Pubdate: Wed, 28 Oct 2015
Source: Orange County Register, The (CA)
Copyright: 2015 The Orange County Register
Author: Sal Rodriguez


Needle-exchange programs are an effective means of preventing the 
spread of HIV, connecting individuals in need with social services 
and even preventing the improper disposal of drug paraphernalia.

According to the latest figures from the California Department of 
Public Health, Orange County reported 972 Hepatitis C cases and 502 
of Hepatitis B in 2011. As of June 30, 2014, the county also had the 
fourth-highest number of HIV cases in the state. Injection drug use 
is a significant risk factor for all of them and a known factor in 
the majority of Hepatitis C cases and roughly 10 percent of HIV infections.

So, one wonders why a needle-exchange program, which allows injection 
drug users to turn in used needles for sterilized ones, has yet to 
take root in this county, the largest in California to lack one.

Thus, it is encouraging that the Orange County Needle Exchange 
Program, led by UC Irvine School of Medicine students, was 
provisionally approved by the California Department of Public Health 
on Sept. 30. The OCNEP proposes that, for three hours, on weekends, 
it would offer needle exchanges, on-site testing for Hepatitis C and 
HIV and referrals to treatment and other services.

It would operate at the Santa Ana Civic Center, and organizations, 
such as the Orange County AIDS Service Foundation, have pledged to assist.

"Out of an abundance of caution, we really tried to set up a program 
that won't negatively impact the community," said Kyle Barbour, an 
organizer of the proposal.

The effort initially called for the program to operate out of the 
LGBT Center Orange County office, but Santa Ana officials objected to 
its proximity to Davis Elementary School and residential 
neighborhoods. There were also concerns about funding, and the 
proposal was rejected. The OCNEP has since received substantial 
financial support.

 From a public health perspective, there is every reason to encourage 
such a program in Orange County. The World Health Organization has 
noted that access to sterilized needles can be an effective tool to 
combat the spread of HIV. Additionally, a panel convened by the 
National Institutes of Health in 1997 concluded such programs do not 
lead to more drug use, more drug users or improper discarding of needles.

A recent study of a needle-exchange program in Washington, D.C., 
found that, within two years, the program prevented 120 cases of HIV. 
By doing so, reported the researchers from the Milken Institute of 
Public Health at George Washington University, the program saved over 
$44 million in lifetime HIV treatment costs.

Needle exchange programs, from San Francisco and Indiana to Taiwan 
and France, have reported significant benefits. Far from enabling 
drug use, such programs facilitate harm reduction and accessing of 
services that many drug users most often need.

"We are taking a social service with known public health benefits to 
people who at this time do not access services," the OCNEP's Nathan 
Birnbaum said. "Our proposal makes accessing these services easily available."

The stigma around injection drug use often impedes discussion of how 
to make an already potentially dangerous activity less harmful. As 
one of the many unintended consequences of drug prohibition, the 
longer communities go without considering and tolerating 
harm-reduction efforts, the more lives will be put at risk.

"From a cultural standpoint, we have stigmatized people who are drug 
users or abusers in such a horrific fashion that it has created a 
barrier to thinking about these things as a public health issue," 
said Diane Goldstein, a retired Redondo Beach police lieutenant and 
board member of Law Enforcement Against Prohibition.

There is a clear need for needle exchange in Orange County. Efforts 
like the OCNEP can save lives and money and prevent needless 
suffering. The California Department of Public Health is seeking 
public comment on the OCNEP application.
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