♪ MUSIC REPORT FROM SANTA FE IS MADE POSSIBLE IN PART BY GRANTS FROM THE NEW MEXICO MUNICIPAL LEAGUE, A BETTER NEW MEXICO THROUGH BETTER CITIES, AND FROM THE HEALY FOUNDATION.

TAOS, NM.

HELLO, I'M LORENE MILLS AND WELCOME TO REPORT FROM SANTA FE .

I'M HAPPY TO SAY OUR GUEST TODAY IS JOSH SWATEK, DID I SAY IT RIGHT, WHO IS POLICY DIRECTOR WITH THE NEW MEXICO DEPARTMENT OF HEALTH.

ONE OF THE REASONS I'M PARTICULARLY EXCITED TO HAVE YOU HERE IS THAT YOU ARE AN EXPERT IN WHAT'S CALLED HARM REDUCTION, THAT'S A TANTALIZING CONCEPT.

FIRST I WANT YOU TO TELL ME A LITTLE ABOUT YOUR BACKGROUND AND WHAT STEPS YOU'VE BEEN ON IN PURSUING HARM REDUCTION AND THEN WHAT IS HARM REDUCTION, WHO CAME UP WITH THAT TERM?

>>JOSH: ABSOLUTELY, THANK YOU FOR HAVING ME TODAY, I'M REALLY EXCITED TO TALK ABOUT THIS.

>>LORENE: YES, ME TOO.

>>JOSH: SO MY BACKGROUND IS I STARTED DOING HARM REDUCTION WORK REALLY IN COLLEGE, ONE OF THE FIRST JOBS THAT I HAD WAS DOING ALCOHOL-BASED HARM REDUCTION AS A PEER EDUCATOR TO HELP REDUCE HARMS OF ALCOHOL USE AMONG COLLEGE STUDENTS.

WHEN I GRADUATED, I GOT A JOB AS A HARM REDUCTION PROGRAM MANAGER, SORT OF, I MANAGED A SMALL HARM REDUCTION PROGRAM IN ALBUQUERQUE, DID THAT FOR A FEW YEARS.

>>LORENE: AND WHAT HARMS WERE THEY SEEKING TO REDUCE?

>>JOSH: THEY WERE REDUCING, PRIMARILY, WE WORKED A LOT WITH PEOPLE WHO WERE USING HEROIN, YOU KNOW, ILLICIT SUBSTANCES, THOSE SORTS OF THINGS.

SO, PEOPLE WHO WERE INJECTING DRUGS, THAT'S THE POPULATION THAT WE WERE WORKING WITH.

I RAN THAT, I DID A LOT OF OUTREACH, DID OUTREACH WITH INDIVIDUALS WHO WERE EXPERIENCING HOMELESSNESS, THAT WAS THE COMMUNITY THAT I STARTED WORKING WITH.

I REALLY DEVELOPED A PASSION IN THAT JOB WORKING DIRECTLY WITH THE COMMUNITY.

AFTER THAT, I CAME TO THE STATE HEALTH DEPARTMENT.

I GOT MY FIRST JOB HERE, I WAS THE DEPARTMENT OF HEALTH'S FIRST OVERDOSE PREVENTION COORDINATOR BACK IN 2014.

>>LORENE: OH MY GOODNESS, BACK IN 2014?

>>JOSH: BACK IN 2014, THAT WAS OUR STATE'S FIRST OVERDOSE PREVENTION COORDINATOR.

>>LORENE: HOW DID THAT WORK OUT?

>>JOSH: IT WORKED OUT GREAT, WE ACTUALLY MADE SOME REAL CHANGES.

WE WERE ABLE TO PASS SOME LAWS THAT EXPANDED THE AVAILABILITY OF NARCAN, WHICH IS THE OVERDOSE REVERSAL DRUG AND WE WERE REALLY ABLE TO EXPAND THE PROGRAM.

FROM THERE, I WENT INTO VIRAL HEPATITIS PREVENTION AND HIV PREVENTION, I EVENTUALLY RAN THE STATEWIDE HARM REDUCTION PROGRAM, WHICH NEW MEXICO IS A LEADER IN.

THEN THAT LED ME TO HERE, TODAY, AS THE POLICY DIRECTOR FOR THE DEPARTMENT OF HEALTH.

>>LORENE: THANK YOU FOR ALL THAT YOU'VE DONE.

ONE THING THAT YOU MENTIONED IN PASSING ABOUT NARCAN, TALK TO ME ABOUT TRANK AND WHY NARCAN IS NO LONGER EFFECTIVE, BECAUSE THEY'VE ADDED XYLOCAINE, WHAT IS IT CALLED?

>>JOSH: XYLOSINE.

SO WHAT WE'RE SEEING RECENTLY IS THEY'RE ADDING TRANQUILIZERS.

YOU'VE MENTIONED TRANK, THERE'S ALSO SOMETHING CALLED MEDETOMIDINE, IT'S A STRONGER VERSION OF THAT, AND THEY'RE BASICALLY VETERINARY TRANQUILIZERS.

