With legalization, needle exchange programs hope to expand services


The non-profit group Shot in the Dark offers safe injection kits on its needle exchange sites. Kits usually include clean needles, alcohol wipes, swabs, and tourniquets. A law coming into effect next month legalizes such programs, which research shows are effective in reducing the transmission of viral infections through dirty needles. (Photo by Gianluca D’Elia / Cronkite News)

Jaclyn Brown, Volunteer Coordinator at Shot in the Dark, began working with the needle exchange program after her brother, Marc, died of a heroin overdose in 2018. She wears a bracelet commemorating a blood drive. fund that she organized in his honor. The tattoo on her arm – “stay golden” – is a phrase her brother used frequently. (Photo by Gianluca D’Elia / Cronkite News)

PHOENIX – For about a year, Jaclyn Brown has been training volunteers for a needle exchange program that works with drug addicts in Maricopa County. One of the first things she told her assistants was that the job they signed up for could be considered a crime in Arizona.

“This is the # 1 thing I would say… in case they were thinking, ‘Oh, that’s totally cool (and legal)’ because we have a website,” Brown said, sitting on boxes of unopened syringes at Phoenix storage. installation for Shot in the Dark.

Soon, Brown and other volunteers will face no risk of arrest – and neither will those looking for the materials they distribute.

Arizona lawmakers in May passed a law with bipartisan support legalizing syringe access programs, and Gov. Doug Ducey signed the measure days later. The law comes into effect on September 28, 90 days after the legislative session closes on June 30.

The exchanges provide sterile syringes, throw away used needles, and connect people to other resources or medical care, such as testing for HIV and hepatitis C. About 30 states allow such programs, and the research shows that they are safe, effective and useful in reducing the transmission of viral infections through contaminated needles.

For Shot in the Dark and similar programs, Arizona law does not make drastic changes, but does establish specific guidelines. For example, the number of syringes disposed of in an exchange program should equal the number of syringes distributed. Exchanges will also be necessary to distribute needles free of charge and provide access to overdose medications as well as educational material on blood-borne diseases and drug treatment.

Despite past legal risks, Brown said the work was too important for her not to be involved. She joined the group last summer as a volunteer coordinator, driven by the loss of her brother, Marc Kane, who died of a heroin overdose in November 2018 at the age of 29.

Jaclyn Brown, Volunteer Coordinator at Shot in the Dark, visits the association’s storage facility. One of the biggest challenges facing trading in clean needles, she says, is the misconception that they allow drug use. (Photo by Gianluca D’Elia / Cronkite News)

The resources Shot in the Dark offered – such as clean needles, safe injection kits, and the overdose reversal drug naloxone – could have been a lifeline for his brother, whose addiction began with opioids prescribed for pain after a car accident, Brown said.

“After my brother died, I didn’t care what people thought of us or our family, and I didn’t care about the stigma that came with it,” she said. “I’m just going to help people as much as I can, so no one has to go through what we’ve been through. And if that means I could be arrested for it… I don’t care. I really don’t care.

The law comes as drug overdose deaths rose 30% in the United States last year and 32% in Arizona, largely due to the pandemic.

“The disruption of daily life from the COVID-19 pandemic has hit people with substance use disorders hard,” Robert Redfield, former director of the Centers for Disease Control and Prevention, said in a statement imploring Americans “to take care of those suffering from unintended consequences.

Dozens of programs statewide have long made it easier to trade clean syringes, despite the potential consequences. In Phoenix, Brown said, Shot in the Dark has not faced any legal issues other than occasional trespassing complaints or a request to vacate properties where volunteers have arranged exchanges.

LifePoint, a needle exchange program founded by the Pima County Department of Health, was among the first in Arizona to offer this form of harm reduction. The program was founded in 1996 as the nation battled HIV and AIDS.

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Miguel Soto, HIV program coordinator in Pima County, has been involved in needle exchange since 1999 and has advised other Arizona organizations that have followed in his footsteps. The involvement of behavioral health organizations, nonprofits and public health services can build support for such programs among the public, law enforcement and politicians, he said. .

Pima County has made a deal with police to keep officers away from the exchanges unless problems arise.

“It has always been an open secret in Pima County,” Soto said. “Because he’s based in the health department, I think there was a lot more buy-in from the community and even the police department. We have always been at the forefront to be really open and communicative with the police and local representatives, and even the neighborhood associations we have moved into. ”

The new law decriminalizing these programs protects employees, volunteers and participants from charges of possession.

Soto said he hopes legal recognition will lead to state and federal government funding for needle exchanges. Local, state, and tribal health departments have been allowed to use federal funds to support syringe programs, but not to specifically purchase needles or syringes.

Rita Leal, of Shot in the Dark, said legalization would give more legitimacy to exchanges and potentially help programs expand services and locations.

“We tried to ask people to use their parking lots – and that’s when a business was closed – but they were so afraid of the responsibility for what we were doing,” he said. she declared. “So now if it’s like, ‘Hey, that’s legal. Your governor signed this. … I think people will be more receptive.

Future needle exchange work is likely to focus on more than just syringes. Overdose deaths from synthetic opioids, particularly fentanyl, have been on the rise across the country. Ducey also signed a law this year to remove fentanyl test products from the state’s list of illegal drug accessories.

The exchange volunteers said they will adapt their services as substance use changes.

Leal started working with Shot in the Dark five years ago, while overcoming a heroin addiction. Now, she said, people are more likely to turn to the pills, sometimes placing them on pieces of foil, lighting them from the bottom and inhaling the smoke through a straw. Shot in the Dark provides items like straws and foil to prevent reuse.

Regardless of the drug, Brown said, one of the biggest challenges trading faces is the misconception that it allows drug use.

“Before Shot in the Dark existed, people used drugs. People have used drugs. They will do it anyway, ”she said. “But if we can be there and help them, and they don’t have to reuse, (they) have naloxone, whatever it is, why not be there?” “

Editor’s Note: If you or someone you know needs help with a drug addiction problem, the SAMHSA National Helpline – 1-800-662-HELP (4357) – is a hotline for you. confidential and free information 24/7, in English and Spanish. SAMHSA’s Buprenorphine Practitioner Locator can help identify a qualified practitioner who can prescribe buprenorphine for the treatment of opioid use.

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