State scrambling to develop plans for legal needle exchange

Monday , April 18, 2016 - 7:31 PM3 comments

DOUG GIBSON, Standard-Examiner Staff

OGDEN — Heather Bush, viral hepatitis prevention coordinator for the Utah Department of Health, has this to say of House Bill 308: “This sort of came up out of nowhere.”

The new law allows a needle-exchange program in Utah. It officially “starts” on May 10. But no needles will be exchanged on that date.

Instead, Bush says, the first part will be gathering as many of the health players in Utah — public, private, clinics, pharmacies, and social services — to meet and figure out how to administer the new program. By the middle of May, workshops should commence.

This is good news for local groups waiting for details of a bill that offers an outline, but no money appropriated. 

RELATEDUtah legalizes needle exchanges aimed at reducing illegal drug use, disease

Jed Burton, Weber Human Services clinical director, says his organization is “absolutely in support of the bill,” but for now, “we’re waiting for direction ... the framework and how it will be funded.” Bob Ballew, of the Davis County Health Department, said there’s been some talk about the new law.

Hepatitis C is increasing. According to the Utah Department of Health, it grew by 35.4 percent in 2014, 49 cases per 100,000. Using dirty needles is a key cause of Hepatitis C, Bush said.

“We’re really relying on collaboration between organizations. We don’t have a lot of resources and data right now as to the impact this will have,” Bush said.

DATA NEEDS TO BE COLLECTED

“The key goal is getting the data,” Bush said. Besides creating a needle-exchange program, the Legislature requires feedback by Oct. 17, 2017, and every two years thereafter. The questions include:

  • The number of individuals who have exchanged syringes;
  • The number of used syringes exchanged for new syringes;
  • The number of new syringes provided in exchange for used syringes;
  • The impact of the programs on blood-borne infection rates;
  • The impact of the programs on the number of individuals receiving treatment for a substance use disorder;
  • Whether the programs promote illicit use of drugs; and
  • Whether the programs should be continued, continued with modifications, or terminated

“A (needle) exchange program is so much more than just having a clean needle,” Bush said. Contracting AIDS, Hepatitis C, as well as heroin addiction, are all related to unsafe needle exchanges. For any program to succeed, it’s got to reach the people who need the help, she added.

Sarah McClellan, project director for the Northern Utah Coalition, said there’s a need for clean, free needles in Ogden. “You’re always going to have folks who will have risky behavior,” she said. 

Even though there are needles that can be bought at stores, that costs money, and many drug users don’t have the cash, she added. 

Clean needles will prevent disease. “A lot of people get infected with HIV.” The reason? They’ve been sharing the needles, she said.

UTAH AIDS FOUNDATION PLANS TO MOVE MORE QUICKLY

At the Utah AIDS Foundation in Salt Lake City, Stan Penfold, executive director, says they plan to have a needle-exchange program before the state. Tyler Fisher, program director at the AIDS Foundation, hopes it will start this year. The foundation has received a small grant to get that going, Fisher added.

However, Penfold said the foundation is eager to work with the state in implementing HB308. One reason is that the state health department has statistical information that helps the foundation and other groups.

The foundation wants to reach as many of those who will benefit. “A challenge is to ... reach the target audience,” Penfold said. The organization is working with homeless assistance groups, such as Volunteers of America Utah, to reach these people. “It can be kind of a difficult population to reach,” he added. Many don’t want to be identified before trust can be reached, he added.

Fisher calls clean needle-exchange programs one tool to treat the problem. “It’s a process. ... Making healthy decisions is the key,” he said. If the process is working, the individual will start making the right decisions.

Burton says about 75 new people a month with these struggles are met by Weber Human Services staff. Using clean needles will save taxpayers money because they won’t have to pay for the consequences of using dirty needles, he added.

However, he agrees with Penfold that the challenge is finding clients. “Right now it’s pretty tough,” he said. Those they help are primarily court-ordered or seeking help on their own initiative.

Collaboration, finding interested groups to work together, is the key to success, Burton said. But the lack of a fiscal note to the bill is a concern. It needs to be funded, he said.

ONLY A FRACTION BEING HELPED IN UTAH

Bush says that the costs of a needle exchange program are relatively inexpensive. “The actual cost of the equipment is pretty minimal,” she said. Part of the planning will entail looking at funding sources, including grants.

One thing is certain. Only a small fraction of Utahns who suffer from substance abuse problems are receiving help. According to the Division of Substance Abuse and Mental Health 2015 Annual Report, 134,764 adults in Utah needed treatment for substance abuse in 2015. The public system only served 14,841 individuals, or 10 percent. In Weber County, only 1,336 of 11,215 received public help. In Davis County, only 896 of 13,229 received public help. The numbers for youth substance abusers in Utah (12-18), while lower in number, are at the same 10 percent help ratio. 

The report reads: “A combined total of approximately 131,726 adults and youth are in need of, but not receiving, substance abuse treatments services.” 

Another drug of concern is being used via the needle. As prescription painkillers have become more expensive or harder to access, heroin has become an alternative.

“We’ve been really concerned with the spike in heroin use,” Penfold said. In 2002, Utah had 64 heroin deaths; in 2014, 116 heroin deaths. 

With HB308, there are some long-term goals, Bush said. “Store-front locations or mobile vans,” she said, might provide suitable access for the exchanges. A pilot program in a single location may be started, and results checked. 

But she stresses that each location is distinct, and will have resources or expertise. For organizations with a head start, such as Utah AIDS Foundation, “we want to make sure at the very least we know what is going on.”

For the others, the state wants to lay the groundwork and “get some things going by the end of the year,” she added.

dgibson@standard.net

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