AND THEY'VE BEEN ADDED TO WHAT'S IN OUR SUPPLY NOW, WHICH IS PRIMARILY FENTANYL AND SINCE THEY'RE NOT OPIOIDS, NALOXONE DOESN'T WORK ON THEM.

BUT SINCE THEY'RE MOST COMMONLY MIXED WITH FENTANYL OR OTHER OPIOIDS IN THE ILLICIT DRUG SUPPLY, NALOXONE WILL WORK ON THE OPIOID, BUT THE PERSON WILL STILL BE PASSED OUT BECAUSE THE TRANQUILIZER IS STILL IN EFFECT.

SO WE STILL TELL PEOPLE, MAKE SURE YOU'RE GIVING PEOPLE NALOXONE BECAUSE THEY MAY BE OVERDOSING ON BOTH.

THEY'LL START BREATHING AGAIN, BUT THEY MIGHT NOT WAKE UP, WHICH IS IMPORTANT TO MAKE SURE THAT PEOPLE ARE BREATHING, RIGHT, THAT'S REALLY KEY.

SO THAT'S WHAT WE'VE STARTED SEEING MORE AND MORE OF THAT RECENTLY HERE IN NEW MEXICO AND WE WANT TO MAKE SURE THAT WE'RE ADDRESSING THE CHANGING SUPPLY THAT WE'VE REALLY SEEN SINCE ABOUT 2019, WHEN WE SAW THE SHIFT FROM BLACK TAR HEROIN TO FENTANYL.

>>LORENE: THERE HAVE BEEN MANY SHIFTS IN THE ABUSE OF ILLICIT DRUGS, BUT WASN'T THERE ONE WHEN THEY WENT RIGHT FROM SHOOTING UP TO SMOKING, SMOKING THE DRUG, TALK TO ME ABOUT THAT.

>>JOSH: YEAH, THAT HAPPENED REALLY PRETTY QUICKLY.

IT WAS THE MOST QUICKLY I'VE EVER SEEN THE SUPPLY AND THE ROUTE OF ADMINISTRATION CHANGE.

SO BLACK TAR HEROIN WAS PRIMARILY INJECTED AND DEALT WITH THAT IN NEW MEXICO FOR A LONG TIME, BUT WHEN IT SWITCHED TO FENTANYL, THAT'S PRIMARILY SMOKED.

SO PEOPLE WILL SMOKE THAT OFF OF FOILS, SO WE HAD TO ADJUST HOW WE DO HARM REDUCTION BECAUSE PEOPLE CHANGE THE WAY THAT THEY CONSUME, LIKE YOU MENTIONED.

>>LORENE: YEAH, WHAT'S THE FATALITY RATE OF FENTANYL, HOW MANY, IF YOU, I DON'T WANT TO SPRING THIS ON YOU, BUT HOW MANY FATALITIES DO WE HAVE A YEAR FROM FENTANYL OVERDOSES, YOU MAY NOT HAVE THIS INFORMATION.

>>JOSH: I DON'T HAVE THAT EXACT NUMBER.

>>LORENE: IS IT HORRIBLE, IS IT SOMETHING TO PAY ATTENTION TO?

>>JOSH: IT IS ABSOLUTELY SOMETHING TO PAY ATTENTION TO.

WE'VE SEEN THE MORTALITY INCREASE OVER THE PAST YEAR, OVER 20% FROM THE PREVIOUS YEAR, SO THAT'S SOMETHING THAT WE REALLY WANT TO PAY ATTENTION TO BECAUSE WE SAW THAT SPIKE IN 2019 AND 2021, YOU KNOW, AND THEN WE SAW A DECLINE IN 23 AND 24, THEN TO 25 AND THEN THROUGH 25 TO 26, THROUGH JANUARY 2025 TO JANUARY 2026, WE SAW THAT OVER 20% INCREASE.

YEAH, IT'S SOMETHING THAT WE'RE ADDRESSING AS A HEALTH DEPARTMENT, WE'VE STOOD UP AN INCIDENT COMMAND STRUCTURE, WE'RE MEETING WEEKLY AND WE'RE WORKING WITH OUR LOCAL PARTNERS, OUR LOCAL COMMUNITIES TO PROVIDE NALOXONE, PROVIDE EDUCATION, TO REACH POPULATIONS THAT WE HADN'T BEFORE.

SO WE'RE SORT OF ALL HANDS-ON DECK TO ADDRESS THAT.

>>LORENE: YOU WOULD THINK THAT THE PEOPLE WHO ARE PROVIDING THE ILLICIT DRUGS WOULD NOT WANT TO KILL OFF THEIR CUSTOMERS AND YET, THAT IS VERY MUCH WITH THESE CHANGES THAT HAVE COME ABOUT, WE'RE LOSING MANY MORE USERS BEFORE WE CAN DO, LIKE YOU SAY, A HARM REDUCTION AND COMMUNITY INTERVENTION.

