The Voices for Voices TV Show and Podcast Episode 60 with Megan Scott (Harm Reduction)
Voices for Voices, Justin Alan Hayes:
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Today's episode, we are grateful to have a special guest with us, and what we're going to talk about today is maybe a little bit different than some of the other episodes that we've had, but it is very timely and the information needs to get out, and so that's what we're doing. So this episode today is going to be on harm reduction and stigma. We're going to talk about syringe exchange programs, Naloxone distribution, stigma training, among others. It's very important to talk about this in a very humanistic fashion because, as we know, we are all human beings. So joining us live in studio today is the public health coordinator at the Summit County Public Health, and she is Megan Scott, thank you for joining us.
Megan Scott:
Hi, thank for having me.
Voices for Voices, Justin Alan Hayes:
You bet. So part of what you do is around harm reduction and stigma. Can you describe maybe what that is, just for the common person?
Megan Scott:
Sure. So I am the public health coordinator for our harm reduction program. I also have a couple other projects that are all related to the opioid epidemic, and Naloxone distribution, and things like that. Harm reduction, that's a great place to start, actually, because harm reduction isn't just about substance use, substance misuse, we use that a lot as a blanket term right now, but really harm reduction is just a way to really give people the power to make their own decisions while making sure we're protecting the community in the best way that we can. So hard hats are an example of harm reduction, cigarette filters, having the Tobacco 21 rules change, that you have to be 21 years old to buy tobacco and cigarettes. Those are all types of harm reduction that have allowed us to keep our communities healthy.
Voices for Voices, Justin Alan Hayes:
Yeah. And as you're speaking through that I'm even thinking about children's toys, some of the safety features that are on those, that it's community-wide, it's not just a segment of population, which I think some may think that it only affects or is only pertinent to a certain amount of individuals. Now digging a little bit deeper, maybe talking about syringe exchange programs, what that is and why it's important.
Megan Scott:
Sure. Syringe exchange programs, syringe service programs, there's a lot of different levels of syringe service or syringe access, but basically they all have the same underlying thought process, which is that if we provide people sterile use supplies, then we're going to reduce the amount of bloodborne illness that is transmitted. So that'd be things like hep C, hepatitis C, HIV, certain STIs that can be spread through IV drug use, intravenous drug use. But we also provide a safe space for people so that we can build rapport with them, get to know them.
So it's not just syringes, actually, that we pass out, we have other sterile use supplies, like clean water, and things like that, so that people aren't having to mix their substances with unhealthy things. Wound care supplies, to make sure that they can keep any wounds clean. We have safer sex supplies, like condoms, to make sure that people are protecting themselves all around. But mostly we provide some connection to people too. So our service is managed by peer support and other people who have lived experience, and that really helps us connect with the community.
Voices for Voices, Justin Alan Hayes:
Yeah, and I'm just thinking, for my thought process, when I previously would hear syringe exchange programs, and some of those other ones, you talk about clean water to mix, and sterile supplies, some individuals, for whatever reason, they're using, and there's two ways to use, one is a little bit less safer, and one's a little bit more safer. And I think that's really the thing to think about, and not put people in a box and let them be there, it's okay, if I was in that position, as a user, would I want to be safer or want to live longer, or not? So the fact that those options and opportunities are available is, I think, very helpful after hearing how you explain it. How do individuals find out about the programs and to be able to partake in the programs, get the supplies, and some of the things that you mentioned?
Megan Scott:
Sure. Well, our program is completely anonymous, so most of it's word of mouth. So we have clients who've used us, we have clients who are currently in recovery, who have longterm recovery who used us while they were still actively using that spread the word to people who are still out there. We do have all of the information for our syringe service programs on our website, summitcountypublichealth.org, scph.org. But yeah, we don't really advertise, we don't really have to, the people who need us know that we're there and they come and meet us.
Voices for Voices, Justin Alan Hayes:
Great. Shifting the focus a little bit to Narcan distribution and availability of that. If an individual, for whatever reason, is going through an overdose and symptoms to be able to help them not continue on that negative track that could end in unfortunate death, what are you doing and the county doing to how just get that distribution of that, and what opportunities are there? If there's an organization out there, or even an individual that is thinking, maybe I interact in certain areas of the community, might be helpful to have one on me.
