HomeMy WebLinkAbout2018 Annual SEP ReportAlways working for a safer and healthier community
615 Sheridan Street Port Townsend, WA 98368
www.JeffersonCountyPublicHealth.org
Community Health Environmental Health
Developmental Disabilities Water Quality
360-385-9400 360-385-9444 360-385-9401 (f) (f) 360-379-4487
Jefferson County Syringe Exchange Program (SEP)
Annual Report 2018
Jefferson County Public Health (JCPH) has provided a Syringe Exchange Program (SEP) since 2000 to reduce the
risk of HIV and hepatitis C among injection drug users (IDU), their families, and communities. Additional goals
include overdose prevention, linkage to care such as medication assisted treatment (MAT) for opioid addiction,
substance abuse treatment, and medical care. The SEP is scheduled for two hours, three days per week.
Disease prevention success is not easily measured but the disease transmission prevention capacity of this
program is reflected in the number of clients seen and syringes exchanged. The number of syringes exchanged
increased slightly in 2018, to 94,140, after a substantial increase in 2017. The number of client visits decreased
slightly in 2018, to 288. 123 naloxone kits were dispensed, with 31 reported as being used to reverse an opioid
overdose. See tables and graphs on the following pages for details.
Syringe Exchange Program Goals
• Reduce risk of HIV and hepatitis C infection in our communities by providing access to anonymous, safe,
syringe exchange services. This includes providing clean syringes, other supplies, and risk reduction
education. Educating clients on the importance of using each syringe only once and avoiding sharing any
type of equipment is a key disease prevention strategy. Another key strategy is promoting revisits by
clients and encouraging clients to tell others about SEP so that staff have more face-to-face opportunities
with clients. Continued funding for the staffing of this program is essential for every goal listed.
• Prevent disease transmission by referring clients internally for HIV, hepatitis, and STD screening,
immunizations, and TB screening.
• Screen all clients for opioid use. Educate these clients about MAT and refer to a MAT provider as well as
substance abuse treatment agencies. A MAT provider clinic that bills Medicaid and will take referrals from
JCPH SEP opened in the spring of 2018.
• Prevent opioid overdoses by continuing to provide access to the overdose reversal medication naloxone
for clients that use opioids and friends or family of those at risk.
• Work with local providers to develop a referral system for clients needing medical care, including prenatal
care and hepatitis C evaluation and treatment, as well as MAT. Advocate for increased MAT options.
• Prevent unplanned pregnancies by referring SEP clients to JCPH Family Planning services.
• Assist all clients to move toward stability by referring for substance abuse treatment, medical and dental
care, mental health care, domestic violence services, shelter and housing assistance.
• Encourage uninsured clients to sign up for health insurance through www.wahealthplanfinder.org.
• If SAMHSA funding for naloxone through the Center for Opioid Safety Education (COSE) at the University
of Washington is discontinued, explore other funding possibilities.
• If WA State DOH support for purchasing supplies is discontinued, explore other possible funding options
and prioritize supplies as those deemed most necessary to maintain safer practices among IDU clients.
Inform clients of alternative safe materials, such as plastic bottles for the collection of used syringes in lieu
of sharps containers.
2018 Annual SEP Report 2
State DOH HIV prevention dollars partially funded the SEP from 2000 – 2011. Since 2012, funding for SEP staff
time has come from the County general fund. DOH provides funds to purchase syringes and other supplies. We
expect this to continue for 2019.
Figure 1: Syringe Exchange Utilization, 2004 – 2018
Table 1: Naloxone Distribution and Training Provided
First
Naloxone Kit
Naloxone
Refill1
Refills with known
OD treatment
reported1
Total Kits
distributed
2018 55 68 31 (46%) 123
2017 59 76 41 (54%) 135
2016, March-December 44 17 6 (35%) 61
Note: 1 Clients frequently reported the first kit was given away.
