REDUCING RISKS
Health official says benefits of new needle exchange program include encouraging addicts to get treatment, preventing overdoses and infections
Orange County’s first-ever needle exchange program launched this month with little attention, though its mission is to help contain two big health problems in Central Florida — the rising number of accidental fatal overdoses and the spread of HIV.
Needle exchanges provide people addicted to intravenous drugs with clean syringes and a safe place to dispose of used ones.
“There’s a lot of value in ‘harm reduction’ programs” like needle exchanges because the programs “do more than just trade needles,” but also reduce transmission of blood-borne infections, said Raul Pino, Orange County’s state health officer.
Pino said the programs also introduce treatment to people who might otherwise be unlikely to seek help for drug addiction.
He also said needle-sharing puts people who are addicted to intravenous drugs, their sexual
partners and their children at risk for other deadly diseases.
The county program, operated by the Hope & Help Center of Central Florida, offers screenings for HIV and hepatitis C — a treatable liver infection — provides mental health assessments and offers drug treatment to every participant.
“We don’t coerce or judge people but we just always let them know there is help if they want it,” said Adam Troy, prevention manager for Hope & Help. “We want to meet people where they’re at and offer help and support without preconditions.”
Participants can remain anonymous, he said.
Hope & Health, formed in 1988, is a nongovernmental group that provides services to prevent and treat HIV.
Troy said the program hopes to address drug addiction and other health crises including HIV.
The Metro Orlando area, including Kissimmee and Sanford, has the nation’s third-highest HIV incidence rate, according to the most recent Centers for Disease Control and Prevention Surveillance Report.
Only Miami and Atlanta have higher rates.
Also, accidental drug deaths in Orange and Osceola counties soared to 567 in 2020, a nearly 30% increase from 439 fatal overdoses in 2019, according to data compiled by the District 9 Medical Examiner’s Office, which investigates deaths in the two counties.
More than 400 overdose deaths involved fentanyl, a synthetic opioid similar to morphine but more potent.
The program offers participants “harm reduction” kits that include naloxone — commonly known as Narcan — a medicine used to attempt to reverse the deadly effects of an opioid overdose, and fentanyl test strips that help people addicted to intravenous drugs identify the presence of fentanyl, Troy said.
Orange County Public Safety Director Danny Banks, who formerly served as the Florida Department of Law Enforcement’s special agent in Central Florida, said street drugs are often laced with fentanyl which can make a mixture lethal to an unsuspecting user.
He said most fatal drug overdoses are accidental deaths, not suicides.
“They’re just determined to get high,” he said of victims. “The unfortunate thing is they have no idea what they’re using.”
On its website, the CDC offers a fact sheet for “syringe services programs,” the agency’s name for needle exchanges.
The agency says over 2,500 new HIV infections occur each year among people addicted to intravenous drugs.
Using sterile syringes can reduce the risk of getting or transmitting infections. The CDC estimates exchange programs reduce the incidence of HIV and hepatitis C transmission by about 50%.
In March 2020, Orange County commissioners voted to create a needle exchange after a Health Services presentation outlined its potential to slow the spread of infectious diseases among people addicted to intravenous drugs, their sexual partners and their children.
Though effective in containing infectious outbreaks, needle exchanges are often criticized as making drug use or misuse easier.
Florida forbid counties from offering free hypodermic needles and syringes in exchange for used ones until 2019 when state lawmakers learned the results of a five-year pilot program in MiamiDade County. That summer, the Infectious Disease Elimination Act was then signed into law by Florida Gov. Ron DeSantis. Disease prevention must be the goal of every exchange program.
According to the University of Miami, tasked with overseeing the pilot project, the number of opioid-related deaths in MiamiDade fell from 321 deaths in 2016 to 305 in 2017 to 213 in 2018. It was the only Florida county where opioid deaths decreased in 2018.
“I think the idea of enabling, unfortunately, comes to mind when someone thinks of a needle service,” Troy said.
In Indiana, where a needle exchange program was credited with containing an HIV outbreak in rural Scott County in 2015, that program was halted last month by county commissioners, one of whom was quoted as saying, “I know people that are alcoholics, and I don’t buy him a bottle of whiskey …”
Orange County’s program is at least Florida’s third to follow Miami-Dade’s lead. Palm Beach and Hillsborough counties also have launched programs. But local governments are still prohibited from using state, county or municipal money to fund them.
Troy said the program, funded by private grants and health partnerships, will provide services next month from a specially outfitted bus as well as a fixed site at Hope & Help Center of Central Florida’s headquarters near Full Sail University in Winter Park.
The mobile unit’s location will be posted on Facebook at www. facebook.com/IDEA.Orlando.
Troy said Hope & Help also plans to open in July a fixed second site in west Orange on Silver Star Road.
Services are free.