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West Valley City Journal

Syringe exchange proving successful

May 03, 2019 09:13AM ● By Bill Hardesty

By Bill Hardesty | [email protected]

Meet Angel Flores, age 36.

Angel was born in Salt Lake City and started using drugs at age 12. He is a long-term recovery addict.

Angel lived on the streets for seven years. He now lives in an apartment on Main Street.

Angel is now employed at All Weather Products in Salt Lake City.

Two years ago, while on the street, he saw that the Utah Harm Reduction Coalition (UHRC) had set up a tent and asked what they were doing. He was told they were doing syringe exchange.

He responded, “Syringe exchange. What?”

Angel is now clean and volunteers with the UHRC at syringe exchange events and tells his story to participants.

Utah Harm Reduction Coalition

Mindy Vincent, a licensed clinical social worker, founded UHRC in 2016 after her own recovery. She is 12 years sober. She lost a sister to a drug overdose and knew she had to do something to save her little brother, who was also an addict. He is now three years sober.

While there is no universally accepted definition of harm reduction, it is generally a public health strategy aimed at respecting drug users, reducing the risk of HIV, hepatitis B and C, and offering approaches to prevent or end drug usage.

UHRC embraces this approach by focusing on individuals and their power to change. Vincent calls herself a “recovered addict” not the more common “recovering addict.” Vincent feels the key to long-term success is “becoming a new person.”  

“Build a life worth living,” Vincent declared.

Vincent looked at current practices and concluded that if a person is labeled “recovering,” there is no end. The person always feels that a slip up can happen anytime. They don’t see themselves in a new light, but rather just avoiding the habit as long as they can.

Vincent also realized, “I never asked [the addict] what they would like.” Vincent feels it is too common for recovery services to tell clients rather than listen to them. The UHRC mission statement declares: “Everyone is their own primary agent of change and we support their rights to choose their own definition of recovery.”

“We meet them where they are at and don’t leave them there,” is an often-spoken mantra at UHRC.

Sometimes, harm reduction strategy is painted as an “anything goes” approach. However, Vincent pointed out that “harm reduction has boundaries.” In fact, she said those boundaries are important as people build their new life.

UHRC therapy approach is based on four principles: healing from traumas of the past; learning new coping skills; reducing risk factors in your life; and building protector factors.

“Love is really the thing that heals,” Vincent observed, which is why participants are never kicked out of treatment. “People need to be allowed to recover fully,” she added.

UHRC offers substance abuse treatment, free or low-cost testing, drop-in counseling, group sessions, recovery resources, and naloxone (Narcan) distribution.

“We have provided about 3,000 kits and know of 1,000 reversals,” Vincent said.

This means a thousand people are living rather than dead following an overdose.

Syringe exchange

UHRC is most known for their syringe exchange service, which is also the most misunderstood. At first glance, the notion that agencies can give clean needles to users so that they can continue to use seems nonproductive in helping people become clean. However, the evidence shows the opposite.

Syringe exchange programs became legal in Utah on March 25, 2016 with the signature of Governor Gary Herbert. HB 308 went into effect May 10, 2016. The law states that agencies in Utah “may operate a syringe exchange program in the state to prevent the transmission of disease and reduce morbidity and mortality among individuals who inject drugs and those individuals' contacts." The law does not provide funds for syringe exchange programs, but it does provide guidelines and requires reporting. It also follows the restrictions of federal funding for syringe exchange.

A participant in the Utah Harm Reduction Coalition syringe program safely disposes of their used needles. (Bill Hardesty/City Journals)

Currently, UHRC only holds syringe exchange events in Salt Lake City. However, they hope to expand into other areas soon because they see the need. They simply need an informed and understanding community. 

This is not a “throw in the towel” approach. But rather a way to introduce treatment options to users, reduce the amount and the cost of HIV treatment as well as hepatitis B and C, and reduce syringe litter.

Treatment options

In an August 2017 information sheet, the Center for Disease Control (CDC) reported that, “People who inject drugs are five times as likely to enter treatment for substance use disorder and more likely to reduce or stop injecting when they use a [Syringe Service Program].”

At a recent syringe exchange on the west side of Salt Lake, participants stood in line to exchange used needles for new ones. For health reasons, syringes are given in bags of 10. This means that if a participant dumps 1-10 needles, they get a bag of 10. If they dump 11, they get two bags of 10. They also are given a user kit consisting of items needed to inject and information about HIV and hepatitis B and C. If needed, they are given a safe disposal container. The items are given individually allowing the volunteer to invite the receiver to additional therapy treatments. It is like the practice used by countless other groups that offer items such as a warm bed or coffee and donuts so that the person can listen to their message.

Since August 2018, UHRC has provided 6,300 treatment referrals. 

Reduce public health concerns

It is common wisdom that preventing disease is less costly than treating the disease. The CDC reports, “[Syringe programs] saves taxpayers money by lowering the financial burden of treating the diseases and associated health risks” of injections. By providing users with clean needles, they are less likely to reuse or, in worst cases, share needles. The latter increases the risk of HIV and hepatitis B and C and the former increases the risk to the user.

The website, reported, “According to the Centers for Disease Control, needle exchange programs have resulted in a reduction of risky behavior by as much as 80 percent. HIV/AIDS cases have declined by as much as 30 percent. They are also cost effective. It can cost up to $12,000 to prevent one HIV/AIDS case through the needle exchange program, but it can cost $190,000 to treat someone infected with the disease.”

BD, a global medical technology company and a manufacturer of syringes, stated on their website: “The harm you can cause yourself by reusing a needle is much greater than any convenience or cost savings. The tips of needles may become damaged after just one injection. Even though you can't see this damage with the naked eye, it's still there — and it may become worse each time you reuse. There are a lot of good reasons not to reuse syringe or pen needles:

  • The tip of a reused needle can be weakened to the point where it breaks off and gets stuck under your skin.
  • A reused needle doesn't inject as easily or as cleanly as a new one and can cause pain, bleeding, and bruising. 
  • Studies have shown that there's a link between needle reuse and the appearance of lumps of fatty tissue that can form at an injection site (lipodystrophy).”

Vincent commented, “They are already suffering. Why should they have to suffer more negative consequences?”

Syringe litter

With the 2019 opening of the Homeless Resource Centers, such as the one being built on the west side of South Salt Lake City, syringe litter is becoming a concern for neighbors. Syringe litter is discarded needles that could be picked up by others or stepped on.

The CDC reports that a syringe exchange program “reduces the amount of needles found in public places by 50 percent and up to 90 percent of syringes distributed by exchanges are returned.”

In addition, at UHRC exchange events, volunteers look for syringe litter and dispose of it properly. 

For Angel Flores, it made all the difference. 

“Syringe exchange gives addicts hope. Look at me. I cleaned up my life.”