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Geisel Students Confront Granite State's Opioid Epidemic

Geisel students Louisa Chen '20 (left) and Nasim Azizgolshani '20 (right) with supplies for the
harm reduction center they founded in Claremont, NH.

By Susan Green

In an effort to reduce opioid overdose deaths in New Hampshire,and to prevent blood-borne disease transmission, two Geisel School of Medicine students, Louisa Chen '20 and Nasim Azizgolshani '20, opened a harm reduction center this summer in the Claremont Soup Kitchen.

The first program of its kind in the Granite State distributes free naloxone (an overdose reversal drug also know as Narcan(R)), sharps containers, and clean syringe kits while educating the community about overdose protocol and preventing the spread of diseases such as HIV and Hepatitis C, which are prevalent among intravenous drug users.

Seeking a way to stem the state's rising tide of deaths, then first-year medical students Andrew Blake '19, Margot LeNeveu '19, and Michelle Scheurich '19, founded Project 439 in 2015 (named for the number of New Hampshire overdose deaths that year) as part of their Schweitzer fellowships. Under the auspices of the project, they proposed legalizing needle exchange programs, which were illegal in the state at that time, and worked with state legislators to draft a bill. This spring Governor Chris Sununu signed the bill into law.

Chen and Azizgolshani took over managing the project as first-year students in fall 2016 and began laying the groundwork for the harm reduction center in Claremont. They chose the city, and the location, because of community need and accessibility—quite a bit of foot traffic passes through the soup kitchen daily, and it's easily accessible by bus.

A true community project, Azizgolshani and Chen initially spent countless hours meeting with people in Claremont—the fire chief, the police chief, the mayor, and community organizers, making sure Project 439's goals aligned with the city's.

A true community project, Azizgolshani and Chen initially spent countless hours meeting with people in Claremont...

On the first and third Mondays of each month, Azizgolshani and Chen see walk-ins in the late afternoon when the soup kitchen opens for dinner. "We distribute supplies (clean needles and sharps containers for needle disposal) and whatever else is needed," Chen says. "The most important thing that we distribute is naloxone, and we teach not only users, but also family members about how to recognize signs of overdose, how to use the medication, who to call, and appropriate next steps. Each box of Narcan(R) we give out is a potential life saved."

According to Azizgolshani, the response to their services has been overwhelming. "It's been going really well. The last time I was in Claremont people were lined up outside the door and coming in for a variety of reasons," she says.

They are in talks with both Valley Regional Hospital and Dartmouth-Hitchcock Medical Center to dispose of the sharps they collect for free. Safe disposal of used needles not only keeps users healthy, but also protects their families, friends, and community members from disease transmission.

As future physicians, Chen and Azizgolshani think it's vitally important to ameliorate the worst aspects of the opioid epidemic. "We truly stand behind the mission of our program—it's the first of its kind in the state—and we want to make sure we set a precedent so future programs have the support to thrive," Azizgolshani says. "This is something we want to be sustainable, especially given the high stakes of what we are providing. If it is at all inconsistent, the trust we worked so hard to build will be ruined."

Both want to make sure their effort is built upon a stable foundation, and are cognizant of their limitations as medical students. They plan on grooming a few first-year students to help take over some of the day-to-day operations. But whether or not the day-to-day operations are taken over by enthusiastic first-years committed to the mission, Chen and Azizgolshani will together be guiding and helping the program as much as possible to ensure its continuous growth and success.

Read more about this program at dartgo.org/project439


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