Megan Scott:
Yeah, we actually suggest that anybody, regardless of whether you know someone who's actively using a substance or not, carries Narcan on them. You do not have to be an illicit substance user to have an opioid overdose. So people who have maybe respiratory problems, maybe we just had surgery, we're on an opioid for pain reduction, that person could accidentally overdose if they take too many, they forget they took their pill earlier in the day. So that is somebody, we try to get the word out, that also should be cautious.
Narcan is the brand name of Naloxone, so most people know it by Narcan, but Naloxone just blocks the effects of opioids. I want to make sure that we get that out there. It is not a treatment medication, it's not going to cure anybody of their disease of addiction, and it's not going to remove the opioid from their system. So if someone is overdosing and they're given Narcan, it is very important to call 9-1-1 because they could go back into the overdose if they are not given medical attention. Yeah, it's very, yeah.
Voices for Voices, Justin Alan Hayes:
Yeah, that's intense.
Megan Scott:
So Narcan also can't get anybody high, it is very safe to be used, it can be used on pregnant women, it can be used on children should it be necessary. Again, the important thing is just to get medical attention afterwards. As for distribution, there's lots of different ways that we distribute. We are actually a partner with the Ohio Department of Health's Project DAWN program. I think we have over 30 different partners here in the county as well. So we get our Naloxone from the state, and then we have partners like the ADM board, and various other behavioral health organizations, that distribute to their clients, to their communities. Being a distributor is very simple, especially now that Narcan is considered over the counter, somebody could get ahold of us, we can get them set up, and they could have Narcan on site to pass out to whoever they feel needs it.
Voices for Voices, Justin Alan Hayes:
Yeah. And that's county-wide, so it doesn't matter what kind of an organization or, as you mentioned, as individuals, to have that on them, and if they're worried about being arrested for having it on them.
Megan Scott:
No, yeah, it's not illegal, it's completely safe. I recently went to a music festival, no one in my group of people uses any illicit substances like that, I still kept it on me just in case. Because you never know if you're in a crowd like that, you could be the person that saves someone else's life. We also partner with several of the police departments and fire and EMS jurisdictions, so they're able to leave it behind at the scene of an overdose. And actually some of our police departments here in Summit County, you can walk in and ask them for Narcan. Fire departments, some of them as well, and they can give it to you for free.
Voices for Voices, Justin Alan Hayes:
Right. So the program, touching organizations, individuals, through the police departments, fire departments, EMS, is there any area that you want to continue focusing on or getting that awareness out about a specific thing, a specific way that we can share?
Megan Scott:
Yeah. Well, it's probably not a surprise, the highest overdoses are typically in zip codes that are considered Akron. We knew that, that's not something that's a big shock, it's our largest populated part of the county, but we do have other populations of people that we try to get the word out to. For example, we know that the Black and African-American communities and the LGBTQ+ communities are heavy hit with overdose, a lot of that having to do with stigma, that struggle to ask for help, how am I going to be treated? Those kinds of things.
We also have seen a rise in polysubstance use, so people who don't know that they're getting fentanyl or another opioid mixed in with a substance like cocaine or methamphetamine could overdose because of the fentanyl that they don't know is mixed in. We also know, I don't think it's any secret that college students experiment, so recreational users, people who really aren't struggling with substance use, but might be about that age range, we want to make sure that they have Naloxone on them as well.
Voices for Voices, Justin Alan Hayes:
Yeah, and I think that another important point is, when somebody hears, "Oh, overdose," think overdose is a certain part of the population, that there are sometimes individuals that experiment and think they're getting one thing, but don't know where that one thing came from, that it could have been three things and then cut down. And I think that's a stigma in itself, of people just thinking that, oh, it's the people that use every day and multiple times a day, and it's like, it could be your son, your daughter. And we've seen unfortunate overdoses and deaths around that, it's not just that population, that it can be the high school student, the college student that is at a party and doesn't know what all's in the substances, and I think that's another important stigma to try to bust and break that, is that it's not just...
Basically overdoses doesn't know, it knows some zip codes better than others, but whether it's a gated community or not, I think that's a misnomer that's out there. It's like, "Oh, well, I live in the gated community, crime's low and we don't use and everything is fine," and then they find out that somebody overdosed and died in their community, and it's like, oh my gosh, that's hitting home. I think that's part of what you're doing is creating that awareness that it can be anybody, let's not discriminate, and we talk about specific areas, some areas might be hit a little bit harder, but it's still happening.