SO HOW DO WE SHIFT THE DIRECTION, HOW DO WE STOP THE TITANIC AND, YOU KNOW, MAKE IT GO THIS WAY, BECAUSE I JUST THINK IT'S SO SAD THAT PEOPLE, THERE'S ONLY ONE WAY, AS EXPERTS WE KNOW, THIS ENDS UP ONLY TO DOWNHILL SLIDE.

BUT THE PEOPLE WHO ARE JUST GETTING ON AT THE TOP OF THE ROLLERCOASTER ARE THINKING, OOH, MY COUSIN SAID IT WAS COOL, AND YOU KNOW, ALL THIS, AND THEN BOOM.

YOU'RE DOING SOME COMMUNITY INTERVENTION, TALK TO ME ABOUT WHAT YOU THINK THE BEST WAY TO ADDRESS THIS PROBLEM IS.

>>JOSH: I DON'T THINK THERE'S A SINGLE BEST WAY, I DON'T THINK THERE'S ONE SINGLE MAGIC BULLET THAT CAN SOLVE THE ISSUE, I THINK IT HAS TO BE A COMBINATION OF STRATEGIES.

FIRST, HARM REDUCTION, MEETING PEOPLE WHO ARE ACTIVELY USING SUBSTANCES WHERE THEY'RE AT TO REDUCE THE POTENTIAL NEGATIVE HEALTH CONSEQUENCES OF SUBSTANCE USE.

I'M NOT JUST TALKING ABOUT OVERDOSE, I'M TALKING ABOUT INFECTIOUS DISEASE, WOUNDS, VISITS TO ER, THOSE SORTS OF THINGS.

WE HAVE TO ADDRESS SUBSTANCE USE BY TREATING PEOPLE WHO ARE ACTIVELY USING WITH THINGS LIKE BUPRENORPHINE, METHADONE, MEDICATIONS FOR OPIOID USE DISORDER.

THERE'S ALSO ELEMENTS THAT ARE INVOLVED WITH LAW ENFORCEMENT AND BEHAVIORAL HEALTH.

SO REALLY, I THINK ADDRESSING THIS ISSUE IS MULTIFACETED, AND IT HAS TO COME FROM MULTIPLE DIFFERENT ANGLES TO BE REALLY SUCCESSFUL.

>>LORENE: YEAH, I KIND OF ROCK BACK WHEN I REALIZED, AS YOU SAY, HOW COMPLICATED IT IS AND THAT THERE'S NO ONE-SIZE-FITS-ALL.

THEN YOU'RE DEALING WITH PERHAPS PEOPLE WHO ARE NOT SEEKING HELP.

>>JOSH: THAT'S WHERE HARM REDUCTION COMES IN, THAT'S REALLY WHERE THAT HARM REDUCTION PHILOSOPHY COMES IN BECAUSE FOLKS WHO ARE USING SUBSTANCES OFTENTIMES, THEY FACE A LOT OF STIGMA WHEN THEY'RE INTERFACING WITH THE COMMUNITY IN GENERAL, WHEN THEY'RE INTERFACING WITH HEALTHCARE, LAW ENFORCEMENT, AND JUST OUR COMMUNITY.

SO HARM REDUCTION IS THERE TO PROVIDE A FRIENDLY FACE.

WE'RE SORT OF THAT BRIDGE BETWEEN SOMEONE WHO'S REALLY NOT SEEKING TREATMENT, THEY MIGHT NOT BE SEEKING CHANGE AT THAT TIME TO CHANGING THEIR BEHAVIOR TO EVENTUALLY STOPPING USING.

HARM REDUCTION HAS BEEN HIGHLY SUCCESSFUL AT THAT OVER THE YEARS, ACCORDING TO MANY PEER-REVIEWED ARTICLES.

>>LORENE: YEAH, AGAIN, I'M IN AWE OF THE CHALLENGES THAT YOU FACE AND WE KNOW THE COMMUNITY IS INVOLVED, BUT HOW MUCH IS THE STATE DOING AND THE DEPARTMENT OF HEALTH DOING TO MAKE THIS A MORE SUCCESSFUL OUTCOME?

>>JOSH: SO WE'RE DOING QUITE A BIT.

WE'RE DOING A SUBSTANTIAL AMOUNT AS A STATE.

SO IN 2023, WE PASSED A LAW TO EXPAND THE PROVISION OF THE HARM REDUCTION ACT.

SO LIKE I HAD MENTIONED, THE HARM REDUCTION PROGRAMS WERE FOCUSED ON INJECTION SUBSTANCE USE.

WE HAD THAT SWITCH TO FENTANYL, SO WE HAD TO ADJUST.

WE HAD TO ADJUST WITH OUR CLIENTELE.

AND SO SINCE THAT EXPANSION, YOU KNOW, THAT YEAR WE HAD WE WERE ENGAGING SOMEWHERE AROUND 9,000 PEOPLE.

THIS LAST YEAR, WE'RE UPWARDS OF 19,000 PEOPLE THAT ARE ENGAGED IN THE PROGRAM.

