In the backroom of a Homer office building on a recent Tuesday, long tables held a buffet of supplies like sterile water, tourniquets, fentanyl test strips and sharps containers. The supplies are part of a bimonthly syringe exchange.
Rhonda, who didn’t want to give her last name, walked in and got a big hug from one of the volunteers. She called the exchange a “safe place” and comes regularly for supplies.
“People are not judgmental, and they’re just doing it as a service to help people,” Rhonda said. “It could save your life, potentially. Clean supplies are a lot better than dirty ones. Trust me. I know.”
Volunteers have been running the exchange since 2016 and some of the volunteers are former customers. The program provides free syringes, opioid-overdose treatments and safer smoking supplies like pipes and Vaseline. They also offer testing on-site for HIV and Hepatitis C, which people are at higher risk for if they’re sharing needles.
Syringe access programs like the Homer exchange are shown to reduce transmission rates of HIV and hepatitis C by half, but it can be extremely challenging for people in rural Alaska to get clean supplies. It’s also hard to get new syringes without a prescription. Pharmacies are allowed to sell them without one, but it’s at the pharmacy’s discretion, and even if they choose to, the supplies can be expensive.
Dr. Sarah Spencer, an addiction medicine specialist who works at the Ninilchik Community Clinic, said the Homer exchange was Alaska’s first in-person rural syringe access program. She said people come from as far as Sterling to get supplies, about a 90-mile drive.
“They want to be healthy,” Spencer said. “They want to protect their health. They want to keep themselves safe. That’s an incredible effort for people to drive all the way down here to get those supplies.”
Spencer said people driving from that far out of town can pick up supplies for other people who need them in their home community, a system she calls “secondary peer distribution.”
“That can really help supplies to get to areas where otherwise people wouldn’t have access,” Spencer said. “And we purchase gas cards to be able to give out to people.”
Spencer said they’re also testing a mobile exchange that could serve the central Kenai Peninsula. She said the rough plan is to provide clean supplies and a practitioner who can help people in recovery with medication management–all packed into a vehicle. She said practitioners will be able to see someone for depression, anxiety, or immediate medical care. If it works well, the mobile unit will rotate among as many as four peninsula communities to reach the most people.
Spencer said their programs aim to reduce as many barriers to care as possible, and that means helping people who aren’t ready to quit using drugs. She said that’s a departure from how treatment programs have worked historically.
“No matter where you’re at in your recovery journey, and even if you’re struggling with ongoing drug use, and even maybe not having abstinence as your primary goal, there’s still things that we can do to help to improve your quality of life and reduce the risks to your health,” Spencer said.
But she said the biggest barrier to harm reduction in Alaska tends to be geography and transportation.
Jennifer Summers, who oversees the Alaska Native Tribal Health Consortium’s substance misuse prevention program, said they supply free tests for STIs, HIV, and Hepatitis C, and safer injection supplies delivered to anyone across the state. They also provide naloxone supplies and online training.
“Some of our rural communities don’t even have services that are typical of what you would think of as first responders,” Summers said. “So, our goal is to try to really make sure that people have access to Naloxone and those opioid overdose response kits, that they have training.”
New syringe access program users are five times more likely to enter drug treatment, according to the CDC, and at the Homer exchange, volunteers aim to make that path to recovery easy. Doctors and case managers at the nearby clinic are part of the program and become familiar faces, something that’s crucial for a population that typically faces discrimination and stigma in the healthcare system.
Rhonda, who gets supplies at the Homer exchange, said she likes that some volunteers are former customers.
“People eventually will probably come to a point where they feel like they don’t need to use substances,” Rhonda said. “But then there’s relapse… You just have to be patient. I’ve gone back and forth. Some days are better than others.”
She said sobriety is something she would aim for again at some point. If she’s ever ready to work towards recovery, she’s already connected with people who can help her on that journey. And if not, the Homer exchange will continue to help her and her peers stay as safe and healthy as possible.
Rachel Cassandra covers health and wellness for Alaska Public Media. Reach her atrcassandra@alaskapublic.org. Read more about Rachel here.