Megan Scott:
Mm-hmm. Yeah, for sure. I mean, addiction, again, we know is a disease, it's been recognized as a disease since I believe the 1950s, so it doesn't discriminate, just like no other disease does. Cancer doesn't discriminate, diabetes doesn't discriminate, and neither does addiction. And so as a public health department, what we try to do is provide all the necessary tools for people to make safer choices. We're not going to condone the use of the illicit substance, but we're definitely going to keep people alive until they are able to get past that disease and make some different choices. If we can get Narcan out to communities before it hits home, before a neighbor or a friend or a son or daughter overdoses, that's even better.
Voices for Voices, Justin Alan Hayes:
Absolutely. So how'd you get started with the work that you're doing? How did that interest you, and the work that you're doing and in your career, for an individual that's out there and might say, how can I get involved? And I'm thinking about majors and certificates, and those types of things, that we also want to have people that are helping others like yourself.
Megan Scott:
I accidentally got into this. I actually am in recovery myself. So I started in public health as a peer supporter on one special little project and just moved up as I saw the difference that this program was making. I'm not a peer supporter now, I am a public health coordinator. I have a degree in psychology and sociology, so I've always had that drive to really help people, and I'm nearing the end of my master's degree in clinical mental health. So all of those things are possible partially because of my recovery, but also what I do now has really guided my decision to get into mental health care.
Voices for Voices, Justin Alan Hayes:
Wow. Can you touch on maybe, you mentioned your lived experience, and if you're talking to somebody, individual, an organization, that you're able to relate on, not just the book information of, oh, well, do this because it's says so, or the definition, or the process, but being able to relate to some of the experiences that you've been through, maybe touch on that.
Megan Scott:
Yeah, for sure. Well first, I would never tell anybody I know where they are because I'm not them. They're the experts on their self, just like I'm the expert on myself. But what I can talk about is that I remember what it was like to feel that drive to have my next drink, or whatever it might have been at the time, and how it was really difficult to get past that. And it took a lot of people around me who loved me and supported me, who treated me with dignity and respect and compassion, until I got to a point where I was stronger than that disease was. So I can relay that message to people when I'm working with them.
Unfortunately, as a coordinator, I don't get at the syringe exchange clinics as often as I can, but when I do, I try to engage every client that's there, say hello, welcome them, because we're happy that they're there, we're happy that we see them. Not me personally, but the staff that works there every day, they know their names, they know their families, they know their stories, and they miss them when they don't come in. They worry about them if they don't stop by. So if we can just continue to lead by example and just tell people that they're safe and welcome, and hey, if you ever decide that you'd like to make some changes, we can connect you with the ADM, or we can connect you with housing services, then that's what we want to do, we want to be there for them.
Voices for Voices, Justin Alan Hayes:
Right. Do you happen to have an idea of how many organizations have the Naloxone kits in their premises?
Megan Scott:
Yeah, I believe we have a around 30 partner organizations that will distribute Naloxone. Some of those are behavioral health organizations, some of them are recovery organizations, safe housing, things like that. But there is also what's called a NaloxBox, which is an emergency box that has Narcan in it and an overdose response kit, kind of like an AED, but Narcan instead of the machine, and we have over 70 of those in different locations across Summit County. So those are in businesses, they are in residential areas, they are in, again, behavioral health organizations, every Summit County Public Health building has one, and if somebody is experiencing an overdose you can get Narcan with instructions, and things like that, right out of that box to help them.
Voices for Voices, Justin Alan Hayes:
Can you touch on the importance of an organization or an individual that doesn't have it and may have a stigma of, well, I don't want to get it because maybe my friends and my family and my coworkers, maybe help get through some of that stigma so we can increase that 70 to hundreds, thousands.
Megan Scott:
Well, I think the first thing is just acknowledging that substance use is going to happen. As a realistic person, realistically there is going to be substance use anywhere you go, whether you are an employer, an employee, there's probably somebody in your organization that's already using and hiding that. So the way that we look at it is why not make your organization a place where they can feel safe to come to you and ask for help? And one of the first ways to acknowledge that you want to be a safe place for your employees or your staff or your friends, or whatever it is, is to show that you're willing to have those NaloxBox or Narcan, or whatever it is, on the premises to say, hey, I understand, we're here, we'll help you stay safe.
Voices for Voices, Justin Alan Hayes:
Is there a training that an individual needs to go through to have that NaloxBox on the premises?
Megan Scott:
We usually do tie it with a Narcan use training.
