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Hot Topic (8/4): Needle exchange programs

Posted by on Sep. 4, 2009 at 3:24 AM
  • 13 Replies

From BangorDailyNews.com: 

Drug needle exchanges threatened


Federal budget bill would limit locations available to facilities

By Meg Haskell
BDN Staff

ELLSWORTH, Maine — Three or four times a week, “Kevin” — not his real name — drops by the inconspicuous, side-street offices of the Down East AIDS Network.

He deposits a handful of used syringes — the tiny, sharp-needled variety favored by intravenous drug users — into a red plastic container labeled for safe disposal. He helps himself to a supply of new syringes, along with some single-dose vials of sterile water he later will mix with crushed prescription painkillers, heat and inject into his bloodstream.

These supplies, and others aimed at reducing the dangers of IV drug abuse, are given away freely, anonymously and without question at DEAN, which has run a low-profile needle exchange program here since 2007. The “harm reduction” goal of the program, and of the three other needle exchange programs that have operated in Maine since 1998, is to reduce the transmission of HIV, viral hepatitis and other diseases related to IV drug use, while also collecting used needles and syringes for safe disposal.

Needle exchange programs like this are imperiled at the federal level. A double-edged Health and Human Services appropriations bill recently approved by the House would free up much-needed federal funding, which has been prohibited in recent years. But advocates say a misguided amendment to the bill would ban federally funded programs from operating in the places they’re most needed. The amendment imposes a 1,000-foot perimeter around any school, college, park, library, public pool, youth center or other place where juveniles typically congregate, and prohibits needle exchange programs from operating inside that zone.

When the Senate passes its version of the Health and Human Services budget bill later this year, the two measures will be merged into a single piece of legislation for final approval by both bodies.

“If the House amendment makes it through [into the final appropriations bill] it will affect virtually all programs located in urban areas,” said Andrew Bossie of the Maine AIDS Alliance. “The HIV community here in Maine is very concerned about this.”

“This restriction would make it virtually impossible to operate a needle exchange program in Ellsworth,” said Steve Richard, executive director of DEAN.

Between schools, day care programs, parks and other sites, he said, there is essentially no place within the small coastal city where the program could be located and still be accessible to the people who need it.

In addition to Ellsworth, other needle exchange programs in Maine are headquartered in Augusta, Bangor and Portland. Some offer occasional mobile services that reach into more rural areas of the state. A fifth site in Lewiston has closed but may reopen in the future. Funding is a shoestring of state dollars, foundation grants and private donations.

Patsy Murphy, director of the Eastern Maine AIDS Network in Bangor, runs the city’s needle exchange program out of her Harlow Street offices. She said the specifics of the proposed restriction are unclear, but it’s unlikely the EMAN program would qualify for federal funds if the House amendment were to be included in the final budget bill.

In the past year, EMAN has collected almost 12,000 dirty needles and given away approximately the same number of clean ones, Murphy said. In addition, out of the approximately 200 drug users enrolled, about 150 have been referred for substance abuse treatment, medical care, mental health counseling and other services.

“There is a lot of relationship-building that goes into this program,” Murphy said. “We all have the utmost respect, compassion and commitment to our clients’ health and well-being.”

The needle exchange program at EMAN has a budget of about $30,000, cobbled together from small private grants and personal donations. It’s enough to keep the program running at its current level, Murphy said, but federal funding would enable a much-needed expansion of services.

“People think we are promoting drug use, but that is simply not the case,” she said. “We are committed to stopping the spread of disease.”

Since 1998, when the first program opened in Portland, tens of thousands of clean needles have been distributed in Maine. According to a recent report to the Maine Legislature, the four programs in 2008 collected a total of more than 29,000 used syringes and gave away close to 31,000 new ones. Nearly 900 individuals partici-pated, including about 260 new enrollees.

The programs also collect and compile anonymous public health data, such as the age and ethnicity of enrollees, their drug of choice, whether they’ve been tested for HIV and hepatitis and what the results of that testing are.