WE ARE HANDING OUT NALOXONE LEFT AND RIGHT, WE'RE HANDING OUT OVER 50,000 DOSES OF NALOXONE THROUGH OUR PROGRAMS AND I THINK THE LAST YEAR THAT WE HAD RECORDED, WE HAD OVER 6,000 OVERDOSE REVERSALS REPORTED TO US.

SO THAT MEANS 6,000 LIVES.

>>LORENE: BLESS YOU.

>>JOSH: SO THAT'S SOMETHING THAT WE'RE REALLY FOCUSING ON GETTING THE WORD OUT TO THE PEOPLE WHO ARE USING SUBSTANCES.

BUT NOT JUST THAT, WE'RE FOCUSING ON MAKING SURE THAT EMS HAS NALOXONE, WE'RE FOCUSING ON MAKING SURE THAT THE COMMUNITY, PEOPLE AROUND THOSE WHO MIGHT BE USING SUBSTANCES, ARE USING NALOXONE.

AND WITH THIS INCREASE IN THIS SPIKE THAT WE'VE SEEN, WE'RE TRYING TO MAKE SURE THAT WE'VE REALLY SATURATED THE COMMUNITY, THAT EVERYONE THAT NEEDS IT OR EVEN PEOPLE WHO MIGHT NOT NEED IT, WHO MIGHT JUST BE WALKING DOWN THE STREET HAS ACCESS TO NALOXONE.

>>LORENE: I ACTUALLY HAVE A BOX IN MY GLOVE COMPARTMENT.

>>JOSH: EXCELLENT.

I'M GLAD.

>>LORENE: JUST IN CASE I'M WALKING BY, YOU KNOW, BECAUSE YOU GIVE THEM OUT FOR FREE AND IT COULD BE IT COULD SAVE A LIFE.

SOMEBODY WHO MADE A MISTAKE, WHO DIDN'T THINK IT THROUGH.

>>JOSH: RIGHT.

>>LORENE: THAT THERE'S HELP RIGHT THERE AND THEY'RE AVAILABLE, I THINK.

CAN YOU CALL THE DEPARTMENT OF HEALTH AND GET SOME?

>>JOSH: YOU CAN GO TO ANY OF OUR PUBLIC HEALTH OFFICES, YOU CAN GO TO NMHARMREDUCTION.ORG AND GET IT DELIVERED.

>>LORENE: OH, MY GOD.

>>JOSH: DIRECTLY TO YOUR DOORSTEP.

>>LORENE: THAT'S WONDERFUL, SAY THAT WEBSITE AGAIN.

>>JOSH: IT IS NMHARMREDUCTION.ORG >>LORENE: AND YOU CAN ASK FOR NALOXONE.

>>JOSH: THERE'S A LINK THERE YOU CAN CLICK AND THEY'LL DELIVER IT RIGHT TO YOUR HOUSE.

>>LORENE: YOU'RE SAVING LIVES JUST TELLING US ABOUT IT, THANK YOU VERY MUCH, BECAUSE THE PATIENT OR THE USER PROBABLY DIDN'T PLAN THIS WOULD BE THEIR LAST GASP.

SO THAT IF YOU CAN INTERVENE AND BRING IT BACK, THERE'S A WHOLE LOT OF, AS YOU SAY, BEHAVIORAL HEALTH ISSUES AND IT'S A LONG PROCESS, BUT TO HAVE THE RAW MATERIALS AVAILABLE FOR FREE ANYWHERE ANYTIME, THANK YOU VERY MUCH.

>>JOSH: WE'RE GLAD TO HELP NEW MEXICANS AND MAKE THAT AVAILABLE TO ANY CITIZEN OR ANY PERSON THAT'S IN NEW MEXICO.

ANOTHER THING I THINK WE SHOULD MENTION IS THAT OUR PUBLIC HEALTH OFFICES ALSO OFFER MEDICATIONS FOR OPIOID USE DISORDER.

YOU CAN GO TO A PUBLIC HEALTH OFFICE, AND IF YOU'RE USING SUBSTANCES, YOU'RE USING OPIOIDS, AND YOU COULD REGULARLY BE ATTENDING A HARM REDUCTION PROGRAM AND THEN ONE DAY YOU DECIDE, YOU KNOW WHAT, TODAY, I WOULD LIKE TO START, THE PROCESS OF GETTING OFF IT.

YOU CAN DO THAT IN OUR PUBLIC HEALTH OFFICES, YOU CAN GET AN APPOINTMENT, THEY'LL PROVIDE YOU WITH THE APPROPRIATE MEDICATIONS0 >>LORENE: RIGHT, SO IT'S NOT EXCRUCIATING.

>>JOSH: SO WHEN SO SOMEONE DOESN'T HAVE TO GO THROUGH THAT FULL DETOX OR, YOU KNOW, THESE ARE MEDICATIONS THAT ARE REALLY DESIGNED TO TREAT SUBSTANCE USE DISORDER.

