Pubdate: Wed, 16 Jul 2008
Source: Stranger, The (Seattle, WA)
Copyright: 2008 The Stranger
Contact:  http://www.thestranger.com/
Details: http://www.mapinc.org/media/2241
Author: Dominic Holden
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)

Shot Up

FUNDING CUTS THREATEN GROWING NEEDLE-EXCHANGE PROGRAM

On a recent evening in a University District alley, two men in 
sunglasses sat behind a card table loaded with red bins of alcohol 
swabs, hypodermic syringes, and other supplies for shooting up drugs. 
Every few minutes, someone would wander up the alley to turn in used 
needles, take a few items from the bins, and move on.

The table is King County's last privately operated needle-exchange 
site. But its clientele is growing faster than at any other site in the county.

The syringe exchange in the alley used to be operated five days a 
week by another group, Street Outreach Services (SOS), until SOS lost 
county funding last year for failing to submit an audit on time. 
After SOS went away, the People's Harm Reduction Alliance (PHRA) took 
over the exchange and expanded it to seven days a week. "We felt 
[drug users] needed more access in the north end," PHRA director 
Shilo Murphy says. The group now operates the table 365 days a year 
with the help of about 25 volunteers. By the end of the year, PHRA 
predicts it will have increased syringe exchanges by one-third to one 
million syringes--a 10 percent increase overall from last year for 
the entire county.

"My hope is that when drug users make the choice to be sober, that 
they can do it without having HIV or hepatitis C, which would affect 
them for the rest their of lives," Murphy says.

Spurred by the AIDS epidemic, the national movement for syringe 
exchanges started in Tacoma in 1988. The next year, the model was 
emulated by activists in Seattle, who operated an exchange from a 
table in front of Tower Records on University Way.

According to King County, where 2.1 million syringes were exchanged 
in 2007, the cities that implemented needle exchanges early in the 
HIV boom lowered infection rates among intravenous drug users. For 
example, in cities such as New York and Miami, which were late to 
adopt the once-controversial practice, the HIV rate among injection 
drug users hovers between 40 and 60 percent. In Seattle, it's 2 to 4 percent.

Nevertheless, only a fraction of the injection drug users here use 
clean needles consistently. Michael Hanrahan, who runs the county's 
needle-exchange program, says 20 million syringes would have to be 
exchanged annually to ensure a clean needle for every injection. "If 
our objective is to facilitate a clean, single use of equipment, the 
market penetration is about 10 percent of what the need likely is," he says.

The community-based University District group seems more nimble at 
reaching the target population than the five county-managed exchange 
sites, which operate under more restrictive rules. For instance, the 
county requires users to trade one dirty needle for each clean 
one--rules Hanrahan says are designed as an incentive to get old, 
dirty syringes out of circulation. The independent needle exchange, 
in contrast, allows users to bank and trade syringes, enabling more 
users to take as many syringes as they need.

However, the group struggles to stay afloat. It depends on donations 
from users who come to the table, and its supplies are provided by 
the county, which is facing a $68 million deficit. Countywide, 
syringe-exchange programs cost King County just under $1 million a 
year. In October, County Executive Ron Sims will send a funding 
proposal to the council that will reduce public-health appropriations 
by 33 percent a year for three years--eventually cutting the county's 
contribution to public health to zero [In the Hall, Erica C. Barnett, 
June 11]. King County Council Member Larry Phillips, who chairs the 
council's budget committee, says it's too soon to guess whether the 
needle-exchange program will be impacted, but he hopes to maintain 
it. "It has proven to be a tremendous public-health aid in King 
County," Phillips says.

As the syringe-exchange services strive to stay afloat, SOS has 
morphed into a new organization, Harm Reduction Advocates, which is 
building support to fund needle exchanges and allow anti-overdose 
programs. Executive director Tara Moss says the group was "getting to 
the point, with restricted funds, [that] it makes sense to advocate 
for the programs rather than provide services." 
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MAP posted-by: Richard Lake