The statistics are shocking: Seventy percent of illegal-injection drug users will contract hepatitis C from the use of dirty needles. About 10 percent will acquire HIV.
The lifetime cost of caring for a hepatitis patient is $500,000, and HIV lifetime health care costs are a minimum of $355,000.
Thirty percent of police who deal with addicts eventually will stick themselves with needles when they frisk injection-drug users. Nearly one-fourth of officers suffer two or more needle sticks.
A clean needle costs 97 cents.
There is hope for the future.
In his third try, state Sen. David Parks, D-Las Vegas, succeeded in passing a bill that repeals the law that made it illegal to possess hypodermic needles or syringes. These devices are the so-called “works” of people who inject themselves with crack cocaine, heroin and other prohibited drugs.
Starting in October, Northern Nevada Hopes, a nonprofit Reno organization that works with drug users, plans to begin giving addicts needles and packets for disposing of used needles.
But at this point, no nonprofit or medical organization in Southern Nevada has announced a similar program. This even though there are 3,347 known illegal injection-drug users there — five times as many as in Reno.
“Nobody here seems to be expressing a whole lot of interest,” Parks told the Las Vegas Review-Journal. “I think that will change. I need to get out and talk to groups about the benefits of this law.”
The Southern Nevada Health District is waiting for state officials to pass guidelines for needle exchange and eventually could start a program, said district spokeswoman Stephanie Bethel.
NEVADA ISN’T LAST
Nevada is the 37th state to legalize the use of needles for injection-drug users and to allow needle exchange programs. The Netherlands established programs in the 1980s, but fear that needle exchanges would promote greater illegal drug use prevented Nevada legislators from acting until this year.
The change in attitude in 2013 was striking. Every senator supported Parks’ Senate Bill 410, as did all Assembly members but Ira Hansen, R-Sparks, and Randy Kirner, R-Reno.
Hansen said he was not convinced that needle exchange programs will reduce the spread of HIV and hepatitis C, but instead could promote more drug use.
Even more troublesome, he said, is that by removing hypodermic needles from the list of prohibited devices, anyone, not just needle exchange programs, can legally possess, give away or even sell needles, even to minors, and “the cops cannot do anything about it.”
Eight studies conducted by the U.S. Centers for Disease Control and Prevention and the Institute of Medicine, a nonprofit organization that investigates health matters, have concluded the needle exchange programs do not promote drug use. The studies found injection-drug users are more likely to enter drug treatment programs and get off drugs since the needle exchange programs bring them into contact people who want to help them in a nonjudgmental way.
One study found the incidence of HIV among injection-drug users fell 80 percent in the past 20 years because of their greater ability to acquire clean needles.
POLICE HAD CONCERN
The Metropolitan Police Department initially opposed Parks’ bill. But officer Chuck Callaway, the agency’s legislative lobbyist, said the department switched to neutrality after Parks agreed to remove a clause that would have allowed organizations also to distribute clean crack pipes and other drug paraphernalia to users.
“It’s a balancing act for us,” Callaway said. “We understand the medical side and want to prevent the spread of those diseases (HIV and hepatitis C). But you don’t want to wave a red flag and encourage habitual drug use.”
Callaway does not know how many police in Nevada suffer from needle pricks, but it is a problem.
“If the programs reduce officers getting stuck, that’s a good thing,” he added.
Offering safe ways to dispose of needles also helps the public, especially children and families who frequent parks and places where addicts meet. Dirty needles often are dropped by addicts. Until now they could be arrested for mere possession.
In San Francisco, which has needle exchange and disposal programs, 13 percent of needles are inappropriately discarded. In Miami, which has no program, 95 percent are haphazardly dropped.
Before needle exchange programs in Nevada begin, the state Division of Public and Behavioral Health must prepare operational guidelines, which the state Board of Health must approve. The process could take two months, but rules to alleviate Hansen’s and other concerns might be adopted.
In one hearing on SB410, Assemblyman Mike Sprinkle, a paramedic, said needle exchange programs benefit not only users but first-responders such as himself.
“For those of us who are working in the field and are in a position where we must treat them, it is a level of security and safety for us to know that these exchanges take place and to know that, potentially, the needle in their pocket is a sterile one,” said Sprinkle, D-Sparks.
Parks said some people never are going to be convinced that needle exchange programs do not lead to more drug use.
He noted that Congress, after 21 years of refusing to spend any money on such programs, reversed itself in 2009 and allowed such expenditures.
But Congress reversed itself in 2012. Republican members refused to back a budget bill unless the needle exchange appropriations were withdrawn. Democrats went along with the change.
NORTHERN NEVADA HOPES
Inducing drug addicts to enter treatment programs is one of the primary goals of Northern Nevada Hopes, said Abigail Polus, a key advocate in the Legislature for the new law.
“We meet clients where they are,” said Polus, who runs the Harm Reduction and Outreach Center at Northern Nevada Hopes.
Her organization’s workers visit places in Reno where drug users congregate. They get to know the users as people and try to gain their trust.
“We will give them access to clean instruments. When they are ready, they may go a step further and want to go into drug treatment. We will be the first people they turn to.”
Northern Nevada Hopes already tries to help injection-drug users find behavioral health counseling and social services. Its workers often find cast-off dirty needles. In some states, the needle programs mandate that users return used needles before they can receive clean ones.
Hilary McQuie, of the Oakland-based Harm Reduction Coalition, brought Nevada health care and civic organizations together in lobbying for passage of the needle exchange bill. The nonprofit coalition campaigns for policies to reduce drug use and assist drug users.
She said advocates have a lot of work ahead to publicize the law, particularly the provision that it no longer is a crime to possess a syringe.
Because of the change in the law, she said injection-drug users no longer have to fear arrest because they have a needle in a pocket. They can tell police.
Police no longer will have to play Russian roulette patting down drug users or reaching into their pockets.
But McQuie emphasizes people need to begin to view injection-drug users as human beings, not as pariahs.
Nearly every family today knows of someone who has fallen victim to drugs, she said.
“There are those who think abstinence from drugs is the only course. ‘If you help drug users, you are encouraging them to use drugs.’ That is not the case.”