“Science has told us that for IV drug users … these programs are access points to education, testing, substance abuse treatment and other referrals,” said James Markiewicz, director of the HIV, STD and Viral Hepatitis Program in the Maine Center for Disease Control and Prevention. “The programs are good, sound public health.”

Reps. Mike Michaud and Chellie Pingree both voted for the Health and Human Services budget bill that contains the amendment. Michaud said in a recent interview that he was unaware of the amendment and would have concerns about its implementation. A spokesman from Pingree’s office said Pingree has co-sponsored leg-islation that would negate the ban in future budgets.

A spokesman from Sen. Olympia Snowe’s office said the location of drug treatment programs, including needle exchange programs, is a “multidimensional challenge” often best left to local decision-makers.

Kevin Kelley of Sen. Susan Collins’ office said Collins supports programs that combat the spread of HIV-AIDS. But, he said, the senator feels taxpayer funds should be spent on “bringing help to the population suffering from heroin addiction, not on giving them more effective means to continue their addiction.”

Bossie of the Maine AIDS Alliance said people who don’t understand the principle of harm reduction are fearful that the programs will attract drug users to their neighborhoods and even worsen the problem of drug abuse.

“But statistics show that having a syringe exchange does not encourage drug use,” Bossie said. “It does mean that people with this unhealthy habit do it more safely, while getting dirty needles off the streets.” At DEAN, needle-exchanger Kevin agreed. The 30-year-old clam digger said intravenous drug use is “rampant” in Hancock and Washington counties. “Everybody and his uncle is using,” he said.

“Especially between Steuben and Lubec, it’s amazing how many people are on the needle.” He often picks up extra supplies for his drug-using friends Down East. Paying for illicit drugs is easier for day laborers like him, who can use a portion of each day’s pay to support their habit, Kevin said.

“A lot of us are pretty here-and-now types,” he said. If needle exchange programs are discontinued, he said, it won’t drive addicts into treatment or make them stop using drugs.

“People are going to do what they do,” he said, bagging his clean supplies in a discreet brown paper sack and heading for the door. “A program like this just makes it cleaner and safer.”

* * *

What do you think about needle exchange programs?  Do you think they ought to be federally funded?

Do you believe these programs enable addicts in their addictions? 

Or do you think they are essential in preventing the spread of HIV-AIDS and other diseases?

 





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by on Sep. 4, 2009 at 3:24 AM
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Replies (1-10):
home-sweet-home
by Silver Member on Sep. 4, 2009 at 6:29 AM

What do you think about needle exchange programs?  Do you think they ought to be federally funded?

Absolutely NOT!

Do you believe these programs enable addicts in their addictions? 

Yes! I mean, sometimes they will get bad drugs, should we make drugs so as to make sure they don't get a "bad batch" Drugs are illegal and we are federally funding a program that helps them obtain supplies to break the law, Makes no sense!

Or do you think they are essential in preventing the spread of HIV-AIDS and other diseases

What is essential is to get these people help. Next time they come in to get their drug supplies, grab them up and put them in rehab. Help them get their lives together. What good does it do to prevent AIDS, when the drugs themselves will probably kill them.

Another example of how STUPID our government is.


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SWasson
by Bronze Member on Sep. 4, 2009 at 6:45 AM

What do you think about needle exchange programs?  Do you think they ought to be federally funded?

Absolutely. Every HIV case that's prevented is at least one fewer spouse/SO/child at risk for infection by no fault of their own.

Do you believe these programs enable addicts in their addictions?

No. They'll use anyway, just with dirty, shared needles. This is a way to get them into the system, so they can get help when they're ready.  

Or do you think they are essential in preventing the spread of HIV-AIDS and other diseases?

Absolutely.

The regulations about location in this bill worry me, too. If they can't place a needle-exchange where addicts can get to it, they won't use it. 1000 feet in a rural area is no big deal, but in an urban area, it's a very long distance for a prohibition.

momaof8
by Bronze Member on Sep. 4, 2009 at 6:52 AM

My mom can't get help with her diabetes supplies, but druggies can get free needles. What a crock. I don't think we should enable drug users.

