Rebuilding a Safe Haven for Future Crises

Unfortunately, more than a year after the hurricane’s aftermath, social and health services for drug users continue to be limited. There continue to be many barriers to access medication-assisted treatment (i.e. Methadone and Buprenorphine) for people with problematic opioid use. In addition, there still limited availability and accessibility of syringe exchange services around the island. The declaration of an opioid crisis in the USA allowed for the distribution of the drug naloxone at a large scale in order to prevent opiate’s overdoses, however it is extremely difficult for people in the island to access this antagonist. The government of Puerto Rico has not yet established micro and macro-structural strategies to allow access to Naloxone. The lack of sensitive public health policies has perpetuated the disastrous health and life consequences of problematic use of substances (heroin).

In response to this reality, Intercambios Puerto Rico continues its mission to strive for social justice and provide social and health services for people who are homeless and people who use drugs by meeting them where they are and in their own communities. The syringe exchange program continues to work from a harm reduction perspective in 12 communities in the northeast side of the island. Our regular outreach team includes a service coordinator, two community outreach workers, a case manager and a nurse who attend to the social and health services needs of our participants. Our participants lack access to primary care centers. However, through our mobile street outreach, they are able to access life-saving services for free on a regular basis such as: HIV tests, health evaluation by a certified nurse, linkage to medication-assisted treatment for problematic substance use and other essential services.

In addition, we recently added a new team to our staff that includes a professional mental health counselor, a professional substance-related disorders counselor, a community outreach worker, a case manager and a service coordinator. This new team will carry out mental health interventions from a harm reduction model with the purpose of supporting individuals who are homeless and had problematic substance use in their recovery process. We are excited to inform you that this new project will be working not only in the communities we serve in the northeast of the island but also in the metropolitan area. This guarantees a greater number of marginalized people will be able to access much need health and social services. And more importantly, we will be able to link homeless inviduals with/without problematic substance use to permanent housing programs. According to the Homeless Count of Puerto Rico (2017), it is estimated that there are over 3,501 homeless individuals in the island. This number is bound to increase due to the devastation caused by Maria and Irma’s Hurricanes. At least 30.6% of individuals identified as homeless reported the main reason for being on the street was problematic substance use.

We are extremely grateful to all those who have donated and supported our work in the past and hope to have your continue support as we engaged in Post-Hurricane Recovery Work in our communities. This work is more challenging for Puerto Rico given that is government finds itself in the midst of a bankruptcy and has implemented harsh austerity measures that undermine the provision of essential services, such as health and education, to its population. Thank you for keeping up with the hard work carried out by our team at Intercambios Puerto RIco. We are committed to promoting public policies and direct service that may positively impact our vulnerable populations and ensure that we are better prepared to face similar natural disasters in the coming future.