NEXT Distro: Needle EXchange Technology

NEXT Distro Contact: Jamie Favaro www.nextdistro.com jamie@nextdistro.com 917-828-0203

NEXT Distro (Needle EXchange Technology) is a modern, innovative, and strategic public health response to the opioid epidemic in the United States. NEXT Distro (“NEXT”) is a web and mailbased harm reduction platform that combines the convenience and ease of telehealth with the pragmatic and successful approach of in-person harm reduction programs.

The goal of NEXT is to get to zero new injection-related HIV and Hepatitis infections, and zero opioid overdose deaths. Accidental drug overdose is now the leading cause of death in the United States among people under the age of 50. Furthermore, the economic cost of the opioid crisis in the United States is one trillion dollars and growing. In fact, U.S. taxpayers can expect to spend 500 billion dollars on the opioid crisis between 2016 and 2020.

Currently, 95% of U.S. counties have no syringe exchange program. Historically, harm reduction has predominantly been practiced in urban areas where devastating drug addiction and injectionrelated HIV outbreaks have led to significant community devastation. By requiring individuals to obtain harm reduction services in person, distance and stigma become barriers to engagement and care. NEXT is the first harm reduction model that addresses this problem. Our strategy is to provide tools previously only available in large, blue-leaning cities to people who use drugs in geographically isolated regions by shifting harm reduction education and resources to an accessible online platform. The result is a dynamic, cutting-edge response to the opioid crisis--one that does not rely on geographic proximity.

A web and mail-based harm reduction platform provides the most potential to 1) Connect with people actively using drugs across the United States, especially users living far from treatment centers and other facilities, 2) Provide people who use drugs with life-saving supplies and support, and 3) Aggregate health surveillance data around drug use.

NEXT promotes health equity for people who use drugs because: ● Access to resources is impacted by where people live: rural and suburban people who use drugs do not have access to Syringe Exchange Programs that are often clustered in urban centers. Shifting harm reduction education and supply distribution to a web and mail-based model enables people who use drugs to access resources regardless of their location. ● Access to resources is tied to economics: rural and suburban people who use drugs are limited by how far they can travel to secure harm reduction supplies, as they often live hours away from the nearest syringe exchange program. NEXT delivers supplies to their door.

● Poor technical literacy is a barrier to accessing internet-based resources: to navigate the current scattered landscape of web-based harm reduction health resources, individuals are required to have a high-level of technological literacy. NEXT tools are consolidated into one platform that showcases both text and video-based education. ● To develop targeted health solutions, we need more accurate and relevant health consumer data: NEXT provides groundbreaking drug user public health surveillance opportunities.

Our connection to populations who use drugs across the United States will enable us to track their needs and provide them help before they die of drug overdose or enter the prison system.

This proposed project challenges conventional ideas that the U.S. opioid crisis can be solved through drug treatment, law enforcement (specifically drug enforcement), and prescription drug monitoring. Harm reduction practices are proven to reduce the public health impact of drug use.

Unlike abstinence-based interventions whose efficacy and long-term success are questionable, harm reduction locates individuals as the primary drivers of their own health improvement. Harm reduction-based resources are necessary to address the needs of current drug users in the U.S. who are unable or unwilling to seek conventional drug treatment. That being said, when NEXT system users are ready to explore health and recovery options, NEXT will be their resource for navigating primary care and the drug treatment system.

In March 2018, the Comer Family Foundation committed $25,000 toward start-up costs. To this point, NEXT has been operating thanks to significant pro-bono support in the form of mentorship and oversight from professionals with expertise in medical care and research, technology, data encryption, epidemiology, and policy. NEXT is supported by harm reduction leaders across the country as well as the nationwide harm reduction advocacy and training organization Harm Reduction Coalition (HRC), which supports NEXT through 501(c)3 fiscal conduitship. Office and meeting space is being provided by Harm Reduction Coalition (NYC/Oakland) and the Prime Produce Innovators Guild (NYC).

New York State is the staging ground for NEXT’s proof of concept. The NEXT website is currently in the prototype stage; however, mail-based distribution has reached minimum viable product stage through a partnership with VOCAL-NY. As the next step in building the website, we are currently working with a team of technology experts to develop an encryption strategy that will provide assurance of anonymity and security to system users.

Americans are witnessing the deleterious effects of limited access to harm reduction resources: a serious medical, social, and economic catastrophe. The NEXT platform is the only emerging strategy that is focused on a harm reduction approach to tackling the opioid overdose epidemic throughout the United States. NEXT inspires a new vision for the healthcare system: a holistic, empowering, consumer-centered model of care that addresses the complex concerns of people who use drugs. The NEXT platform will modernize the field of harm reduction and accelerate the availability of resources and education for geographically isolated people who use drugs across the country.