It seems completely counter-intuitive to supply heroin addicts with free syringes, but a growing number of communities are establishing syringe exchange programs (SEPs).
With the recent passing of North Carolina Senate Bill 794, exchanges are now legal throughout North Carolina, and the ones already operating illegally in our area will come out of hiding.
Anticipating the change, a team of law enforcement from Brunswick and New Hanover Counties sheriff’s offices, in addition to Leland, Boiling Springs, Fayetteville and Waynesville police departments and the North Carolina Harm Reduction Coalition visited an established program in Seattle to see how brick-and-mortar exchanges operate.
Before the team arrived, WECT had the opportunity to tour one of the largest exchanges in the country - measured by needles distributed, not square footage.
The University District exchange operates out of a tiny closet that opens into an alley. The rest of the building is a church, located just a block or two from the University of Washington.
The exchange started in 1990 and is operated by Shilo Murphy, Executive Director of the People’s Harm Reduction Alliance. The Alliance operates eight other sites across two states which have collectively given out tens of million of free syringes to addicts.
Murphy first came to the exchange about 20 years ago when he was homeless and ready to get high.
Over the years they have added just about every type of drug paraphernalia you can imagine to their menu of options. Along with a variety of syringes, the Alliance distributes crack pipes and snorting kits in hopes of preventing any and all types of sharing.
The plan for North Carolina’s prospective exchanges is syringe-focused.
All SEPs have one goal in mind which has nothing to do with making drug abuse easier or more convenient: prevent the spread of disease and reduce the number of syringes found discarded in public places like playgrounds and parking lots.
“The cleanest areas, the safest areas are closest to the syringe exchange and closest to services,” Murphy said. “So my question is why don’t you want it?”
Law makers are starting to embrace the idea because of the results other cities have seen.
According to the North Carolina Harm Reduction Coalition, crime decreases in areas with a SEP once participants start to become connected with social services. SEP participants are five times more likely to enter into treatment than non-participants. These programs have also shown to decrease hepatitis C transmission among injectable drug users by as much as 50 percent and decrease HIV rates by 80 percent.
Hundreds of underground syringe operations working under the radar in North Carolina before the passing of Senate Bill 794.
In WECT’s documentary “In Vein,” we introduced you to James who hand delivered syringes to “user unions” in Fayetteville. With no legal means of disposal for the syringes he takes back, James stockpiles them in a nearby garage.
But now, James and many other North Carolina exchange operators are allowed to operate openly.
You would expect a team of deputies and officers who routinely arrest addicts to have a skeptical view of SEPs. Yet the team visiting Seattle is eager to get them into their jurisdictions.
Consider that on any day, drug agents and many deputies at some point have to put their hands on an active user. It’s in their interest that that person be disease free.
Drug agents are also responsible for searching vehicles and homes where a hidden, uncapped needle can stick them.
Where syringe exchange programs exist, that risk to law enforcement drops as much as 66 percent.
Those visiting the Seattle downtown exchange (operated by an organization separate from the University District’s program) were surprised to see what was quietly tucked inside an otherwise average looking storefront.
“It looked like a retail store," Varnell said. “When you walk in, it could have been a lot of different businesses. Not syringes lying around, it’s just a nice counter top. Everybody’s professional, well dressed, friendly.”
The usual criticism of these programs is that they enable drug use by making it cheaper and more convenient for addicts. Research done on SEPs has yet to find a syringe exchange program that accelerated drug use.
Proponents argue that if Health Departments are already giving out free condoms than giving out a syringe is no different, since it accomplishes the same goal: prevent the spread of disease.
“If you’re pro-HIV by all means don’t have these services,” Murphy shrugged.
North Carolina’s Hepatitis C rate has gone up 700 percent in the past ten years. Hep C and HIV are both linked to injectable drug use, and in 2014 alone taxpayers shelled out almost $170 million for treatments.
A clean syringe costs seven cents and there is available funding from private foundations to cover the costs, so North Carolina taxpayers don’t have to.
“You’re making sure that your insurance rates are going to go up. You’re making sure that state care costs go up,” Murphy said. “That’s the system you have right now. What you don’t have is groups fighting against disease prevention in Wilmington.”
Communities will have to decide what works best for them.
The team of law enforcement visiting Seattle each left the exchange encouraged that a similar program could benefit their own jurisdiction.
“It’s hard not to see it as enabling the use of a controlled substance,” admitted Billy West, District Attorney of Cumberland County. “However, I think when you balance that against the healthcare interest, the spread of disease, kids coming across them in playgrounds, them being in parking lots and public places - I think you have to weigh the benefit and cost analysis, and I think it’s something that could work for us.”
Seattle doesn’t require users to turn in their dirty needles to get a clean supply. That idea was immediately unpopular with the agencies visiting from North Carolina who believe a one-for-one exchange is how both users and the community benefit.
Seattle organizers say even without requiring exchange, most users still turn them in.
At most brick-and-mortar exchanges there’s reading material and pamphlets displayed about treatment and safety. Not all exchanges heavily push that information, but the idea is to offer regular contact with someone educated on recovery should the user decide today’s the day.
A study done in Seattle found syringe exchange participants were five times more likely to seek treatment than other users.
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