A statewide collaboration between MaineHealth and several community-based organizations will expand access to harm reduction services thanks to a $1.2 million federal grant.

The program, named Project DHARMA — an acronym for “Distribution of Harm Reduction Access in Rural Maine Areas,” and a reference to the Hindu concept of duty through service to others — will be funded over the course of three years by a grant from the Substance Abuse and Mental Health Services Administration.

Project DHARMA will focus on expanding access to harm reduction supplies, such as the overdose-reversing medication Naloxone or clean needles and sterile gauze, and connecting individuals to support services, like clinical services and recovery groups. The project will also work with Colby College in Waterville to test drug samples to learn more about the contaminants circulating in Maine’s drug supplies.

The majority of this work will be done through the nonprofit harm reduction organizations Amistad, Church of Safe Injection and Maine Access Points. All three organizations are Maine Center for Disease Control and Prevention-authorized syringe access programs and collectively serve residents in all 16 Maine counties.

“This project is going to allow us to reach people in the community who otherwise aren’t connecting to services,” Zoe Brokos, executive director for the Church of Safe Injection, said Friday.

Brokos said many people who are actively using drugs do not feel safe accessing health care through a primary care physician or a local health clinic, for example. Those individuals may also not feel comfortable reaching out to recovery support services.

This means that individuals may not have access to harm reduction services, either. Harm reduction is a broadly defined term that includes providing access to harm reduction supplies, like Naloxone, as well as education and community support.

In addition to providing Naloxone, clean needles and other safe injection supplies, such as sterile water and alcohol pads, Brokos and Chasity Tuell from Maine Access Points said their organizations are looking to boost access to wound care and infectious disease treatment.

“Our syringe service programs here in the state of Maine really do operate as HIV and hepatitis prevention programs because we know that people who are connected to syringe service programs and have access to clean supplies are less likely to share their supplies or reuse their own supplies,” Brokos said.

A ‘BRIDGE’ BETWEEN

DHARMA will help provide HIV and hepatitis C testing and telehealth services as well as onsite wound care.

Would care and disease treatment can be lifesaving, both said.

“It becomes risk reduction for the whole community because keeping needles off of the street and having safe disposal options and making sure people have Naloxone and making sure that people have access to the supplies they need so they aren’t spending months and months in the hospital, you know, on IV antibiotics for something that could be really easily avoided by having access to clean syringes and clean supplies,” Brokos said.

Tuell, Maine Access Points’ Northern Maine Director of Harm Reduction Services, said some of the contaminants circulating in the drug supply are causing some “gnarly wounds.”

Some people who use drugs are not dying from overdoses, Tuell said, but from complications from blood or soft tissue infections and this program will serve as a “bridge” between individuals and health care.

She said some of these contaminants are causing “infections that have never been seen before.” One of the primary culprits is xylazine, an animal sedative that started showing up in “tranq dope” in Philadelphia over a decade ago and has exploded in New England’s drug supply over the past couple of years.

Not only can it make the effects of opioids deadlier as a sedative that slows breathing down, but it appears to be causing bizarre infections that if not treated properly, can lead to sepsis and even death, Tuell said.

This new contaminant is also why the Colby College testing program will be crucial. Unlike fentanyl test strips, for example, which provide on-the-spot results, the testing program will be able to provide something akin to public health advisories, Brokos said.

“We’ll get like a full report on each sample which is important for people to have that level of information because quite honestly, at this point in our community the majority of the substances that are on the street have some amount of fentanyl in them and most people are aware of that,” Brokos said.

The program will be able to alert communities about the potentially deadly contaminants in the drug supply.

“Being able to access this detailed level of understanding as to what is in the drug supply gives us the ability to educate on a level that we have not been able to do before,” she said.

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