Voices for Voices, Justin Alan Hayes:
Okay.
Megan Scott:
Narcan's very simple to use, it's basically like Flonase for the most part, and that way there's at least one person, if not the whole staff, on whatever site that is that's trained in how to use it, how to administer it. But that being said, it is very simple, and the NaloxBoxes do have instructions in them. So if you're just walking by and have no experience whatsoever, you'd still be able to save someone's life.
Voices for Voices, Justin Alan Hayes:
Yeah. I think that's a misnomer that might be out in somebody's head is, okay, I get this NaloxBox, there's going to be all this information, all these things that I'm going to have to do, on top of the stigma, and that might hinder them. But as you mentioned, somebody's walking by, never seen it, heard it, is able to follow those instructions.
Megan Scott:
Very simple, yeah.
Voices for Voices, Justin Alan Hayes:
Right. So what's next for you, the program? I'm guessing it's the expansion, to get those NaloxBoxes as many places as possible.
Megan Scott:
Yeah.
Voices for Voices, Justin Alan Hayes:
And can you maybe just touch on, again, where they can find them, how they can get them?
Megan Scott:
Yeah, for sure. So there's actually a couple things that we're looking at expanding right now. One thing I'm actually really excited about is we have some vending machines that we're going to be deploying, hopefully in the next few months they'll be finished, Cuyahoga County and Stark County already have them, and we'll stock them with Naloxone, but also hygiene supplies for our houseless population. There'll be information in there, resources so people can get help if they need it. And these are just like big soda vending machines, so everything in them is free, there's a short registration process for an anonymous code, and we're really excited to get those out into the community.
As for the Narcan or NaloxBoxes, you can get ahold of us at Summit County Public Health. We do have different staff members that handle it based off the type of organization, so we will just get you in touch with the right person and they'll get you all set up, come out and train staff if that's what someone needs, and give you all the information on the NaloxBox.
Voices for Voices, Justin Alan Hayes:
So they can just come by to the building itself and show up, if that's an option?
Megan Scott:
Yes.
Voices for Voices, Justin Alan Hayes:
Or do you call ahead?
Megan Scott:
Yeah, I would say call ahead, that way we can make sure the right person is available, we can schedule something. But if it is something where you just want to stop by, you're welcome to. Worst case scenario, they'll get a message to us and we'll call you back.
Voices for Voices, Justin Alan Hayes:
Great. Well Megan, thank you so much for your time with us today and sharing the important work that you and the public health department's doing in Summit County, and we hope we can just spread that awareness, not only with Summit County, but also be a trendsetter for other counties in the state of Ohio, and even the country, that there's issues going on, whether we want to think they are or not, and let's try to go the safest route possible and not judge people, I think that might be.
Megan Scott:
Yeah, absolutely. We are more than happy to be here. We say, I heard this from someone else, but as long as someone's breathing there's still hope for them, so we do our best to keep people breathing. That's really what harm reduction's about.
Voices for Voices, Justin Alan Hayes:
Great. Well, thanks so much for joining us.
Megan Scott:
Yeah, thanks for having me.
Voices for Voices, Justin Alan Hayes:
And thanks to you, our audience, our guests, our listeners, those checking out our transcript this episode. Our special guest in studio is Megan Scott, she is the public health coordinator for Summit County Public Health. All the information that she mentioned, the links, we'll be including in our show notes, and please share the word to friends, family. If you're a business owner or somebody in a place of authority that, do you want your employees to be as safe as possible regarding life in general, to have the best chance of the employee coming to work the next day? Because, I'm going to speak for myself, having skeletons in the closet, things that go on as individuals and as an organization, I think nothing better to make sure, or have the best chance of having our employees be healthy in this program, that Summit County Health Department is doing, and the series of podcasts and TV shows that we are doing is really wanting to get the awareness out to individuals, organizations, people that might be impacted by certain, maybe criminal justice things that have happened to them throughout the course of their lives.
So we want people to be healthy, we want people to be able to work, we want people to be able to have a house, to eat, if they're in an unfortunate situation, to have the Naloxone, to be able to help somebody, or having not gone through that, maybe they're able to help them themselves. So until next time, I am Justin Alan Hayes, founder and executive director at Voices for Voices, and until next time, we hope you have a great day, and please be a voice for you or somebody in need.
Please donate to Voices for Voices, a 501c3 nonprofit charity today at: https://www.voicesforvoices.org/shop/p/donate
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