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Turning the tide: Red Project fights HIV, overdose, and stigma amid national health crisis

Camille Hoorn drives the mobile health unit.

Today, the Red Project offers direct service in six western Michigan counties (Kent, Ottawa, Allegan, Muskegon, Lake, Mason and Oceana) as well as technical assistance statewide. The organization employs 18 full-time staff and is supported by a growing network of volunteers. Many are former clients themselves.
Brandon Hool was in and out of jail and addicted to heroin when he first encountered the Grand Rapids Red Project.

“There wasn’t a whole lot of positivity in my life,” he says. Like many struggling with addiction, Hool felt outcast by society and misunderstood by the healthcare system. “Everywhere I went … was completely judgmental.”

The Red Project, Hool says, was different. Hool came to the nonprofit in 2008 as a client of its Clean Works initiative, a unique program authorized by local government to distribute sterile syringes to drug users in Grand Rapids.

Hool stopped using in 2010, and in recovery began volunteering for the Red Project, first distributing condoms as part of the nonprofit’s work helping prevent HIV. He became the organization’s second paid employee in 2012, and today oversees the Clean Works initiative as well as overdose prevention and response programming. Steve Alsum, Red Project executive director, says the organization has since entered a period of “rapid expansion,” partially in response to surging demand as West Michigan grapples with the opioid epidemic.

Today, the Red Project offers direct service in 6 western Michigan counties (Kent, Ottawa, Allegan, Muskegon, Lake, Mason and Oceana) as well as technical assistance statewide. The organization employs 18 full-time staff and is supported by a growing network of volunteers. Many, like Hool, are former clients themselves.

The Red Project was founded in 1998 by a group of individuals involved with other HIV/AIDs service organizations in West Michigan. At that time, the group was known as HIV/AIDS Services, Inc.

Jon Lamaire, Overdose Prevention Coordinator“Initially when the Red Project started … our mission was very focused on HIV,” says Alsum. “But being that the major population that we served for the first 10 years of our existence were people who were injecting drugs, there are multiple health issues and epidemics affecting that population.”

While HIV remains at the core of the Red Project’s mission, Alsum notes the focus has expanded more broadly as drug abuse has ravaged the community. Today, with funding from the Michigan Department of Health & Human Services, community health partners like Network 180, and individual donations, the Red Project offers HIV testing and case management, Hepatitis C testing, the Clean Works syringe access program and overdose prevention services.

Turning the tide

The impact has been significant.

Between 2000 and 2011, the percentage of HIV cases resulting from injection drug use in Kent County decreased from 25 to eight percent. The Red Project has recorded more than 465 successful overdose reversals since it began distributing Naloxone rescue kits in 2008.

In recent years, the nonprofit has partnered with more than 50 law enforcement departments throughout the state and trained more than 1,000 officers on overdose reversal. The Red Project has also organized an opioid task force in partnership with the Kent County Health Department, and is actively working to expand collaboration among the West Michigan medical community.

Mark Hall, medical director for the Kent County Health Department, is convinced the Red Project is making an impact. While hesitant to say the local epidemic has reached its peak, Hall notes that opioid-related deaths in Kent County actually declined between 2015 and 2016 despite a statewide increase of 54 percent in the same time period.

“I think it’s the work of the Red Project,” he says, noting that the Centers for Disease Control & Prevention has charged community health providers with overseeing a “three-pronged attack” on the opioid crisis, comprised of prevention, addiction treatment, and safety. “Safety is really where the Red Project has made a huge impact,” adds Hall.

The Red Project’s Naloxone distribution program, Hall says, is a game-changer.

In 2008, the Red Project began providing Naloxone — a drug that can reverse the effects of opioid overdose — directly to concerned community members. Each Naloxone kit contains four doses of the medication, four syringes and a rescue breathing mask. The rescue kits and training are provided free of charge in five different Grand Rapids neighborhoods, six days per week by staff and volunteers working with the group’s Mobile Health Unit. The Red Project has also been instrumental in equipping law enforcement agencies with the rescue kits.

“We’re very fortunate as a county that we have a program that was very much on the leading edge of Naloxone distribution,” Hall says. “I think that the number [of opioid-related deaths in Kent County] would have continued on an exponential curve as it has in many communities, without what they’ve done, which is to focus on the safety part.”

Community partnerships

Alsum says community partnerships are key to that effort.

In addition to the Red Project’s work with local health departments and law enforcement agencies, recent legislation has opened up opportunities to collaborate with the private sector. In 2014 Governor Rick Snyder signed Public Acts 311-314, creating a “standing order” which allows participating pharmacies to distribute Naloxone to anyone without a prescription. The laws also protect those who administer Naloxone from civil and criminal liability. Since the legislation’s passage, the Red Project has partnered with West Michigan pharmacies like SpartanNash and Meijer to increase access to overdose rescue kits.

Such programs are critical in West Michigan, says Hool, who notes that in more than 50 percent of overdoses statewide, “the victim actually filled a prescription for the drug within the last 30 days.”

Camille Hoorn, AmeriCorps MemberRobin Curtis acknowledges the challenge. Curtis is clinical care coordinator for SpartanNash, which began making Naloxone readily available through its pharmacies in 2015.

“I think that we complement the Red Project,” says Curtis. “While we each have a different target audience, in the end it is the same community.”

“We’ve done an amazing job reaching the community,” Alsum says. “But the issue is, we reach primarily people who are abusing drugs, and primarily who are abusing heroin, whereas the majority of fatalities in West Michigan are people who are prescribed opioids. So we really need to engage more with the medical community.”

A commitment to dignity

It’s been nearly twenty years since the Red Project launched. In that time, challenges to public health have accelerated, and the nonprofit’s portfolio has expanded far beyond its original HIV-focused mission.

The commitment to individual dignity, however, remains the same.

Hool knows it firsthand. He describes his experience before coming to the Red Project:

“Up until that point, I’d been given every reason… not to trust other professionals,” he says. “Not necessarily because they weren’t going to keep my information confidential, but because they were going to turn it back on me.

“There’s people out there that are very frustrated that other people won’t do what they want them to do,” Hool says. “It’s different here. That was instrumental in my recovery, that I just had a place I was able to go.”

No matter how the Red Project’s mission evolves, Alsum says, providing a judgment-free environment will remain a top priority.

“Often people are stripped of their rights, and their rights to make decisions about themselves, their lives, their families, and their health, because of our defining them through one aspect of themselves...their drug use or their HIV status. Our programming can be seen as a first step in helping highly stigmatized, marginalized individuals begin to regain control over their own lives and their lives direction.”

According to Alsum, the role former clients like Hool are playing in the Red Project’s work is a testament to the power of that vision.

“The public impact of our work is very important,” says Alsum, “but deeper than public health is the social impact. The way we treat people who use drugs, the way we treat people living with HIV is wrong. Socially we define these people by a behavior they engage in, or a health issue they are dealing with, and often don’t look past that. At Red Project, we look at people first and foremost as human beings.”

It’s a subtle but remarkable difference with the power to change lives for the better.

Multi-media by Adam Bird of Bird + Bird Studio.
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