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Buncombe County HHS reports doubling of harm reduction program visits, expands outreach and peer case management
Summary
HHS staff told the board the county’s harm reduction program has rebranded from a syringe service program, added a peer support case manager via a Dogwood Health Trust grant, expanded Spanish-language outreach with UNITE and reported a 103% year‑over‑year increase in participant volume.
Mitch Albers, an HHS staff member, updated the Buncombe County Department of Health and Human Services Board on the county’s harm reduction program during the board’s presentations and updates.
Albers said the program is formally rebranding from a syringe service program (SSP) to a “harm reduction program” to reduce stigma and to encompass expanded services. He reported two multiyear contracts supported by a grant from Dogwood Health Trust: one funds a dedicated peer support case manager (provided through Sunrise Community) who had taken about 61 cases since starting in February, and the other supports outreach and education targeted to Hispanic community partners in collaboration with UNITE. Albers said the UNITE partnership has reached about 215 adults with training, including Narcan (naloxone) training in Spanish.
Albers provided program statistics for the past year: more than 12,900 participant visits, more than 2,700 unique participants, about 1,300 new participants, and 474 participant‑reported overdose reversals. He told the board the program distributed roughly 4,500 naloxone kits (staff estimate) and that participant volume rose by about 103% over the prior year. Albers said the program shifted toward offering alternatives to injection (so‑called safer‑use supplies and safer‑smoking options); about half of visits no longer resulted in syringe distribution, compared with a prior era when approximately 13% of visits did not result in a syringe distribution. He described that shift as reducing syringe waste in the community and producing cost savings that helped the program remain budget neutral despite the rise in encounters.
Disposal and community accessibility were highlighted: Albers said the program has distributed over 1,300 individual syringe disposal options to participants (from pocket cases to two‑gallon containers) and that disposal kiosks installed in collaboration with the City of Asheville bring in “a few thousand” returns per month. He said HHS added at least one kiosk at an AHOPE location and planned another near State Street (near Piscaview, per presentation) pending memoranda of understanding with partners.
Albers described additional services and partnerships: a dedicated case manager has completed 61 intakes and about 664 one‑on‑one peer engagements; staff linked 28 participants to STI testing, 43 to substance‑use treatment and 21 to mental health treatment, and arranged nearly 200 social‑determinants supports (housing entry fees, medication costs, transit). He said some opioid settlement funds were used for immediate supports.
On substances in the local supply, Albers said HHS began submitting samples to UNC Chapel Hill’s drug lab and to independent surveillance sites (StreetCheck). He reported common adulterants and emergent contaminants in submitted samples: xylazine and medetomidine (veterinary sedatives), BIS (an industrial plasticizer), and 4‑ANPP (a fentanyl precursor). He told the board that naloxone reverses opioid effects but does not reverse sedatives such as xylazine or medetomidine; supportive medical care is required for sedative exposures. Albers said in submitted samples the program often finds nine to 13 different substances mixed together, underscoring the need for testing and informed‑use practices.
Albers told the board the program is piloting safer‑smoking supplies and community trainings and that staff are pursuing grant opportunities to obtain in‑the‑moment testing technology (current lab tests take about one week to return results). He closed with two participant success stories — individuals linked to treatment and housing — and invited board members and community organizations to request trainings and supplies; he said the program operates a low‑barrier, walk‑in service (lower level of the HHS building, noon–4 p.m.) and can provide anonymous help and case management when participants opt in.
No board action or vote was taken on the program update; the item was presented for information and future discussion.