THEY'RE PROVEN TO BE EFFECTIVE, AND WE HAVE THAT AVAILABLE THROUGH OUR HEALTH OFFICES AS WELL.

WE'RE TRYING TO PROVIDE THAT FULL PERSON SUPPORT FOR OUR COMMUNITIES.

>>LORENE: WELL, WE'RE SPEAKING TODAY WITH JOSH SWATEK, AND I'M SO GRATEFUL FOR WHAT YOU'RE DOING, BUT I'M ESPECIALLY GRATEFUL THAT YOU'RE COMING ON HERE TO TALK ABOUT IT, TO LET PEOPLE KNOW WHAT'S AVAILABLE AND THAT YOU'VE GOT THEIR BACK IF THEY NEED IT.

>>JOSH: WE DO.

THAT'S OUR JOB AS NEW MEXICANS AND IT'S ALSO WHAT WE DO AS HARM REDUCTIONISTS.

WE SUPPORT OUR COMMUNITY AND THAT'S REALLY WHERE HARM REDUCTION GOT ITS START TOO.

HARM REDUCTION GOT ITS START BY PEOPLE WHO CARE ABOUT PEOPLE WHO USE SUBSTANCES, WHO CARE ABOUT THEIR NEIGHBORS.

HELPING, YOU KNOW, IN THE UNITED STATES, IT STARTED WITH A GUY THAT WAS THAT PURCHASED SYRINGES OUT OF HIS OWN POCKET AND HAD A TV DINNER TRAY AND WOULD HAND THEM OUT THAT WAY AND THEY WOULD GET NALOXONE FROM, YOU KNOW, EMS BEFORE IT WAS REALLY ILLEGAL.

SO THAT'S, YOU KNOW, WAY, WAY BACK IN THE 80S, THAT'S HOW IT STARTED.

>>LORENE: SO WHO WAS THIS JOHNNY APPLESEED WHO SAW THE PROBLEM AND SAW THAT HE COULD HELP?

>>JOSH: THAT WAS THAT WAS DAVE PURCHASE IN WASHINGTON.

HE WAS A COMMUNITY MEMBER WHO WAS REALLY CREDITED WITH REALLY STARTING THE HARM REDUCTION MOVEMENT IN THE UNITED STATES.

>>LORENE: OH, MY GOODNESS.

>>JOSH: AND THEN, YOU KNOW, NEW MEXICO, WE GOT ON BOARD AS A STATE BEFORE ANY OTHER STATE, REALLY PASSED THAT LAW IN 97 AND STARTED DOING SERVICES IN 98, SO WE WERE REALLY A PIONEER IN THAT AREA AND WE WERE ALSO THE FIRST STATE TO ALLOW FOR NALOXONE DISTRIBUTION IN THE EARLY 2000S.

SO WE'VE BEEN PIONEERING, WE'VE BEEN AHEAD OF THE GAME ON THESE PROGRAMS BECAUSE, YOU KNOW, THE LEGISLATURE AND THE GOVERNOR AT THE TIME REALLY SAW THE NEED, THEY SAW THE DATA AND HOW IT SUPPORTED HARM REDUCTION ACTIVITIES, AND THEY PUT THE PROGRAM INTO PLACE.

>>LORENE: I'M REALLY HAPPY TO HEAR THAT BECAUSE IN THOSE EARLY DAYS IT WAS LIKE, OH, IT SUCKS TO BE YOU, YOU'RE AN ADDICT, YOU CHOSE THIS PATH, WE'RE NOT GOING TO HELP YOU, BUT TO STEP FORWARD TO BE THE FIRST STATE THAT DID THIS KIND OF HARM REDUCTION IS I'M VERY PROUD, MOVED BY IT.

>>JOSH: IT'S GREAT AND I THINK IT JUST SHOWS, YOU KNOW, ONE OF THE BEST QUALITIES OF NEW MEXICANS IS WE LIKE TO TAKE CARE OF EACH OTHER.

I THINK THAT REALLY GOES TO SHOW HOW MUCH WE CARE ABOUT EACH OTHER, WE'RE INNOVATIVE AND WE'RE AHEAD OF THE CURVE WHEN WE'RE TAKING CARE OF, YOU KNOW, LOTS OF DIFFERENT POPULATIONS AND LOTS OF DIFFERENT COMMUNITIES.

WE WANT TO MAKE SURE THAT PEOPLE ARE SAFE AND THEY HAVE ACCESS.

>>LORENE: I THINK, YOU KNOW, RAM DASS, WHO'S NAME WAS RICHARD ALPERT, HE KEPT SAYING WE'RE ALL JUST WALKING EACH OTHER HOME AND THAT'S A BEAUTIFUL WAY BECAUSE WE'RE SUCH A COMMUNITY-ORIENTED STATE AND THAT IT'S SIMPLY BEING SURE YOU GET HOME SAFE.

IT'S NOT LIKE YOU'RE BAD, YOU'RE HORRIBLE, HOW DARE YOU, ITS LIKE, IT'S HARM REDUCTION, A BEAUTIFUL TERM.

