Miami Doctor Behind Florida's New Needle-Exchange Program Says It Will Save Lives

Mar 31, 2016
Originally published on April 1, 2016 8:10 am

New cases of the virus that causes AIDS are becoming less frequent throughout the United States.

But not in Florida.

Statewide, HIV infections have been increasing in recent years, with Miami-Dade and Broward counties topping the list. But a new law might help stem the tide of those new cases. For the first time, Florida has a needle-exchange program for intravenous drug users.

And in the next five years, if rates of HIV go down in South Florida, much of the credit might go to a term paper done by a young University of Miami student seven years ago.

That student is now a physician, Dr. Hansel Tookes, who’s doing his residency at Jackson Health System in internal medicine with a focus on HIV.

A few days after Governor Rick Scott signed the new needle-exchange bill into law, Dr. Tookes came to speak with us in the WLRN newsroom:

How the needle-exchange program will work

“We will target drug users in areas where they are using. We will educate them on proper injection technique, which is using a clean syringe every time, not sharing. When drug users don’t share syringes, they don’t share HIV and they don’t share hepatitis. In Washington D.C., within five years of implementing this program, the rates of HIV [in that city] were down by 80 percent.”

On how the needle-exchange program will save Florida money

“A group of doctors and I at Jackson looked through our medical records over the past year to see how many people were hospitalized with bacterial infections from using dirty needles and how much those hospitalizations were costing Jackson. And it was astounding. It was $11.4 million over one year. Over 90 percent of these patients had no insurance, had Medicaid or had our county health plans. So this is overwhelmingly being paid not only by Miami-Dade taxpayers, but taxpayers across the state. If we had just prevented 10 percent of infections [HIV patients who identified IV drug use as their risk factor] the state would have saved $124 million in treatment costs for HIV."

Tookes' response to critics who say that giving addicts fresh needles might not be the best way to fight intravenous drug use

"The best part about this program is that we show people that we care about them. We show them that their lives matter. That's a very powerful thing. Hopefully we'll be able to build relationships with these people who live in the shadows,  and when they're ready, we will have a pipeline straight into detox and then into rehab set up before we even start. So the goal is to get these patients into rehab and hopefully have them complete rehab without HIV and Hepatitis C."

On why intravenous drug use is on the rise in both Miami-Dade and Broward counties

"This is the unfortunate result of the closure of pill mills -- these shops in strip malls where people could see a doctor and walk out with a gallon of Oxycodone. But unfortunately, the addiction was already there and the streets were flooded with cheap heroin. And here we are. We have a new generation that's addicted to heroin. They may not remember the ‘80s when people were dying of AIDS. They don't know the proper ways to handle their addiction, to reduce the harm that they're doing to themselves, and that is where we are right now in Miami-Dade and Broward. The uniqueness of the situation is that we have this heroin epidemic here -- but we also have so many people with untreated HIV. And when what we call the "community viral load" -- the amount of virus that exists in the community -- is high, it's a perfect storm. So this is going to be an essential intervention."

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