kits de Narcan y los entregaba directamente a cualquiera que quisiera uno. “Descubrimos que dábamos kits enteros de Narcan a cualquiera que los quisiera,” dijo Parker. “El alcance en la calle va a ser una forma en la que saldremos regularmente y entreguemos solo el aerosol Narcan directamente a la gente, además de todos los demás suministros.”
voluntarios regularmente y ayudar en la comunidad”, dijo Parker. “Pasamos mucho tiempo en clase hablando sobre los determinantes sociales de la salud y aprendiendo cómo la falta de vivienda afecta la salud. Pero es importante que los estudiantes salgan a la comunidad y hablen directamente con la gente sobre sus experiencias.”
Aunque el alcance en la calle es facilitado por los tres estudiantes de medicina, Parker dijo que está afiliado a Drexel. “Hay un programa de servicio comunitario llamado Health Outreach Project”, explicó Parker. “Tanto el alcance de la naloxona como el alcance en las calles están bajo la misma categoría del programa de alcance de servicio comunitario.” El nuevo alcance en las calles también cuenta con la ayuda de la Coalición Berks para Acabar con la Falta de Vivienda. Parker dijo que los estudiantes están siendo asesorados por Mike Knoll, coordinador del programa de empleo y alcance en la calle de la organización sin fines de lucro.
Parker explicó que el programa será fundamental como una forma regular de distribuir Narcan. “De esta manera, podemos entregar deliberadamente Narcan a las personas y decirles cómo usarlo”, dijo Parker. “Si podemos prevenir una sobredosis, entonces, en mi opinión, vale la pena.”
Winston dijo que el objetivo básico del programa es establecer una presencia en la comunidad y hacer saber a las personas necesitadas que es un recurso para ellos. “La Facultad de Medicina de Drexel tiene muchos recursos, y solo queremos poder brindar nuestros recursos de la mejor manera posible a la comunidad,” dijo Winston. “Los programas que ya están en Reading han sentado las bases. Están haciendo lo que pueden para acabar con la falta de vivienda y solo estamos tratando de colaborar y aprender de ellos y de las personas a las que estamos ayudando.” Parker enfatizó que también es una forma de que los estudiantes se involucren. “Los estudiantes pueden ofrecerse como
“Creo que también es importante para convertirnos en mejores médicos, porque nos hace recordar por qué nos dedicamos a la atención médica, que es ayudar a las personas,” añadió Parker.
Los kits de Narcan están siendo proporcionados por el Consejo Sobre el Abuso de Sustancias Químicas. Parker explicó que los kits de Narcan tienen instrucciones en inglés y español. “Cada vez que entregamos un kit, explicamos para qué se usa realmente Narcan, cómo usarlo, cómo reconocer una sobredosis y asegurarnos de que la persona realmente entienda lo que está pidiendo,” enfatizó Parker. “No es solo una bolsa gratis de algo. Necesitan entender Narcan y por qué es importante.” Van dijo que el plan es instalar una mesa al final de la línea de distribución de alimentos donde las personas sin hogar podrán recoger suministros. “Una vez que salimos y comenzamos a tener conversaciones con ellos, podemos interactuar con ellos y poder proporcionarles artículos específicos en lugar de solo suministros generales como productos de higiene básicos.” predijo Van.
en términos del beneficio,” explicó Van. “Como estudiantes de medicina, estamos aprendiendo más sobre las luchas que atraviesan las personas sin hogar al interactuar con ellos cara a cara.” Winston espera que el programa se expanda a otros lugares consistentes en la ciudad. “Siento que cuanto más tiempo estemos allí, más tiempo tendremos para establecer estas relaciones y podremos comenzar a guiarlos hacia otros recursos en el condado de Berks,” dijo Winston. Van cree que el programa tiene potencial de crecimiento. “Creo que la belleza de esto es que es algo longitudinal y es algo que, generacionalmente, cada año los nuevos estudiantes de Medicina que ingresan construirán sobre lo que construyeron sus predecesores,” dijo Van. Parker agregó que el programa se trata de esperanza. “Quiero que les demos esperanza y podamos conectarlos con otros recursos para ayudarlos a recuperarse,” dijo Parker.
Van agregó que el programa será beneficioso para los estudiantes de medicina. “Es en gran medida una relación bidireccional 29
FEATURE
HEALTH TO GO FREE HEALTH AND WELLNESS ITEMS AVAILABLE RIGHT HERE, WHEN YOU NEED THEM.
