Public Health policy is all about helping everyone for the greater good.
And that’s why programs to help intravenous drug users are so important as the nation seeks ways to battle its continuing opioid epidemic.
Years ago, when forward-looking public health agencies started needle exchange programs, there was considerable push-back from people who objected to spending public funds to help illegal drug abusers.
Of course, addicts who inject heroin or methamphetamine are never going to be the most sympathetic constituency for any community leader seeking to set priorities.
But data collected by health managers show that needle exchange programs can have a considerable positive effect on the community’s overall health in several areas. Studies in New York and the District of Columbia draw a direct link between the decrease in HIV and hepatitis cases to their exchanges.
Across the river, Clatsop County has been offering an exchange program since October 2017 and reports some considerable successes, too. Now a program has begun on the Long Beach Peninsula, run by a private clinic but with enthusiastic support of that county’s Health Department.
Medical professionals attest that IV drug users are some of the hardest to properly serve. Often they live “off the grid,” and may not have year-round access to a primary care physician. When they need medical treatment, the costs often have to be absorbed by health providers, almost inevitably increasing the cost of care to other patients.
In offering needle exchanges, public health staff use the opportunity to offer counseling and medically assisted treatment options. They educate users about wound care and infection risks. And they distribute kits containing naloxone, a medicine with a track record in reducing overdoses. Clatsop County Health notes that it has distributed 458 such kits; some 72 lives have been saved because of this.
During that period, county hospitals report a significant reduction in people hospitalized for abscesses. Besides skin infections, endocarditis, an infection in the heart, can easily develop from using dirty needles with IV drug use. This may be life threatening or cause significant problems. Hospital stays for this kind of treatment may cost $50,000, plus more for long-term expensive antibiotic use, as well as the risk of possible valve and heart failure.
Exchange programs make used syringes a “commodity” — which means users are more likely to save their own and pick up others so they can trade them in. That’s been shown to prompt a huge reduction in the number of possibly contaminated syringes laying around on beaches and in public places. Since it began its program, Clatsop has received 8,508 more syringes than it has given out. Managers of the Portland needle exchange program report the number of discarded syringes in their location have decreased by almost two-thirds.
It’s an apparent small step with positive consequences in connecting with those who are struggling with drug addiction. And it has a benefit for everyone — fewer dangerous syringes to tread on and, in the long term, potentially fewer demands on our health treatment providers.