>>JOSH: YEAH, IT IS.

I REALLY LIKE HOW YOU DESCRIBE THAT, I THINK I'M GOING TO STEAL THAT AND USE IT IN SOME OF MY TRAININGS, THAT'S A GREAT ANALOGY, WALKING SOMEONE HOME.

WE ALSO PROVIDE SERVICES FOR PEOPLE WHO ARE OFTEN IGNORED IN THE COMMUNITY, TOO.

>>LORENE: LIKE WHOM?

>>JOSH: WE WORK WITH, YOU KNOW, POPULATIONS WHO ARE EXPERIENCING HOMELESSNESS, WHO PEOPLE WHO MIGHT WALK BY.

SO WE'RE ACTIVELY REACHING OUT TO THOSE GROUPS, RIGHT, WE'RE ACTIVELY REACHING OUT TO COMMUNITY MEMBERS THAT MIGHT HAVE THE HARDEST TIME GETTING SERVICES, WHO MIGHT BE IN THE TOUGHEST PLACES, AND THAT'S REALLY THE CORE OF HARM REDUCTION, TOO.

SUBSTANCE USE IMPACTS SO MANY DIFFERENT COMMUNITIES, IT DOESN'T IMPACT JUST ONE COMMUNITY, IT IMPACTS EVERYONE ACROSS SOCIOECONOMIC SPECTRUMS, AND WE WORK WITH EVERYONE ACROSS THOSE SOCIOECONOMIC SPECTRUMS.

>>LORENE: WELL, A PERCENTAGE OF THOSE PEOPLE ARE GRATEFUL FOR THE HELP AND SOME REJECT IT, SO HOW DO YOU GET PAST THAT.

YOU KNOW, I'M FINE, DON'T BOTHER ME, I DON'T NEED ANYBODY TO WALK ME HOME.

>>JOSH: I WOULD SAY THAT MOST PEOPLE THAT ARE COMING TO US, YOU KNOW, IT TAKES TIME TO DEVELOP RELATIONSHIPS BECAUSE THAT'S WHAT HARM REDUCTION IS REALLY ABOUT.

IT'S ABOUT BUILDING RELATIONSHIPS WITH COMMUNITY MEMBERS.

PEOPLE, YOU KNOW, FREQUENTLY THINK THAT HARM REDUCTION IS ABOUT HANDING OUT SAFE SUPPLIES, THAT'S AN ASPECT, BUT A MORE IMPORTANT ASPECT IS THE RELATIONSHIPS THAT OUR HARM REDUCTION SPECIALISTS BUILD WITH PEOPLE AND IT TAKES TIME TO BUILD TRUST.

EVENTUALLY, THAT TRUST DOES GET BUILT UP, AND WE ARE THERE FOR THE MOMENT THAT PERSON SAYS, YOU KNOW WHAT, THEY MAKE THAT DECISION FOR THEMSELVES.

THEY'RE LIKE, TODAY IS THE DAY THAT I WOULD LIKE TO MAKE THAT CHANGE AND WE THERE FOR THEM, AND WE WORK WITH THEM AND FIGURE OUT WHAT WORKS BEST FOR THEM TO MAKE THAT CHANGE BECAUSE WE KNOW THERE'S NOT A ONE-SIZE-FITS-ALL SOLUTION.

RECOVERY IS VERY RARELY JUST A LINEAR PROCESS, THERE'S RECOVERY, AND THERE'S RELAPSE, AND YOU KNOW, AND WE'RE THERE TO SUPPORT PEOPLE ALL THROUGHOUT THAT STAGE AND IF THEY DON'T WANT OUR HELP RIGHT THEN, THAT'S OKAY, BUT WE'RE STILL GOING TO BE THERE FOR THEM.

>>LORENE: THANK YOU VERY MUCH.

I HOPE PEOPLE REALLY HEAR THAT.

I HOPE THE PEOPLE HAVE EARS TO HEAR WHAT YOU'RE OFFERING BECAUSE IT'S SORT OF THE BEST THAT NEW MEXICO ALWAYS IS THE COMMUNITY FOR THE LESSER AND THE GREATER MEMBERS, WE'RE ALL IN THIS TOGETHER.

>>JOSH: WE ARE, WE ABSOLUTELY ARE.

>>LORENE: SO WHAT KIND OF OUTREACH DO YOU HAVE, ALL THESE PROGRAMS AVAILABLE THROUGH THE DEPARTMENT OF HEALTH IN THE PUBLIC HEALTH OFFICES, DO YOU DO ANY DRIVES TO TRY TO GET MORE PEOPLE AWARE BECAUSE I'M HAPPY TO HELP.

I THINK IT'S REALLY IMPORTANT WHAT YOU'RE DOING.

>>JOSH: SO WE DON'T JUST PROVIDE SERVICES JUST IN OUR PUBLIC HEALTH OFFICES; WE ALSO WORK WITH OUR COMMUNITY PARTNERS.

