Fla. needle exchange program is new weapon to fight the opioid crisis
Researchers have found the Miami-Dade program has discarded 11,000 more needles than it gave out and reversed 1,304 overdoses
Lois K. Solomon
FORT LAUDERDALE, FLa. — Bring in a used needle, leave with a clean one.
That’s the premise of a needle and hypodermic-syringe exchange program proposed for Palm Beach County’s drug addicts.
The concept: It’s better to have heroin and fentanyl addicts use sterile injection devices than spread their infections by reusing or sharing their needles. Through the exchanges, now legal in 39 states, the addicts encounter workers they trust, who can advise them how to improve their health, including drug treatment when they are ready.
Advocates for the addicted see the needle exchanges as one of several tools to combat the opioid epidemic, which led to an influx of addicted people to Palm Beach County. The county tallied a record 569 opioid-related deaths in 2016, although the rate has been declining, with 558 in 2017 and 326 in 2018. Officials credit a stampede of task forces, lawyers, health officials, police and rehab specialists who have been tackling the scourge.
Owners of rogue sober homes were arrested. Narcan became widely used on patients by rescuers, and now can be purchased over the counter. And cities began hiring staff to work with people hooked on drugs, including Delray Beach, where the police department has its own social worker dedicated to the homeless and the addicted.
The state Legislature approved needle exchanges in its spring session after a successful pilot program in Miami-Dade County. Researchers have found the Miami-Dade program has discarded 11,000 more needles than it gave out and reversed 1,304 overdoses.
Dr. David Forrest, program director at the IDEA Exchange, the infectious disease reduction program at the University of Miami, says the needle swap is just one aspect of the county’s outreach.
“The exchange is just the core activity that gets people to come to us,” Forrest said. “These people have been stigmatized for so long, and they are so severely under-served, it takes a while to build a trusting relationship. They come on a regular basis and enroll in our program, and when they’re ready for treatment, they’ll come to us for it."
Under the new Florida law, county commissions decide whether to approve the needle swaps. The Palm Beach County Commission will consider a new law Tuesday to develop a model similar to Miami-Dade’s, using a fixed location for an exchange center or mobile van units, or both.
The state law does not allow public money to be used for the needle exchange programs, which must be funded through donations or grants.
In Broward, County Commissioner Steve Geller said he is intrigued by Miami-Dade’s success but wants to learn more before introducing legislation.
“Now that Dade has passed it, and Palm Beach is about to, I’m fairly confident Broward will consider it as well,” he said. “I would want to ensure this is not increasing the amount of drug use. We may wait a year and see how it works in Palm Beach.”
Many communities have feared an increase in drug use and needle litter as a result of exchange programs. In Santa Ana, Calif., officials denied a permit last year to a mobile needle exchange, saying the program created litter and a threat to public health as addicts improperly disposed of their injectors in public places. The program remains closed.
The Florida law seeks to avert this problem by requiring the addicts to give back a needle in order to get a fresh one, making it less likely for the sharp objects to be discarded in public. The U.S. Centers for Disease Control and Prevention reports these zero-sum transfers reduce overdose deaths, increase entry into substance abuse programs and prevent the spread of hepatitis and HIV, thus saving money on health care.
In Miami-Dade, 1,128 people are registered in the needle exchange, which opened in December 2016. Participants are tested for HIV and hepatitis C when they enroll and are given medicine, which the program stores for them if they are homeless. Forrest said they can also get containers for carrying their needles and clean equipment for their drug use, such as cookers, filters, sterile water and tourniquets.
Justin Kunzelman, executive director of Rebel Recovery in Lake Worth, lobbied the state to expand the Miami-Dade program. He said he hopes his rehabilitation center is chosen as one of the exchange sites in Palm Beach County.
“We’ve known through peer-reviewed research how effective these programs are since the 1980s,” said Kunzelman, who was addicted for 11 years to alcohol, pills and cocaine. “It’s not a question of will it work. It works.”
©2019 the Sun Sentinel (Fort Lauderdale, Fla.)