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hsteele
by on Sep. 4, 2009 at 8:21 AM

It is more expensive to pay for drug rehab than to just make sure their needles are clean. I personally think that person can do any drugs they want. Even if its IV drugs. But the risk of contracting AIDs puts the rest of society at risk thats why I support these needle exchange programs.

Quoting home-sweet-home:

What do you think about needle exchange programs?  Do you think they ought to be federally funded?

Absolutely NOT!

Do you believe these programs enable addicts in their addictions? 

Yes! I mean, sometimes they will get bad drugs, should we make drugs so as to make sure they don't get a "bad batch" Drugs are illegal and we are federally funding a program that helps them obtain supplies to break the law, Makes no sense!

Or do you think they are essential in preventing the spread of HIV-AIDS and other diseases

What is essential is to get these people help. Next time they come in to get their drug supplies, grab them up and put them in rehab. Help them get their lives together. What good does it do to prevent AIDS, when the drugs themselves will probably kill them.

Another example of how STUPID our government is.


Heather
Proud Pagan Momma

"If Evil exists its a pair of train tracks,
And the Devil is a railroad car."

Josh Ritter "Harrisburg"

MontclairMama
by on Sep. 4, 2009 at 11:12 AM

There is always a chance that someone can sober up in the future and I would rather that they did that without AIDS.

luckcharm
by Bronze Member on Sep. 4, 2009 at 11:39 AM

 What do you think about needle exchange programs?  Do you think they ought to be federally funded?

I think this program helps in several ways,  and not just drug users,  so yes I do think they should be federally funded.  Not only does it get dirty needles off the street but it does help stop the spread of diseases.  And not just to drug users.  

What do you think happens to those dirty needles?  How many of them get thrown away improperly?  Would you like to be a trash man picking up someones trash and get stuck by a dirty needle because a drug addict threw it away instead of trading it in for a clean one?

Do you believe these programs enable addicts in their addictions? 

Yes,  I do think it enables them,  but I think that HIV is a lot worse than drug addiction,  their is the chance of breaking the addiction.  

Or do you think they are essential in preventing the spread of HIV-AIDS and other diseases?

I don't know if I would use the word essential, but it definatly can help with HIV spreading.  

                   

luckcharm
by Bronze Member on Sep. 4, 2009 at 11:41 AM

Forcing someone into rehab doesn't do any good,  if a person doesn't want to go then they will get clean long enough to get out of rehab and then bounce right back to it when they get out,  so all you've done by forcing them is wasted money and time.

Or do you think they are essential in preventing the spread of HIV-AIDS and other diseases

What is essential is to get these people help. Next time they come in to get their drug supplies, grab them up and put them in rehab. Help them get their lives together. What good does it do to prevent AIDS, when the drugs themselves will probably kill them.

Another example of how STUPID our government is.


Mergath
by Silver Member on Sep. 4, 2009 at 2:41 PM

I absolutely agree with needle exchange programs, and think we should give them all the funding they need.  We may disagree with a person's choices, but that doesn't mean we shouldn't help make their lives better in some small way if we are able.  Some of you appear very bitter and seem to have the attitude that we shouldn't give these people any help, that they're just too lazy to quit drugs, or perhaps too selfish.  But believe me, no one sits down and makes a conscious choice to throw their life away and become an addict.  There are many complex factors that contribute to this problem, and we should give these people all the help they are willing to accept.



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witch_e_woman
by Bronze Member on Sep. 4, 2009 at 8:29 PM
Being an x nurse I can tell you this new bill seriously bothers me.

The implications of just such a bill would have dire consequences to the healthcare community as well as those that deprend & rely on the need for this program.

It makes no sense to me why the bill needs to be changed.

The programs purpose is to help those that can not help themselves and to reduce others from being infected with serious blood born diseases.

To take this program away from our inner cities would be disasterous for anyone living in our outside of the inner cities..
Raven (WitchE)


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ntimeout
by Member on Sep. 4, 2009 at 10:58 PM

Hate to sound like a witch but send them to Amsterdam. If theey make it out they won't need a needle & this comes from a sister of 2 & mother of 1 former users.

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