TAMPA — It’s a controversial solution to a complicated problem — and one that Hillsborough County has never tried before.
But with a groundswell of support from local health agencies, county commissioners gave final approval on Wednesday to launch a countywide needle and syringe exchange program.
Local governments throughout the country have operated similar programs for decades as a way to combat the spread of HIV/AIDS, hepatitis and other blood-borne diseases among intravenous drug users, their sexual partners and their children. But Hillsborough’s forthcoming Syringe Service Program, expected to begin in March, will be one of the first of its kind in state history.
Launching any county-wide programs where citizens could get free hypodermic needles and syringes in exchange for used ones was banned by the Florida Legislature until late last year, when lawmakers learned the results of a five-year pilot program in Miami-Dade County and reversed the ruling.
Local governments are still prohibited from using state, county or municipal funding to launch a needle exchange. Yet at least three other counties — Manatee, Palm Beach and Broward — have also begun efforts to begin their own programs in the wake of the decision.
For Commissioner Sandra Murman, who has worked to launch a Hillsborough-based program, the proof was in the numbers.
The University of Miami, which was tasked by the state with overseeing the pilot project, reported steady decreases in the the number of opioid-related deaths in Miami-Dade County – from 321 deaths in 2016 to 305 in 2017 to 213 in 2018. It was the only county in the state where the number of opioid-related deaths actually decreased in 2018.
In 2017, Hillsborough County reported 179 opioid-related deaths. In 2018, that number increased to 222.
The county has also grappled with a surge in the number of citizens living with HIV. In 2018, Hillsborough County counted 7,521 citizens living with the virus, at least 323 of whom were newly diagnosed. Considering that the average lifetime cost of HIV treatment is about $400,000 per person, Murman said, the new initiative will not only save lives but also taxpayer dollars.
“Hillsborough County is experiencing one of the highest HIV rates in the state of Florida. We have the highest opioid death rate. We have to do something,” Murman urged the board at Wednesday’s meeting.
“This is a tool in the toolbox,” she said. “Every single inch of this program has been scrutinized legally, medically and socially because I wanted to answer my own concerns on whether we were doing the right thing. And I can say now we are absolutely doing the right thing.”
The initiative came to the board with the unanimous support of Hillsborough’s 52-member Health Care Advisory Board as well as the county’s Behavioral Health Task Force. A lengthy review of programs throughout the country found little evidence that these initiatives led to increased intravenous drug use or crime like lawmakers feared, county health officials said.
Commissioners have yet to approve any contracts or agreements with the agencies needed to support the program. But the county’s Health Care Services department has already secured partnerships with agencies including Tampa General Hospital, the University of South Florida’s College of Medicine, the USF Department of Mental Health Law and Policy, Gracepoint, Metro Inclusive Health and the Drug Abuse Comprehensive Coordinating Office, known as DACCO.
The program can easily be supported by existing outreach initiatives sponsored by the university and Tampa General Hospital. The current plan is to operate the program out of vans owned by USF’s Tampa Bay Street Medicine student organization.
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, said Dr. Asa Oxner, a doctor at Tampa General and an associate program director of internal medicine at USF.
“We have a grant already that we are using to pay for prescription medications for these patients, and that grant could be used to buy the starting stock of syringes that we would use for the exchange,” Oxner said. “We would be ready to go as soon as it’s voted into ordinance.”
Jason Wilson, an emergency medicine doctor at Tampa General, is tapped to serve as one of the program’s medical directors. With the county’s existing partnerships, Wilson said, the program can also provide those patients with mental health counseling, connect them to social services for long-term care and provide on-site medical treatment for high blood pressure, diabetes, hepatitis C and HIV.
“When I trained, patients would come in with a drug overdose and we really had no options for those patients,” Wilson said. “We would tell them, ‘Good luck, here’s a list of resources, I hope you do better.’ Patients died.”
“I think we have an opportunity here today to save patients’ lives,” Wilson said.
In other actions on Wednesday:
º Commissioners passed a resolution of support for Senate Bill 810, which seeks to increase the minimum age for purchasing, selling or possessing all tobacco products from 18 to 21 throughout Florida. In the event the bill is rejected by the state Legislature, commissioners directed staff to begin drafting an ordinance that would have the same effect throughout Hillsborough County.
º Commissioners scheduled a public hearing on proposed amendments to the Pet Retail Sales ordinance for February 19 at 10 a.m. The proposed changes would ban all commercial pet retail stores operating within county limits. Stores currently operating within Hillsborough County would have about six months to adapt to an “adoption-based model."
º Commissioners scheduled a second public hearing for February 19 at 10 a.m. to consider decriminalizing the possession of up to 20 grams of marijuana.