When IUPUI student Madison Weintraut started working at the Marion County Public Health Department three years ago, the idea of creating a syringe services program was a long shot.
"When I was interviewed for a position as a nurse epidemiologist, I asked if there was a chance we would do a syringe program," Weintraut said. "At the time, it didn't seem possible."
But with some grit and determination, and support from Dr. Virginia Caine, director of the Marion County Public Health Department, a syringe services program in Marion County did happen. In fact, after nine months of meetings with everyone from city and county officials, local hospitals, and faith-based organizations to the Indiana Minority Health Coalition and community members, the program was approved by a unanimous vote.
"Madison spent so much time working with people who didn't have experience with harm reduction, who might not fully understand harm reduction and maybe who vocally opposed it," said Joan Duwve, associate dean of public health practice at the Richard M. Fairbanks School of Public Health. "By taking the time to reach out to people, educate them and explain the need for such a program, she was able to create a system of advocates in Marion County."
With a three-year grant from the Richard M. Fairbanks Foundation, the Safe Syringe Access and Support Program officially kicked off in April. Operated through a mobile unit, the program provides community members with sterile syringes and harm-reduction kits. The program also provides HIV and hepatitis C screening, naloxone, immunizations, peer recovery coaching, and referrals for substance use disorder treatment.
Since its launch, the program has served nearly 70 individuals, with 60 percent receiving HIV and/or HCV testing; has assisted two individuals with medication-assisted treatment; and has distributed more than 300 naloxone kits.
"It was a lot of work and a lot of talking with people and educating them about the importance of a syringe program," Weintraut said. "But we wanted to make sure that when we announced that we wanted to create this program, there was no room for argument. When you take the time to sit down with people and walk them through why this type of program works, they can't argue against it."
Weintraut, a Master of Public Health student at the Fairbanks School of Public Health, always knew she was interested in the public health field, but she wasn't sure where that interest would take her. She started out in pharmacology but settled on a degree in neurobiology and physiology. She then went on to pursue a secondary nursing degree, but she still wasn't sure exactly what she wanted to do.
Then her grandmother was diagnosed with gastric cancer, and Weintraut served as her hospice nurse.
"That made me more passionate about what I was doing," she said.
Weintraut then began working in the neonatal unit at a local hospital, where she worked with babies with neonatal abstinence syndrome. That sparked her interest in addressing the opioid crisis ravaging the country, which eventually led her to the Marion County Public Health Department.
For many, harm reduction around substance use can be a hard sell. While non-addiction-related harm reduction like wearing a seat belt or being vaccinated is widely accepted in our country, many people, Weintraut said, have a hard time equating the same logic when it comes to substance use, even though the Centers for Disease Control reports that people using syringe services programs are five times more likely to enter into treatment and three times more likely to stop using drugs altogether.
Weintraut admits that before working so closely with the topic, she too had her own biases.
"When I was working in the NICU with babies going through withdrawal, I felt mothers deserved to be incarcerated," she said. "I thought addiction was more of a choice than a disease. The more I've learned and the more education I've gotten, the more I've been able to see it as a public health issue. It is a public health problem, not a moral issue. We are all just one or two decisions away from being in this type of situation."
The health department's director said it is Weintraut's integrity and honesty about the issue that appeals her to so many.
"She's got the kind of personality that, whether you are a teenager or a mature adult, she can relate to you," Caine said. "She brings a human element of caring that deserves a lot of recognition and honor. She has this huge sense of commitment to her patients, and when she is interacting with our clients, they can see that she cares."
April Toler is the associate director of research communications in the Indiana University Office of the Vice President for Research.