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Hillsborough takes first steps toward needle exchange pilot program

If approved, used syringes could be swapped for free, sterile ones
County commissioners agreed Wednesday to pursue a local ordinance establishing a needle exchange program in Hillsborough County. [C.M. GUERRERO  |  Miami Herald]
County commissioners agreed Wednesday to pursue a local ordinance establishing a needle exchange program in Hillsborough County. [C.M. GUERRERO | Miami Herald]

TAMPA — With the county commission now on board, Hillsborough is on track to become one of the first counties in Florida to take advantage of a new state law allowing local governments to offer free, clean syringes in exchange for used ones.

The commission gave its first nod of approval Wednesday to a proposed pilot needle exchange program that would not only provide free hypodermic needles to the community, but also offer on-site medical treatment, mental health counseling and access to the overdose-reversing drug Narcan.

It would be a welcome addition to the county’s existing efforts to combat the rampant spread of HIV and opioid addiction, Health Care Services Director Gene Earley said. State research shows that Hillsborough County has the highest rates of opioid addiction in the state, as well as the highest hospital-related costs for treating intravenous drug-use diseases like soft tissue infections.

“We have the infrastructure, we wouldn’t need any county funds to do it, and we have the full support of our health care providers and stakeholders,” Earley said. “This would be the missing piece in the puzzle for us when it comes to reducing HIV and opioid rates in the county, and the prevention possibilities are exceptional.”

Related: Hillsborough wants to study starting needle exchange program

Such needle exchange programs have been legal in other parts of the country for decades, but it wasn’t until last May that Florida’s conservative-run Legislature agreed to reverse a long-standing ban on allowing counties to launch their own projects. For seven years, critics in Tallahassee dismissed syringe swapping as enabling drug use. But with the number of opioid deaths and and injection drug users on the rise, a bill reversing that decision passed with nearly unanimous support in both chambers.

Hillsborough leaders had their concerns, too. In the days after the ban’s reversal, commissioners asked the county’s Health Care Services staff, Behavioral Health Task Force and Health Care Advisory Board to investigate whether a county-wide needle exchange program would be worth the possible risk.

The results, presented at Wednesday’s commission meeting, were “staggering," Commissioner Sandy Murman said.

Related: This needle-exchange program is saving lives in Miami-Dade. Now it could be coming to Tampa Bay.

In communities where drug users are invited to swap out used needles without retribution, hospitals have reported major declines in the spread of blood-borne infections like hepatitis C and HIV, increased enrollment in drug treatment programs and fewer opioid-related overdose deaths, said Dr. Khary Rigg, an associate professor at the University of South Florida’s Department of Mental Health.

“When I first started thinking about introducing this program I was very skeptical,” Murman said. “But when you look at the research you’ll be blown away by the positive outcomes. This will help our community save lives.”

Rigg has studied drug use and the spread of HIV for 15 years, he said. And when it comes to needle and syringe exchange programs, experts throughout the world are strongly in favor. As for the cost, research has shown that every $1 spent on needle exchange programs yields an average $7 savings in avoided costs for HIV-related medical treatment, he said.

“In my work I’ve spoken to hundreds of people who use drugs and you’d be surprised by the lengths they go to avoid contact with the health care system,” Rigg said. “The real magic behind these programs is that folks are not condemned for their drug use so then they feel comfortable to come in to talk to staff about their health issues, often for the very first time.”

Related: Needle exchange in Florida gains new support to go statewide

Under Florida law, all future needle exchange programs within the state must be modeled after a five-year pilot program operated out of the University of Miami. Counties aren’t allowed to provide any funding to support a needle exchange, but USF and Tampa General Hospital have pledged to sponsor a future needle exchange in Hillsborough should an ordinance be passed into law.

Researchers within USF’s School of Medicine also hope to work alongside the team of doctors and nurse practitioners, collecting data on the program’s outcomes for future scientific studies on its effectiveness.

The pilot would fit seamlessly into existing programs operated through partnerships with the university, Tampa General Hospital, the Drug Abuse Comprehensive Coordinating Office and Gracepoint, said Dr. Asa Oxner, a doctor at Tampa General. Nurse practitioners, supervised by USF doctors, could use the Tampa Bay Street Medicine Mobile Van to “meet our patients where they’re at," she said. The group has already identified three target areas around Hillsborough Avenue and 22nd Street where the mobile teams would not only pass out free syringes, but also provide condoms, alcohol swabs, and Narcan. They would provide primary care to patients, checking for high blood pressure, diabetes, hepatitis C and HIV and would help connect them to social services for more long-term care.

A grant already pays for prescription medications for patients of those existing programs, and the team has already confirmed that money can be used to buy the county’s first batch of hypodermic needles and syringes.

It was unclear Wednesday when a needle exchange program could launch in Hillsborough. USF officials said they’re ready to start right away, but county staff still have to draft a proposed ordinance for the pilot project and hold a public hearing before the commission takes its final vote of approval.

Contact Anastasia Dawson at adawson@tampabay.com or (813) 226-3377. Follow @adawsonwrites.

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