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Jennifer Murphy, Ph.D. Profesora Asociada de Justicia Penal, Penn State Berks
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as muertes por sobredosis continúan aumentando en el condado de Berks y se ven exacerbadas por la adulteración de drogas con sustancias altamente peligrosas como el fentanilo y la xilacina. Las soluciones innovadoras a la crisis de sobredosis son más necesarias que nunca para ayudar a las personas que corren el mayor riesgo de sobredosis de drogas a obtener naloxona, el medicamento que revierte la sobredosis de opioides. Una de esas innovaciones, un quiosco de salud interactivo, pronto estará disponible para los residentes del condado de Berks. El quiosco “Salud para Llevar” administrará artículos de salud y bienestar, incluido el aerosol nasal de naloxona que salva vidas, de forma gratuita y anónima. El quiosco, también descrito como una
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THE RESPONSE // WINTER 2023-24
máquina expendedora “inteligente,” estará abierto al público a finales de año y estará ubicado en el vestíbulo de la YMCA de Reading, 631 Washington Street. Su gran pantalla táctil interactiva mostrará los artículos disponibles, junto con los recursos locales para ayudar a las personas a acceder a la atención médica, el tratamiento de drogas y otros servicios sociales. Un equipo de investigadores de la Universidad Estatal de Pensilvania se ha asociado con S.O.S. Berks para diseñar e implementar la máquina en Reading. También evaluarán su eficacia para proporcionar suministros de reducción de daños a los residentes y reducir las muertes por sobredosis. La subvención piloto, otorgada por la Facultad de Medicina de la Universidad Estatal de Pensilvania, financia los costos iniciales de dos quioscos de salud interactivos en Pensilvania y su operación durante un año. La otra máquina estará ubicada cerca de la entrada del Departamento de Emergencias del Centro Médico de la Universidad de Pittsburg en el centro de Harrisburg. La Dra. Alice Zhang, médica de medicina familiar en Penn State Health y una de las coinvestigadoras principales del proyecto, vio el quiosco como una forma de llegar a personas que de otro modo no buscarían atención médica. “Mi deseo de ayudar a aquellos que no necesariamente ven a un proveedor de atención primaria, ya sea debido al costo, las limitaciones de tiempo o no estar listos para conectarse a la atención, combinado con el creciente número de sobredosis que aumentaron durante la pandemia de COVID-19, me motivó a implementar los quioscos Salud para Llevar. Parecía la oportunidad perfecta para entregar artículos de salud gratuitos a la comunidad, al tiempo que los conectaba con la atención al enumerar los recursos y servicios disponibles en la pantalla táctil interactiva.”
La ubicación de Reading fue elegida debido a la concentración de llamadas por sobredosis en el área y debido a la creciente disparidad racial y étnica en las muertes por sobredosis. En Pensilvania, la tasa de mortalidad por sobredosis de opioides entre las poblaciones negras e hispanas es más alta que la de las personas blancas y continúa aumentando a un ritmo desproporcionado, según los Centros para el Control y la Prevención de Enfermedades. La YMCA en el centro de Reading se ofreció a albergar la máquina en el vestíbulo de su primer piso, cerca de las otras máquinas expendedoras. Las personas podrán acceder al quiosco las 24 horas del día y no necesitan ser miembros de la YMCA para ingresar al edificio. Ken Borkey, Jr., Director de Operaciones de la YMCA de Reading y el Condado de Berks, explica por qué querían colaborar en el proyecto: “Estamos orgullosos de asociarnos con S.O.S. Berks y Penn State para albergar la máquina expendedora de naloxona en las instalaciones de la YMCA de Reading. Nuestra ubicación, en el corazón de la comunidad, es ideal para esta iniciativa que salva vidas. La Y está comprometida con el bienestar y la salud de los miembros de nuestra comunidad, y esta iniciativa se alinea perfectamente con nuestra misión más amplia de brindar apoyo y recursos para mejorar la salud y la seguridad general de nuestra comunidad.” El quiosco interactivo tendrá una gran pantalla táctil donde los usuarios podrán obtener varios artículos de salud y bienestar, incluyendo naloxona, kits de sexo seguro, bolsas de desecho de medicamentos, productos para la menstruación, pruebas de embarazo, desinfectante de manos, kits para el cuidado de heridas y pruebas de VIH. También dispensará tiras reactivas de fentanilo, para que las personas puedan detectar si el fentanilo está presente en su suministro de drogas. El fentanilo se ha detectado en casi el 67% de las muertes por sobredosis que han ocurrido en el condado de Berks en 2022. Dado que
la legislatura de Pensilvania acaba de despenalizar el uso de tiras reactivas de fentanilo a principios de este año, son una herramienta relativamente nueva para las personas y pueden proporcionar información que salva vidas sobre el contenido del suministro de drogas. Además de los artículos, los usuarios podrán utilizar el quiosco para acceder a información sobre organizaciones locales que abordan las necesidades sociales y de salud, incluido el tratamiento de drogas, la atención médica, la salud mental, la vivienda y otros servicios sociales. Debido a que el quiosco se encuentra en un lugar público y las personas pueden acceder a los artículos y la información de forma anónima sin costo alguno, tiene el potencial de disminuir el estigma que rodea el uso de drogas y el tratamiento de drogas. Si bien las agencias en el condado de Berks, incluido el Consejo Sobre el Abuso de Sustancias Químicas, brindan educación y distribuyen naloxona, una gran proporción de la población consumidora de drogas todavía no carga con naloxona. “Estos quioscos inteligentes, diseñados específicamente para la reducción de daños y la promoción de la salud, pueden ser más efectivos al reducir el estigma asociado con el acceso a los métodos tradicionales de prevención,” declara la Dra. Aleksandra Zgierska, profesora de medicina familiar y comunitaria en Penn State Health y la otra coinvestigadora principal del proyecto. Todo el texto en el quiosco, incluida la información sobre los recursos, se ofrecerá tanto en español como en inglés. Debido a la capacidad interactiva de la máquina, se pueden agregar nuevos elementos y recursos si se demuestra que son demandados por la comunidad. S.O.S. Berks y Penn State están finalizando las especificaciones de los artículos y recursos de la máquina. Prevén que la máquina estará en funcionamiento a principios de 2024.
Para obtener actualizaciones sobre el quiosco “Salud para Llevar,” visite: Health To Go Vending Machine - Coming Soon to Berks County - SOS Berks - Opioid Coalition. 31
TODAY THERE’S
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