Providing heroin users with sterile needles to reduce heroin use may appear to be a self-defeating step. However, many major cities in several countries have been doing just that with surprisingly good results.
People who are addicted to heroin might share their needles and even their syringes with others, which facilitates the transmission of HIV and hepatitis C. Many heroin users are injecting on city streets and drop their syringes and needles on the ground right after use. These items are a danger to children, animals and anyone who comes into contact with them.
In South Florida, the use of heroin and synthetic opioids has caused many overdose deaths, and dangerous discarded needles litter the streets. Use of the powerful drug fentanyl is on the rise; fentanyl is 50 times more potent than heroin, and drug dealers are mixing it with the heroin they sell on the streets. The drug user is unaware of the presence of fentanyl, and many deaths have occurred from overdose. The drug is so powerful that mere skin contact with it can cause symptoms.
Just when emergency responders and police may have thought fentanyl was the worst possible drug on the streets, along came carfentanil. This is a large animal tranquilizer used by veterinarians to tranquilize large animals such as hippos and elephants for medical procedures or to transport them. Carfentanil is a head-spinning 100 times more potent than fentanyl. When veterinarians use it, they must be gloved, masked and gowned, wear goggles and have the antidote directly beside them.
A few grains of carfentanil the size of a few grains of salt can kill a person. Dealers have been mixing heroin with carfentanil with disastrous results: Multiple overdoses and deaths have occurred in many states, and in some cases emergency responders have been so busy that they can barely keep up with the number of daily overdoses.
In Miami, the medical examiner’s office stated that in the one-year period between 2014 and 2015, fentanyl-related deaths shot up a staggering 700 percent. Hansel Tookes, M.D., a public health physician at Jackson Memorial Hospital told CBS Miami, “Florida is being ravaged by opioids.” Needles are disposed of on streets and in parks or reused again and again intensifying the risk of disease.
When Dr. Tookes was a student at the University of Miami Miller School of Medicine, he was involved in a research project that found hundreds of used needles on the streets. His findings sparked an idea to create a needle exchange in South Florida. The project was called the Infectious Disease Elimination Act or IDEA Exchange. The proposal was put to the Florida legislature by Sen. Oscar Braynon, D-Miami Gardens, in 2013 and was finally passed in March 2016.
Dr. Tookes said, “After four years of blood, sweat and tears, we finally passed the legislation. A lot changed in that time though. The nation was reeling with the heroin epidemic and Miami was not spared.”
This is how needle exchange works: A person can bring in one needle and exchange it for a sterile needle. Regardless of the number of used needles a person brings in, he or she gets the same number of sterile needles in return. The goal of the program is to eliminate used and contaminated needles from the streets and reduce the spread of HIV and hepatitis C, which are transmitted by sharing needles. South Florida has one of the highest rates of new infections in the U.S.
The needle exchange is housed in a couple of shipping containers repurposed for the job. Opponents believe that providing clean needles encourages drug use. No drugs change hands; only sterile needles are provided, which helps keep people free of HIV and hepatitis C. The program costs $500,000 annually, and funds are provided by private donations and grants. Dr. Tookes explained that lifetime treatment of one HIV patient costs $380,000, so prevention is key.
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Veronica McNamara is a content writer for Sovereign Health. She is a former registered nurse who enjoys writing about the causes and treatment of addictions and behavioral health disorders. She is a proponent of further public education on the subject of mental illness, which, unfortunately, still bears an unwarranted stigma. For more information and other inquiries on this article, contact the author at firstname.lastname@example.org.
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