Needle exchange program helps clean up county

Last September, the Ventura County (Calif.) Public Health Department began a syringe exchange program to provide sterile needles to injection drug users. The program is an effort to prevent the spread of HIV and hepatitis B and C, and to remove used syringes from the waste stream.

In 1999, the California legislature passed a bill that legalized syringe exchange programs on the condition that local governments declare public health emergencies to justify their operation. That bill provided the impetus for Public Health Officer Robert Levin to investigate the feasibility of a syringe exchange program in Ventura County. “We don’t have an overwhelming tidal wave of HIV infections as some counties in the nation do, but it was our sense that even one, two or three preventable deaths was something that qualified as worthy of our attention,” Levin says.

Following the passage of the state law, the Public Health Department began working with the county board of supervisors’ AIDS Advisory Committee to study the efficacy of syringe exchange programs. The group invited the Sheriff’s Department and the District Attorney’s Office to participate in discussions about starting a program to address concerns that such a program would foster drug activity. Together, they researched how syringe exchange programs had worked elsewhere, whether the program could turn someone into a drug user and whether the program would attract crime.

After nine months of research and discussion, the group presented its findings and program plan to the county supervisors. The group presented statistics about the rate of HIV and hepatitis B and C infection among injection drug users. It also provided the board with approximately 20 peer-reviewed journal articles that supported the efficacy and community safety of needle exchange programs. Convinced that a needle exchange program would be useful in the county, the board of supervisors declared a public health emergency.

The county appointed the Ventura County Rainbow Alliance, a non-profit group, to operate the needle exchange program out of its office in Ventura. The Alliance obtained grants to fully fund the program, which also provides on-site blood testing, counseling services, free condoms, education about sexual issues, and information about detoxification programs and 12-step programs.

The Alliance began advertising the needle exchange services by distributing brochures and fliers, but now it relies on word of mouth to attract clients. “[The Alliance staff wants] to make sure that they can handle the flow and that there won’t be any problems in the community,” Levin says.

As of May, 381 clients had used the needle exchange program. In the first eight months of the program, the Alliance collected 5,355 syringes and distributed 4,735 syringes, resulting in 620 fewer needles in circulation. “We’ve found that the program is a magnet for needles,” Levin says. “It’s getting them off the street.”

Based on response to the program, the county is working with the Rainbow Alliance to open another exchange site in Santa Paula. “We’re setting these programs up in areas where we think people might have to travel the least to get to them,” Levin says.

Program participants are anonymous, which makes it difficult for the county to track diseases among clients, but the county is developing a system to improve the client tracking process. “It will be difficult to absolutely prove beyond anyone’s shadow of a doubt that the needle exchange is having a huge impact [on the spread of diseases],” Levin says. “But we’re happy that we’re getting people to enter detox programs and go to counseling. We know the needle exchange program cannot make it more likely for people to get these infections. So even if we never can prove that it is decreasing infections, we know other benefits are accruing.”