THEY GO OUT INTO THE COMMUNITY, AND WE GO OUT INTO THE COMMUNITY, TOO, WE HAVE MOBILE UNITS, AND WE GO OUT TO WHERE PEOPLE ARE, AND I THINK THOSE ARE REALLY SUCCESSFUL, TOO, ESPECIALLY IN RURAL NEW MEXICO, WE'RE GOING TO WHERE THE PEOPLE ARE AT WHO NEED OUR SERVICES, WHO MIGHT HAVE TROUBLE GETTING TRANSPORTATION.

SO WE'RE BRINGING HARM REDUCTION SERVICES, WE'RE BRINGING PUBLIC HEALTH SERVICES DIRECTLY TO OUR COMMUNITY MEMBERS AND I THINK THAT'S WHAT ALSO MAKES US REALLY SUCCESSFUL.

WE'RE NOT JUST SITTING BACK AND WAITING FOR PEOPLE TO COME TO US, WE'RE GOING TO THEM.

>>LORENE: AND THERE MIGHT BE CERTAIN AREAS OF THE STATE WHERE PEOPLE ARE NOT SO INTERESTED IN WALKING EACH OTHER HOME AND THEN YOU SHOW UP AND SAY, WELL, WE ARE.

>>JOSH: WE'RE HERE, COME WITH US, WE'LL HELP YOU OUT.

>>LORENE: SO HOW CAN I HELP?

I WANTED TO TALK TO YOU ABOUT THIS, WHAT OTHER AVENUES OF COMMUNICATION DO YOU HAVE TO DRAW IN PEOPLE TO LET THEM KNOW WHAT'S AVAILABLE?

>>JOSH: WELL, I THINK YOU'RE HELPING, FIRST OF ALL, BY HAVING US ON HERE.

>>LORENE: OK, GOOD.

>>JOSH: IT'S IMPORTANT TO LET THE COMMUNITY KNOW THAT WE'RE HERE.

I THINK ONE OF THE BIGGEST THINGS, LIKE THE BIGGEST WAY THAT PEOPLE CAN BE AWARE OF US IS BY WORD OF MOUTH.

IF SOMEONE THAT THEY TRUST TELLS THEM, HEY, THIS SERVICE IS THERE, THEN THEY'LL BE MORE WILLING TO GO THERE.

AGAIN, THAT SENSE OF COMMUNITY, SOMEONE THAT YOU TRUST, YOU'RE GETTING THIS REFERRAL FROM SOMEONE YOU TRUST.

WE CAN ALSO TALK ABOUT HOW FOLKS CAN GET SERVICES, THE 833 SOUTHWEST NURSE HOTLINE, OUR NURSE HELPLINE.

>>LORENE: WAIT A MINUTE.

TELL ME, TELL PEOPLE WHAT THAT IS AND HOW THEY CAN AVAIL THEMSELVES.

>>JOSH: YEAH, SO THAT'S OUR NURSE HELPLINE.

SO IF FOLKS WANT SUBSTANCE USE TREATMENT, THEY CAN CALL THAT NUMBER AND GET AN APPOINTMENT.

>>LORENE: OK, WHAT IS THE NUMBER?

>>JOSH: IT IS 833 SW NURSE.

>>LORENE: OK, SO YOU DIAL 833 ON YOUR PHONE AND THEN SW NURSE?

>>JOSH: YEAH, IT SPELLS OUT SW NURSE OR ALTERNATIVELY, YOU CAN TEXT NMDOH, AND THAT GETS YOU TO THE SAME PERSON.

>>LORENE: SO IF SOMEONE WANTS TO TEXT THAT NUMBER, IT'S MUCH EASIER.

>>JOSH: THERE'S THAT METHOD.

WE ALSO WORK WITH OUR COMMUNITY, SO AS THE POLICY DIRECTOR, PART OF MY JOB IS WORKING WITH LOCAL GOVERNMENTS, COUNTY GOVERNMENTS AND THAT'S WHAT WE'RE DOING, TOO, IS WE'RE GOING INTO LOCAL COMMUNITIES.

ESPECIALLY WHEN WE SEE A SPIKE IN OVERDOSE IN A COUNTY, WE'RE GOING TO GO AND WE'RE GOING TO TALK WITH ALL THE PROVIDERS IN THAT COMMUNITY.

WE'RE GOING TO TALK WITH THE COUNTY COMMISSIONERS, WE'RE GOING TO TALK WITH THE CITY LEADERS, WE'RE GOING TO TALK WITH THOSE COMMUNITY LEADERS AND REALLY WORK WITH THEM TO DEVELOP A PLAN AND A STRATEGY THAT WORKS FOR THEIR COMMUNITY.

SO THAT'S SOMETHING THAT WE'RE ACTIVELY DOING ALREADY.

>>LORENE: IS THERE A CHANGE AMONG PHYSICIANS, THEY USED TO BE QUITE GENEROUS WITH VERY ADDICTIVE SUBSTANCES.

SOMEBODY HAS BACK PAIN, TERRIBLE BACK PAIN AND AGONY AND THREE YEARS LATER, THEY'RE STILL ON THOSE PILLS, STILL ADDICTED TO IT.

