Northwest Ohio Syringe Services (NOSS)

Crisis Care Services:

Lucas County Crisis CARE Line: 419-904-2273
Available 24/7

Crisis Text Line: Text “4hope” to 741741
Available 24/7

Recovery Services:

Lucas County Crisis CARE Line: 419-904-2273
Available 24/7

Local Help Now (sponsored by the Mental Health and Recovery Services Board of Lucas County)

Recovery Within Reach (Ohio Treatment Providers)

Peer and Family Support Services:

DART Family Support Group
Aldersgate United Methodist Church, 4030 Douglas Rd, Toledo, OH 43613
1^st & 3^rd Monday of Every Month 7:00pm-8:00pm

National Alliance of Mental Illness (NAMI)

Alcoholics Anonymous

Narcotics Anonymous

Heroin Anonymous

Harm Reduction Resources:

Ryan White Program

Equitas

Harm Reduction Ohio

National Harm Reduction Coalition

DanceSafe

NEXT Distro

Who can use NOSS services?

Anyone! Supplies are available to pick up for you and your social circle. You do not need to be a person who uses drugs to pick up supplies for other people.

Is there a limit to the number of syringes provided?

The NOSS team will work with you to determine how many syringes you will need over about 10 days. We encourage you to visit us weekly and you may visit multiple times per week if needed. If you have any concerns about the number of syringes provided, please let the team know so we can work together to meet your needs. We carry limited stock at each clinic and supplies are first-come, first-served.

What if I don’t use syringes to use drugs?

Even if you don’t use syringes, we still encourage you to visit NOSS. Fentanyl isn’t in everything, but it could be in anything. It’s also inconsistent in how strong it can be or how much fentanyl is in a product. We want everyone to be prepared to respond quickly to a possible overdose. Overdose prevention supplies including naloxone and fentanyl test strips are available and critical to prevent fatal injuries. NOSS also offers other harm reduction supplies like pipe covers, condoms and lube, and xylazine testing strips.

Disease can still be spread by sharing any drug use tool, so testing for HIV and hepatitis C are important.

Is the program free?

Yes. All services are free.

Do I need to show my ID?

No staff will ask to see any form of ID. This is an anonymous program.

Why is it important to keep my NOSS card on me?

At your first visit, NOSS staff will give you an ID card with a unique ID number that will identify you as an individual participating in the NOSS program.

The Ohio Revised Code Section 3707.57 states that a participant of a syringe service program who is within one thousand (1,000) feet of a program facility and is in possession of documentation from the program identifying the individual as a participant of the program is not subject to criminal prosecution for the following violations:

• Possessing criminal tools (Section 2923.24)
• Possessing drug abuse instruments (Section 2925.12)
• Knowingly possess drug paraphernalia with purpose to use (Section 2925.14 C1)

If I lose my NOSS card can I get a new one?

Yes.

How long does it take to get tested for HIV or hepatitis C?

Rapid results are available in just 20 minutes.

Can law enforcement access SSP records?

All SSP records are confidential and no identifying information is collected during a visit or included in record keeping.

How can I get support or referrals?

Check in with our Linkage to Care Coordinator or any other NOSS team member to get connected to support and referral services during NOSS hours or call 419-213-2655 M-F 8:00am-4:00pm.

How is NOSS funded?

NOSS is funded by several partners including the University of Toledo Medical Center Ryan White Program, the Mental Health and Recovery Services Board of Lucas County, the Ohio Department of Health, and Ohio Mental Health and Addictions Services.

NOSS is a bloodborne pathogen prevention program that helps prevent the spread of infectious diseases like HIV and Hepatitis and promotes safety, harm reduction, health, and wellness by offering services and care to people who use drugs.

Syringe service programs (SSPs) are proven to save lives, help those with substance use disorders get needed support, prevent overdose deaths, and reduce the impact of drug use in a community.

Why SSPs Matter
Injection drug use is a large contributor to new hepatitis C virus (HCV) infections. More than 2,500 new HIV infections each year are also due to people who inject drugs.

The best way to prevent the spread of these diseases for people who inject drugs is to stop injecting them. If that is not possible, using new, sterile injection equipment for each injection will reduce the risk of infection and prevent outbreaks.

SSPs are associated with an estimated 50% reduction in HIV and HCV infections. NOSS provides connection to other health services, including HCV and HIV testing and treatment, and medication-assisted treatment for substance use disorder.

NOSS offers referrals to medication-assisted treatment. New SSP users are five (5) times more likely to enter drug treatment. They are also three (3) times more likely to stop using drugs than those who don’t use the program.

NOSS also prevents overdose deaths by teaching people who use drugs:

• How to recognize and prevent overdose
• How to recognize, respond to, and reverse an overdose
• How to use naloxone, a medication that reverses overdose

Naloxone, fentanyl test strips, and other overdose prevention tools are available at NOSS.

