In a milestone development, GMHC has won a transformative federal grant to provide comprehensive harm-reduction care at no cost to anyone wanting help with substance use.
The Substance Abuse and Mental Health Services Administration (SAMHSA) Harm Reduction grant, which is for $500,000 per year for five years, allows us to provide medication, counseling, and education to any active substance users ages 18 and over.
“We are excited. We want anyone walking in the door of GMHC to have access to mental health and substance use services, so this is huge,” said Chet Balram, GMHC Managing Director for Mental Health and Substance Use.
The aim is to expand care for people with substance use disorders in medically underserved communities, Balram said. “We want to serve low-income people from Black and Brown communities who are typically not receiving these services, because they don’t have access or the means.”
“This program is for anyone wanting help with substance use – and it’s free. There is no restriction on income or other criteria, and you don’t have to be living with HIV,” he added.
The SAMHSA grant funds a dedicated harm-reduction team that can provide individual counseling,substance-use education, and medication to reduce cravings from opioids, crystal meth, or other substances. Clients also receive training on using Narcan kits and fentanyl test strips for overdose prevention.
Until now, Balram explained, GMHC’s harm-reduction services have been limited to specific populations, due to the nature of the grant funding: The agency’s Women Empowering Women program is for people who identify as women, while the Methamphetamine Ryan White Harm Reduction Services program is for people who identify as men, use crystal meth, and are living with HIV.
That said, Balram added, many of the SAMHSA program’s clients come from New York City communities that are the most impacted by HIV, since substance use can play a role in transmitting HIV, as well as STIs and viral hepatitis. “It can impair someone’s judgment around sharing needles or risky sex, so one aim of this program is to provide people with the resources they need to stay safe,” he said.
“Many individuals whom we’re seeing now want help with reducing or stopping crystal meth use,” Balram said. “Often people will use crystal meth and then have unprotected sex, because it numbs inhibition and provides a euphoric feeling, so safer-sex education is part of the harm-reduction strategy.”
“It’s not just about substance use,” he emphasized. “Through both medication and counseling, we want to reduce harms associated with substance use and help clients having difficulties to move forward with what they want to achieve.”
Building the Harm-Reduction Team
Since GMHC received the SAMHSA grant award last September, Balram and his colleague Keila Morales, Managing Director of Clinic Operations, have been building a dedicated harm-reduction team to provide both in-person and telehealth services. It is led by Baron Nelson, who recently joined the agency as the SAMHSA Program Coordinator, Substance Use Treatment.
Right now, the SAMHSA program is serving about 20 active clients, all internal referrals from other agency programs, Balram said. That will expand to about 200 clients annually, once the full team is in place for broader community outreach.
The first step for many clients is Medication Assisted Treatment (MAT) to reduce cravings from substance use disorder. GMHC’s clinical medical director, Dr. Arnab Datta, can prescribe naltrexone or its long-acting injectable form, vivitrol. A psychiatric nurse practitioner, Lucio Gonzalez, has just joined the harm-reduction team. Gonzalez, who is bilingual in Spanish, can administer vivitrol injections on site and provide other medical care.
Clients are then referred to Credentialed Alcoholism and Substance Abuse Counselors (CASACs), which Balram called one of the major benefits of the SAMHSA program. “Our counselors help clients identify triggers that are causing them to use and find better ways to manage cravings. That could be feeling sad or lonely, or even passing by a building where they once used,” he said.
In addition to Nathan Pecchia, the agency recently hired Colby Walsh and is currently hiring a third CASAC counselor. The harm-reduction team’s case manager and client navigator, Dale Nelson, can link clients to other needed agency services, such as housing, food, access to health insurance, or job training.
“People feel safe coming to GMHC, because the agency offers care that is client-centered, trauma-informed, and culturally competent,” Balram said. “There is no stigma around substance use here. We want to find out how we can help and get our clients to where they want to be.”
Stay in the Know
Sign up to receive our monthly newsletter, updates about events, and other helpful information.