THE DOCTOR'S FEELING THEY'RE DOING THEIR JOB, THE PATIENT IS OUT OF PAIN.

AND IS THERE A MEANS FOR THE PATIENT OR THE PHYSICIAN TO SAY, LET'S CHECK UP ON THIS, HAVE WE REACHED THE BEST SOLUTION FOR THIS, IS THERE FURTHER HARM THAT CAN BE REDUCED?

>>JOSH: I THINK WE'VE DONE A REALLY GOOD JOB OF THAT AS THE STATE.

>>LORENE: I'M SO GLAD.

>>JOSH: WE HAD, LIKE MUCH OF THE COUNTRY, WE HAD THAT INCREASE IN PRESCRIPTION OVERDOSE IN THE MID-2010S, LIKE 2014-15 TIMEFRAME.

WE'VE REALLY CHANGED PRESCRIBING PRACTICES.

WE'VE FOLLOWED THE EVIDENCE AND SHOWN WHAT PRESCRIBING PRACTICES ARE CORRECT, WHAT LEVELS OF OPIOIDS YOU SHOULD BE PRESCRIBING, AND WHAT YOU SHOULDN'T BE PRESCRIBING AND THEN FOR THE PEOPLE WHO MIGHT HAVE BECOME DEPENDENT UPON THAT BECAUSE OF THAT TIME PERIOD WHERE PRESCRIBING WASN'T AS, I DON'T THINK PEOPLE KNEW THE CONSEQUENCES OF THE PRESCRIBING PRACTICES BACK THEN.

BUT NOW THAT WE'VE GOT THAT UNDER CONTROL, WE'VE GOT LOTS OF WAYS TO EDUCATE PROVIDERS AND COMMUNITY MEMBERS.

WE DO ACADEMIC DETAILING, WHICH IS A PROCESS WHERE WE GO TO DOCTORS' OFFICES, AND WE TALK TO THEM.

WE TALK TO PAIN CLINICIANS, WE TALK TO SURGEONS ABOUT RESPONSIBLE PRESCRIBING, HOW TO WEAN PEOPLE OFF OF OPIOIDS THAT THEY MAYBE NOT, MIGHT NOT NEED ANYMORE.

THEN WE ALSO TALK ABOUT OTHER ALTERNATIVES, THINGS LIKE MASSAGE THERAPY, CHIROPRACTIC, ACUPUNCTURE, ALL THOSE ALTERNATIVES.

>>LORENE: REFLEXOLOGY.

>>JOSH: EXACTLY, ANYTHING THAT MIGHT HELP REDUCE PAIN THAT DOESN'T REQUIRE AN OPIOID.

>>LORENE: WELL, YOUR WORK IS REALLY, REALLY CUT OUT FOR YOU.

WE HAVE A MINUTE LEFT IF YOU CAN JUST CALL OUT TO PEOPLE HOW THEY CAN GET IN TOUCH WITH YOU AND HOW YOU CAN HELP THEM.

>>JOSH: SURE, SO THEY CAN VISIT NMHARMREDUCTION.ORG AND THEY CAN GET NALOXONE THERE, ANYONE IN THE STATE.

THEY CAN CALL 833-SW-NURSE, OUR NURSE HELPLINE, THEY CAN TEXT NMDOH, WHICH IS OUR HELPLINE, OR THEY CAN GO TO ANY PUBLIC HEALTH OFFICE IN THE STATE TO GET THE SERVICES THAT WE HAVE AVAILABLE.

>>LORENE: OH GOSH, I JUST, I CAN'T THANK YOU ENOUGH.

>>JOSH: THANK YOU FOR HAVING US ON AND LETTING US GET THE WORD OUT ABOUT HOW WE'RE HELPING PEOPLE AND HOW FOLKS CAN COME TO US IN A JUDGMENT-FREE ENVIRONMENT.

>>LORENE: RIGHT, RIGHT.

WELL, OUR GUEST TODAY IS JOSH SWATEK, WHO IS A POLICY DIRECTOR AT THE DEPARTMENT OF HEALTH SPECIALIZING IN HARM REDUCTION.

I'M SO GRATEFUL FOR WHAT YOU DO AND THANK YOU FOR COMING ON TO TELL US ABOUT IT.

>>JOSH: THANK YOU FOR HAVING ME.

>>LORENE: YOU BET AND I'M LORENE MILLS.

I'D LIKE TO THANK YOU, OUR AUDIENCE, FOR BEING WITH US TODAY ON A VERY IMPORTANT EDITION OF REPORT FROM SANTA FE .

WE'LL SEE YOU NEXT WEEK.

REPORT FROM SANTA FE IS MADE POSSIBLE IN PART BY GRANTS FROM THE NEW MEXICO MUNICIPAL LEAGUE, A BETTER NEW MEXICO THROUGH BETTER CITIES, AND FROM THE HEALY FOUNDATION.

TAOS, NM.

♪ MUSIC