Table 2: Jefferson County SEP Clinic Visits/Demographics
Total SEP
Visits
New Clients Returning
Client Visits
Secondary
Exchange Visits
Female Client
Visits
Male Client
Visits
2018 288 42 246 184 107 (39%) 169 (61%)
2017 308 58 250 236 113 (37%) 195 (63%)
2016 242 28 214 159 66 (28%) 173 (72%)
2015 238 36 202 152 77 (33%) 158 (67%)
2014 350 50 300 227 199 (58%) 145 (42%)
2013 185 28 157 126 115 (62%) 70 (38%)
2012 150 18 132 96 NA NA
2011 142 19 123 110 NA NA
2010 81 13 68 40 NA NA
2009 65 12 53 35 NA NA
2008 68 6 64 67 NA NA
64 36 58 65 70 65
81
142 150 185 350 238 242 308 288
18,060
13,716 17,905
24,585
21,133 14,044
9,156
17,726 17,405
24,596
42,809
35,328
47,790
91,290
94,140
-
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
100,000
-
50
100
150
200
250
300
350
400
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 Number of Syringes ExchangedNumber of clinic visitsNumber of client visits
Number of syringes exchanged
2018 Annual SEP Report 3
Table 3: New Client Visits by Age and Gender
Female
< 20 yr
Female
20-29 yr
Female
30+ yr
Total
Female
Male
< 20 yr
Male
20-29 yr
Male
30+ yr
Total
Male
Grand
Total
2018 0 9 9 18 (43%) 0 5 19 24 (57%) 42
2017 0 15 11 26 (45%) 0 13 19 32 (55%) 58
2016 2 5 2 9 (32%) 1 5 13 19 (68%) 28
2015 0 4 9 13 (36%) 0 11 12 23 (64%) 36
2014 2 7 11 20 (41%) 3 8 18 29 (59%) 49
2013 6 4 3 13 (46%) 2 6 7 15 (54%) 28
Table 4: Total Client Visits by Age
< 20 years 20 -29 years 30+ years
2018 4 (2%) 92 (33%) 180 (65%)
2017 11 (4%) 142 (46%) 155 (50%)
2016 9 (4%) 71 (30%) 159 (66%)
2015 9 (4%) 68 (29%) 158 (67%)
2014 53 (15%) 100 (29%) 191 (56%)
2013 23 (12%) 77 (42%) 84 (46%)
Figure 2: SEP Participant Visits by Zip Code
Figure 3: SEP Participant Reported Primary Drug Used
Most participants reporting “other” for primary drug used report they are using prescription medications, usually
opioids.
57%
41%
10%
46%51%
13%
48%
40%
12%
34%40%
26%
40%44%
16%
0%
10%
20%
30%
40%
50%
60%
98368 Other within Jefferson
County
Outside Jefferson CountyPercent of Participants by Reported Zip Code2014
2015
2016
2017
2018
56%
19%18%
7%
0%
47%
19%19%
13%
2%
34%
23%
40%
2%1%
36%
27%32%
3%2%0%
10%
20%
30%
40%
50%
60%
Meth Only Heroin Only Meth and
Heroin
Other, including
other opoiods
Meth Heroin
and OtherPercent of Visits with Drug Choice2015
2016
2017
2018
2018 Annual SEP Report 4
Figure 4: SEP Participant Secondary Exchange
Figure 5: SEP Participant Reported Syringe Use, 2015 – 2018
Figure 6: SEP Participant Reported Syringe Use, 2011 – 2014
35%
18%
39%
8%
35%
21%
32%
12%
33%
11%
47%
9%
22%22%
46%
10%
34%
17%
40%
9%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
No secondary exchange Exchanging for one
other person
Exchanging for 2-5
other people
Exchanging for 6+ other
people
2014
2015
2016
2017
2018
72%
17%11%
76%
20%
4%
75%
16%9%
71%
17%12%
0%
10%
20%
30%
40%
50%
60%70%
80%
Each syringe used once Each syringe used twice Each syringe used 3+ times
2015
2016
2017
2018
49%
22%
3%
26%
64%
12%
2%
22%
64%
21%
1%
14%
67%
25%
1%7%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Each syringe used once Each syringe used 2-5times Each syringe used 6+times Unknown
2011
2012
2013
2014
2018 Annual SEP Report 5
Table 5: Materials, Education, and Referrals Provided
Syringes
Exchanged
IDU
Prevention
Materials1
Condoms/
Latex
Barriers2
Educational
Materials3
Provided
Referral
Information4
Outreach
Education5
2018 94,140 32,984 296 13 262 162
2017 91,290 39,347 305 17 179 237
2016 47,790 17,293 464 14 71 132
2015 35,328 15,414 692 19 86 109
2014 42,809 18,373 625 52 139 177
2013 24,596 15,984 377 18 129 105
2012 17,405 11,535 406 28 128 90
2011 17,726 16,512 319 10 142 86
2010 9,156 11,024 102 7 67 29
2009 14,044 7,098 271 26 51 33
2008 21,330 7,941 140 32 35 32
Notes
1 IDU Prevention Materials include: Sharps containers, tourniquets, cookers, cottons, sterile water, alcohol preps,
antibiotic ointment, band aids and sterile pads for wounds, tape. Individual items are given on an as needed basis.
2 This number is for condoms dispensed in SEP only, condoms may also be picked up in the lobby.
3 Educational Materials include information on hepatitis, HIV, STDs, health alerts (ex. wound botulism, overdose),
care of abscesses, street drugs, tattoo safety, needle reuse, IDU safety, domestic violence, immunizations, Apple
Health application.
4 Referrals: Internal referrals include STD, HIV, and Hepatitis C testing, tuberculosis testing, family planning and
immunizations. External referrals include medication assisted treatment (Suboxone, Vivitrol), drug treatment
counseling, medical care, mental health care, domestic violence, food, clothing, and shelter. A client may get
more than one referral during a visit.
5 Outreach education is defined as education on blood borne pathogens, overdose prevention, medication
assisted treatment, risk reduction methods, safe injecting practices, vein care, and other as needed.
6 N/R: Not reported
4/26/2019
Lisa McKenzie lmckenzie@co.jefferson.wa.us