Needle swaps: ‘We’re in crisis’
Funding shrinks while demand increases
Drug addicts will swap more than 1 million dirty needles for clean syringes this year as narcotics use soars.
The number of needle exchanges logged by the Spokane Regional Health District is unprecedented and affirms what doctors, counselors and police have been saying for several years: The stresses of job losses, deep service cuts by government and a ready supply of cheap drugs is taking a toll on the vulnerable.
Public health agencies have been cobbling together money to buy clean needles so that drug users can avoid infection with HIV, hepatitis C or a host of other skin and bacterial diseases from using contaminated needles.
“We’re in crisis,” said Lynn Everson, coordinator of the health district’s needle exchange program.
In 2009 her office exchanged about 500,000 needles. In 2011 the number ballooned to 968,000.
This year her office expects to trade more than 1 million.
“When we’re distressed, we retreat to what we know,” Everson said. “For some people that means family or friends.
“For people with drugs in their past … they often go back.”
On Monday afternoon people lined up outside her office. They brought plastic grocery bags and small boxes full of used syringes, disposing them into large red pails and later leaving with packages of fresh needles.
Last year Everson estimated that 1,400 people used the needle program. Each of those likely exchanged needles for at least one or two other users too ashamed, afraid or busy.
Volunteers logged 600 hours to help make it all work.
One 44-year-old woman, who asked that her name be withheld, has been coming to the needle exchange office twice a month for the past year.
Her ex-husband beat her so badly years ago that she doesn’t work and qualifies for disability pay.
Worse, she said, he hooked her on heroin.
“I know that ultimately the addiction is my choice,” she said. “But I had to survive. It’s so hard.”
She wants to enroll in the county’s methadone program, which is designed to wean addicts from heroin and other opiates such as prescription painkillers. The program slots for Medicaid patients are full, however, and the wait list is long. She lacks the money to pay for private drug rehabilitation.
She has avoided HIV infection and other diseases because of the availability of free, clean needles.
Whether it is addiction to cheap heroin or more expensive prescription painkillers, narcotics use often has a deadly aftermath.
In Spokane County the death rate from prescription drug overdoses is 12.8 per 100,000 people, according to health records. That’s double the rate of King County and higher than the statewide average of 7.1 deaths per 100,000 people.
Though needle exchanges prompt accusations of enabling drug users, public health officials stand behind the controversial programs.
Dr. Joel McCullough said his agency is tasked with trying to keep people healthy and fighting the spread of disease.
The needle exchange program helps do that, he said.
“Drug addiction is an issue that is very difficult for us to do anything about,” McCullough said.
Communities tend to put higher priorities on other programs.
“We have to operate in the world as it is, not as we want it to be,” McCullough said.
As state funding for the needle exchange program has shrunk by a third to about $90,000 annually, McCullough has directed staff to backfill the losses with local dollars and find savings wherever possible.
Similar programs across the country have been widely credited with curbing the number of new HIV infections among injection drug users.
Local data comparing five-year spans in the 1990s and 2000s found the number of new HIV/AIDS cases among needle users fell from 19 percent to 11 percent, said Lisa St. John, the district’s HIV/AIDS program manager.
The local health district had pinned some hopes for new funding on federal dollars.
Congress, however, reinstated its ban on syringe exchange funding even as the federal Centers for Disease Control and Prevention completed a recent study that noted the continued vulnerability of injection drug users contracting HIV/AIDS.
McCullough said while the ban deflated one possible source of funding, the district would keep trying to fight the spread of HIV/AIDS with other public and private agencies that contributed volunteer hours, in-kind services and money.
“Fighting (HIV/AIDS) is a multisector effort,” he said. “Needle exchange is one part of it. An important part.”