TAMPA — County Commissioner Sandy Murman still has her doubts about launching a needle exchange program in Hillsborough County.
It's a decades-old idea: slow the spread of blood-borne infections diseases like hepatitis C and HIV by letting drug users swap used needles and syringes for clean ones, free of charge, instead of sharing infected needles. It could also reduce intravenous drug use by spurring users to enter drug treatment programs and obtain other social services. The state has only allowed one pilot program, a five-year test run in Miami-Dade County, and its effectiveness is still being studied.
The data was promising enough to change the minds of legislators who spent years thwarting similar efforts from spreading throughout the state. Earlier this month, bipartisan legislation that would allow counties to start their own exchange programs passed both the Florida House and Senate with near unanimous support.
And as Murman rattled off those same numbers Wednesday to her fellow commissioners, state senators were poised to vote on the final changes to the bill before sending it to the governor's desk for final approval.
"I think we have to be very careful — very careful — but I'll be honest with you, I think it's worth us studying," Murman said."If this is another tool in the tool kit we need to combat this high number of opioid deaths in our county, I do think we should move in that direction ...
"And I'll say I think in Miami they're saving lives, and that's something that's worthy of our consideration."
Commissioners, however, weren't convinced just yet. So instead of voting to start their own program, they directed the county's Health Care Services staff to look into what it would take to bring a needle exchange to Hillsborough.
Those efforts will include gathering input from the county's Behavioral Health Task Force and Health Care Advisory Board, a panel of 52 healthcare experts, researchers and community providers. Then a final recommendation will comes back to the board for a vote.
A new way of combating the opioid crisis couldn't come soon enough, Murman said. More people die from opioid overdoses in Hillsborough than any other county in Florida, she said, and the death toll has risen by about 24 percent in the past five years. The county's Opioid Action Plan reported 270 opioid overdose deaths last year alone and the birth of 579 babies who were exposed to those substances.
It was a visit to the Miami-Dade program's Overtown clinic that convinced House Speaker Jose Olivia, R-Miami Lakes, to finally support needle exchange legislation. Murman said she'll take a trip there, too. From the time the University of Miami earned approval to launch the program to Dec. 31, 2018, about 250,000 sterile needles and syringes were exchanged for more than 260,000 used ones. They've enrolled more than 1,000 participants and made about 9,000 needle exchanges.
More importantly, Murman said, 66 participants in Miami-Dade enrolled in treatment programs for substance abuse disorders. The program administered 913 HIV tests and made 64 positive diagnosis. More than 700 Hepatitis C tests were administered, yielding 298 positive results.
The needle exchange clinic also reported passing out the overdose-reversal drug Naloxone to about 1,900 participants and their families. The antidote was then used to reverse 1,075 overdoses.
The proposed legislation to expand needle exchange programs expressly prohibits counties from using state, county, or local funds for the program. Instead, they must be supported by grant donations from private sources.
But if Hillsborough does launch its own needle-exchange program, Commissioner Stacy White said, then the county must also provide the addiction treatment and social services that the Miami-Dade program provides.
White, a licensed pharmacist, said he believes such programs reduce the spread of blood-borne diseases. But he still has questions about just how effective needle-exchange programs are and said researchers could use the county's program to figure out the answers:
"I'm suggesting that we move forward, but that researchers keep collecting data along the way so that Hillsborough County has a chance to be on the cutting edge of seeking to answer those questions that are not answered within scientific literature."
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