Friday, July 7, 2006 | For three years, the survival of the city of San Diego’s used-needle exchange, hailed as a vital tool against the spread of HIV and hepatitis C, was little more than a formality.
Then the city’s political struggle hit crisis-level with the convictions and subsequent resignations of two City Council members. Shorthanded, an ideologically split City Council was unable to muster the five votes necessary every two weeks to declare the state of emergency that kept the program alive.
In one year, the number of dirty needles taken off the streets dropped dramatically, falling from 147,000 to 4,000. Users of injected drugs such as heroin and methamphetamine no longer had the incentive to turn in their used needles for clean ones.
“In a three-hour period, we would serve 50 to 70 clients. Now, that number has dropped to three or four,” said Bob Lewis of Family Health Centers of San Diego, the program’s operator.
Without the city’s blessing, the health centers couldn’t legally dispense clean hypodermic needles for non-medical purposes. But one year later, the program that became one of the quiet casualties of a raucous year at City Hall appears to be headed for a comeback, as city officials, led by Mayor Jerry Sanders, announced this week an attempt to resuscitate a program in which drug users can dispose of used needles for clean ones without the fear of legal consequences.
Frank Kole, owner of UrbanBody gym and juice bar in North Park, has noticed the drop off since the program was discontinued last July.
“Since the program’s not in place, I’m starting to pick up needles again,” said Kole, who added that he estimates he finds a needle every few days near his business.
His health club, which he describes as being entrenched in a neighborhood that carries a subculture of drugs and disease, is across University Avenue from where the Family Health Centers trailer settles on Friday night.
There, and in downtown’s East Village, Family Health Centers sets up shop three hours at a time in an attempt to collect used hypodermic needles. The needles, which are often obtained illegally for illegal purposes, would otherwise be shared with other drug users or strewn in streets, parks and beaches. Experts say that creates a health hazard, as research shows the needles are major cause of the spread of HIV and hepatitis C.
To better lure needle users to Family Health Centers’ trailer, the San Diego City Council voted every two weeks beginning in 2002 to declare a state of emergency because of the spread of HIV and hepatitis C. Doing so allowed them to waive a state law that classifies the possession and distribution of a hypodermic needle for non-medical uses as a crime.
The program has been heralded by proponents as a way to stem the transmission of disease and provide health care to a segment of the population that often shrugs it.
“They have a place to get clean needles, to drop off dirty needles, whatever, but the reason I’m in favor of the program is that these people have a point of contact,” said Kole, who said he has lost friends and lovers to drug addiction, disease, or both.
Researchers from groups from Sandag, the U.S. Surgeon General and John Hopkins University have endorsed clean-needle exchange programs. More than 150 cities nationwide have similar programs.
Exchanging clean needles for old ones is based on the nexus found between intravenous drug use and blood-borne diseases. James Dunford, the city’s medical director, said needle-injected drug use accounts for one-third of all HIV infections and the two-thirds of the cases of hepatitis C – a disease he referred to as the “epidemic of the millennium.”
Now, with a replenished council and a supportive mayor, the city may reinstate the clean-needle exchange next week, pending a vote by the City Council on Tuesday. Five votes are needed top reinstate the program: Four incumbent council members have voted for the initiative in the past, and the recently elected Councilman Ben Hueso has signaled his support during his campaign.
For Lewis and other supporters of the clean-needle exchange, it’s clear: the often-antisocial clique of needle users will only come out to receive services and turn in hazardous instruments if they’re also doled new needles.
“It’s a good hook to get people in here,” said Lewis, whose group dispenses water bottles, hygiene kits, condoms and health advice to users who visit the trailer. The program’s staff and supplies are paid for by Alliance Healthcare Foundation, a nonprofit. No taxpayer money is used to support the program.
For some, dispensing clean needles as a reward for turning in old ones is condoning illicit drug use, especially as hypodermic needles are obtained on the black market primarily for injecting heroin and methamphetamine. Councilmen Jim Madaffer and Brian Maienschein have historically opposed the program, as did former Mayor Dick Murphy.
The Sandag study, as well as other research, shows that drug use did not increase while the city’s clean-needle exchange program was in effect.
The program’s supporters say handing out new needles is better the alternative – allowing addicts to reuse and share needles that are otherwise hard to obtain.
Hypodermic needles are hard to come by legally. A diabetic history is needed to obtain a smaller needle, according to George Delgado, a medical supply worker at Park Boulevard Pharmacy in Hillcrest. Syringes, which are larger and used for intravenous drug use, are not normally available at pharmacies. “It’s not possible to do drugs” with the smaller needles, Delgado said.
“Sometimes these needles are not easily obtainable, which is why people keep reusing and sharing them,” said Lt. Al Guaderrama of the San Diego Police Department’s narcotics division, who noted that the needles themselves are a misdemeanor to own without the proper authorization
Guaderrama said it’s unreasonable to think that intravenous drug use will stop without the supply of needles.
“If there’s a will, there’s a way,” he said.
Sanders and other elected officials said they also support clean-needle exchange because it reduces the amount of used needles that are found in public places.
While neighborhood cleanup organizers say they haven’t noticed an increase in the number of needles scattered in the creek beds, beaches and playgrounds that are so often cited as dumping grounds for dirty needles, Kole said they have become rife in his neighborhood again.
“There are always a number of people who I see around here walking around high, and they’re dropping them somewhere,” he said.
The city’s Environmental Services Department says it’s impossible to tell if needles have been tossed into the trash more often this year compared to last because garbage collection is automated. However, residents will often call the agency’s customer-service line to learn about how to dispose of these needles properly – by placing them in a bleach container and duct taping it shut.
The City Council will vote on the item at 2 p.m. on Tuesday in the council chambers, which are located at 202 C St.
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