The Obama Administration has a new plan to combat the abuse of heroin and prescription drugs. The president is calling for a shift away from incarceration, and towards prevention, and a Florida Democratic Representative is working on just that: a needle exchange program.
According to the Institute of Medicine, about a third of Americans suffer from chronic pain. And a lot of people seek relief for that pain. In 2012, healthcare providers wrote 259 million prescriptions for opioid based medications. That’s one bottle for every adult. But with the increased use came dependency, then a crackdown on lax prescribing laws. Jason King, from the AIDS Healthcare Foundation, says this might be why more people are turning to a cheaper high: heroin.
“Law enforcement throughout Florida suggests that the state has been doing a really good job cracking down on pill mills. The problem is now addicts are turning to other intoxicants, which may explain a significant increase in heroin and methamphetamine use,” he said.
There is a strong correlation between injection drug use and preventable infections like HIV and Hepatitis C. Scott County, Indiana experienced this in the spring of 2015 when the rural area became the epicenter of an HIV outbreak. That county’s city of Austin, population 4200, saw 170 new HIV cases in eight months. Enter Dr. Beth Meyerson, co-director of the Rural Center for AIDS and STD Prevention at Indiana University. Meyerson says the way to prevent these illnesses is through needle exchange programs.
“It isn’t just about the clean needle, but the clean needle is important, very important. What happens in these programs is that the people and organizations that work in syringe access programming actually provide linkage to testing and to primary healthcare,” she said.
The public health community says decades of research support the efficacy of needle exchange programs. A longstanding ban on the use of federal dollars for these controversial exchanges has slowed their growth. But 35 states and Washington DC have established the programs anyway. Broward Democratic Representative Katie Edwards is proposing one such program for Miami-Dade County. House Bill 81 would establish a needle exchange pilot program at the University of Miami. The program would be funded by private donations, not state, county or federal dollars. Edwards says the state should turn towards harm reduction.
“It’s a one to one needle exchange. So if you can imagine, what we’re doing is creating a program, where they can get that needle to be able to wean themselves off of it and prevent the further transmission of HIV and Hepatitis C and other blood-borne illnesses,” she said.
Critics don’t want to give needles to addicts at the taxpayers’ expense. But supporters say they’re already paying for treatment. Many users don’t have access to private healthcare, and their bills are picked up by the state. Dr. Hansel Tookes at Miami’s Jackson Memorial Hospital says preventing even 10% of these infections could result in a $124 million saving.
“So my colleagues and I at University of Miami, we were seeing more and more people hospitalized for abscesses, cellulitis, so we wanted to look at the numbers at Jackson and see just how much money we were spending on treating these preventable infections. And we found that it was $11.4 million over one year,” he said.
Public health officials say needle exchange programs provide more than clean needles; they link users to the public health system. Healthcare workers can establish trust and provide testing, counseling and addiction treatment. The House Health Quality Subcommittee approved Representative Edwards’ plan. Similar bills have been proposed in recent years, but none have passed into law.