Tribal Syringe Services Program Helps Reduce Harm from Injection Drug Use

EASTERN BAND OF CHEROKEE INDIANS PUBLIC HEALTH AND HUMAN SERVICES

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The Eastern Band of Cherokee Indians’ syringe services program aims to decrease the spread of bloodborne infections while helping people who inject drugs access referrals for substance use disorder treatment, medical care, and other community services.

Photo: Picture of a syringe-return kiosk

January 30, 2020

The opioid overdose epidemic in the United States has led to a dramatic increase in infections associated with injection drug use, particularly hepatitis C virus (HCV) infection. The Eastern Band of Cherokee Indians (EBCI) in North Carolina is one of many communities experiencing this surge in hepatitis C. After conducting a tribal health assessment pdf icon[PDF – 5MB]external icon in 2018, EBCI made hepatitis C prevention one of the tribe’s top 10 public health priorities.

The rising rate of hepatitis C, coupled with an increase in injection drug use, prompted EBCI health officials to create the Tsalagi Public Health Syringe Services Programexternal icon in 2018. This comprehensive harm reduction initiative aims to decrease the spread of bloodborne infections while also enabling people who inject drugs to access referrals for substance use disorder treatment, medical care, and other community services.

The program offers a variety of public health services, resources, and supplies to participants—

  • Sterile syringes and other equipment for safer injection, such as tourniquets, alcohol pads, sterile water, anti-bacterial ointment, and sharps containers to store used syringes
  • 20 syringe-return kiosks placed across the tribal lands
  • Education on safer injection practices
  • HIV and HCV testing
  • Referrals for substance use disorder treatment, medical care, and community resources
  • Distribution of naloxone for opioid overdose reversal

A priority of the program is to build trusting, meaningful relationships with participants by providing a safe environment that is anonymous and free of judgement. Outreach workers foster this relationship by answering questions about recovery and making sure participants are aware of the many services the program provides. This connection and trust are formed between staff and participants with the hope that they will seek treatment for substance use disorder and other health conditions.

The program is already having a positive impact on the EBCI community, with—

  • 570 participants and counting
  • 400+ referrals made for various services throughout the community, including an estimated 40 participants who have accessed treatment for substance use disorder
  • More than 2,500 naloxone injections or nasal sprays dispensed, and 406 opioid overdose reversals reported

For more information
Vickie L. Bradley, Secretary, Public Health and Human Services, Eastern Band of Cherokee Indians

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Disclaimer: Field Notes is designed to spotlight success and innovation in state, tribal, local, and territorial (STLT) health agencies. It is part of the Centers for Disease Control and Prevention’s (CDC’s) effort to highlight what is happening on the front lines of public health. The information in Field Notes is provided by STLT agencies external to CDC. Provision of this information is for informational purposes and does not necessarily constitute an endorsement, recommendation, and/or represent the views of CDC.

Page last reviewed: January 30, 2020