Read more about SSPs here.

Section 3707.57 in the Ohio Revised Code determines that a bloodborne infectious disease prevention program (aka syringe service program) may be established by a board of health and shall do the following:

• If resources are available, provide on-site screening for bloodborne pathogens
• Provide education to each program participant regarding exposure to bloodborne pathogens
• Identify health and supportive service providers and substance use treatment programs available in the area served by the prevention program and, as appropriate, develop and enter into referral agreements with the identified providers and programs
• Encourage each program participant to seek appropriate medical care, mental health services, substance use treatment, or social services and, as appropriate, make referrals to health and supportive services providers and substance use treatment programs with which the prevention program has entered into referral agreements
• Use a recordkeeping system that ensures that the identity of each program participant remains anonymous
• Comply with applicable state and federal laws governing participant confidentiality
• Provide each program participant with documentation identifying the individual as an active participant in the program

Syringe service programs (SSPs) benefit communities and public safety by reducing needlestick injuries and overdose deaths, without increasing illegal injection of drugs or criminal activity.

Studies show that SSPs protect first responders and the public by providing safe needle disposal and reducing the community presence of needles.

Evidence demonstrates that SSPs do not increase illegal drug use or crime. Studies in Baltimore and New York City have found no difference in crime rates between areas with and without SSPs.

Read more about public safety and syringe service programs here.

What is harm reduction and why is it needed?

Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.

Harm reduction is an evidence-based approach that is critical to engaging with people who use drugs and equipping them with life-saving tools and information to create positive change in their lives and potentially save their lives. Harm reduction is a key pillar in the U.S. Department of Health and Human Services Overdose Prevention Strategy.

Harm reduction in a community can help fill gaps in connection to people who use drugs. Harm reduction offers an opportunity to reach people who don’t otherwise access healthcare services and offer them the tools they need to avoid fatal overdose and connect them to other needed services. Harm reduction services save lives by being available and accessible in a manner that emphasizes the need for humility and compassion toward people who use drugs.

Read more about Harm Reduction here.

Always carry naloxone. Naloxone is available at no cost through NOSS and the Toledo-Lucas County Health Department. Visit the Naloxone page for more information on how to get your naloxone kit.

Never use alone. Carrying naloxone and using with a friend can help save a life. If you have no one to use with, call the Never Use Alone line, 877-696-1996. This is a toll-free national overdose prevention, detection, life-saving crisis response, and medical intervention services for people who use drugs while alone. Never Use Alone’s peer operators are available 24 hours a day, 7 days a week, 365 days a year.

Test for fentanyl. Fentanyl test strips (FTS) are available at no cost through NOSS and the Toledo-Lucas County Health Department. FTS are small strips of paper that can detect the presence of fentanyl in different kinds of drugs and drug forms (pills, powder, injectables). FTS can inform people about the presence of fentanyl so they can take steps to reduce their risk of overdose.

Watch this video on how to use a fentanyl test strip:

Risks of Injecting Drugs

Reusing needles and/or syringes is unsafe and can spread disease and put you at risk for infections. Risks include:

• The criminalization of injection paraphernalia causes unnecessary exposure to risk for people who inject drugs.
• Shared equipment can lead to HIV or hepatitis C transmission
• Skin and soft tissue infections like abscesses and other bacterial infections can be fatal

Tips for Safer Injection

#1. Prepare yourself:

• Find a safe, clean, well-lit area
• Clean hands or fingertips with soap and water or an alcohol pad
• Wipe the injection area with an alcohol pad in one direction

#2. Prepare your solution:

• Using your own clean cooker or spoon, mix drugs with sterile water, heat (add Vitamin C if necessary)
• Add a filter (piece of cotton – avoid cigarette filters) using clean fingertips
• Insert tip of syringe into filter and pull up solution

#3. Find a vein:

• Body heat can help veins be more accessible – find a warm place or bundle up!
• Use a tourniquet a few inches above the injection site to help with vein pump up (avoid using shoestrings or leather belts)
• Insert the needle bevel up into the vein

#4. Register your shot:

• Before injecting, pull back slightly on the syringe to check for dark red blood (this means you hit a vein)
• If the blood is bright red, frothy and pushes back the plunger, you hit an artery, take the syringe out immediately, and seek medical advice or attention!
• After registering, release tourniquet before injecting.
• Click here for more information on avoiding arteries and nerves.

#5. Do a test shot:

• Inject a little bit of the drug solution to “taste” and test strength and effect before injecting more from that syringe
• This can help prevent overdose

#6. Inject and tidy up:

• Once you finish injecting, dispose of the used syringe(s) in a sharps container

For more safer drug use tips visit the National Harm Reduction Coalition website.