Florida Legislature approves Miami-Dade needle exchange, sends bill to Gov. Rick Scott

Published March 2, 2016

TALLAHASSEE — Determined to reduce the spiraling number of new HIV infections in South Florida, the Florida House sent a bill to the governor Wednesday that will create a pilot program in Miami-Dade County to allow drug addicts to exchange their dirty needs for free, clean needles and syringes.

For four years, Sen. Oscar Braynon, D-Miami Gardens, sponsored the bill but was unable to get it through both the House and Senate. But this year — with blood-borne diseases among intravenous drug users rising in Florida — he and House sponsor, Rep. Katie Edwards, D-Plantation, were able to win bi-partisan support for the idea.

"It took a while for us to get people to understand what this program did," Braynon said.

The state leads the nation for new cases of HIV/AIDS with the number of infections rising each year, even as it drops nationwide. The infections have risen as heroin use has exploded and county health departments have been shrinking under Gov. Rick Scott and the state's top health officer, Dr. John Armstrong, who have made it a policy to cut programs and employees at the Department of Health.

The HIV epidemic is most severe in Miami-Dade and Broward counties, which have the highest rates of new infections per 100,000 residents of any area in the country, according to state and federal data. A study done at Jackson Memorial found that the cost of treating patients with bacterial infections as a result of dirty needles is about $11.4 million a year.

The program will be run through the University of Miami, which will be allowed to circumvent the state's drug paraphernalia laws and use a mobile unit to reach addicts, encouraging them to replace dirty needles for clean ones. The effort will include helping people find drug treatment and counseling programs. The university is responsible for finding the money to pay for the program through grants and donations so there is no cost to state taxpayers.

The measure, SB 242, won approval in the House Wednesday, 95-20. It had previously cleared the Senate, 37-2.

Opponents argued that the program could make it easier for addicts to get access to drugs but proponents said the main goal of the program is to prevent the transmission of HIV, AIDS, viral hepatitis and other blood-borne diseases by offering addicts clean needles.

Rep. Michael Bileca, R-Miami, was the only lawmaker to speak against the bill Wednesday. He objected to the provision that allows the needle exchange to occur through a mobile unit, and not at a fixed site where addicts could be encouraged to get counseling and treatment.

But Rep. Julio Gonzalez, a conservative Republican from Naples who is an orthopedic surgeon, countered that a mobile unit is necessary because an addict's world is "a very, very horrible place," and they are often unable to "leave that world to go someplace else to go get a needle to protect themselves."

He described treating HIV patients at Jackson Memorial with GI tracts "riddled with infection" so severe they they couldn't digest food and veins were so damaged by their intravenous drug use that medical personnel could not find a vein, forcing them to ask patients to insert their own IVs.

"This is a very palpable, very real, very threatening disorder that threatens not only the lives of people that are affected but their families, their communities, our budget," he said.

Edwards noted that the bill includes a requirement that the program refer addicts to drug abuse treatment, counseling and prevention programs and gives the university the flexibility "to employ mobile units to locations where they know they will reach the highest population of addicts."

Dr. Hansel Tookes, a resident physician of internal medicine at Jackson Memorial Hospital, who treats HIV patients, first brought the idea of needle exchange to Braynon.

"This all came about because we were seeing more and more people entering the hospital with [bacteria-related infections] and they studied the cost of treating those patients at Jackson in a year and found it was $11.4 million in cost to the public health care system,'' he said. "If we can decrease any HIV cases in Miami, we've done the community a service."

He cited the experience of Scott County, Indiana, which saw an explosion of 140 HIV diagnoses tied to drug use in just a few months, prompting the governor to declare a state of emergency and launch a needle exchange program.

"Before the perfect storm happens where we have a situation like Indiana, I'm really happy we're able to bring back this proven, evidence-based public health effort to prevent an epidemic of unknown proportions," he said.

Several legislators from both parties indicated they would like to expand the pilot program in the future to go beyond Miami-Dade.

"The issue we have of addiction and AIDS is not only a Miami-Dade issue, it's a Florida issue,'' Braynon said. "This is just the beginning."

Contact Mary Ellen Klas at Follow @MaryEllenKlas.