The Thurston County Syringe Exchange Program is not the only organization that distributes free, clean syringes to intravenous drug users in downtown Olympia.
Volunteers with the nonprofit Emma Goldman Youth and Homeless Outreach Project, or EGYHOP, also distribute free needles to homeless and at-risk IV drug users. EGYHOP volunteers who distribute syringes do so through their work with the People’s Harm Reduction Alliance, a nonprofit based in Seattle.
Public health advocates say distributing free, clean syringes to IV drug users saves lives by discouraging the sharing of dirty needles, which can spread blood-borne pathogens such as HIV and hepatitis C.
But unlike the Thurston County Syringe Exchange Program on Cherry Street, which insists on a one-for-one needle exchange for every person who uses the service, EGYHOP volunteers who distribute syringes, also known by their slang term, “sharps,” make no such claim, according to Shilo Murphy, executive director of the PHRA, and an EGYHOP volunteer.
Although EGYHOP volunteers collect syringes — both littered and directly from IV drug users — a client is not required to give a volunteer a dirty syringe in order to get a clean one, Murphy explained.
Murphy and Samuel Silvestro, another local EGYHOP volunteer who works with PHRA, said studies show distributing needles without requiring a one-for-one exchange is a more effective way to stop the spread of disease. And, Murphy added, common sense dictates that if three IV drug users want a clean needle, but only one person has a dirty needle to exchange for a clean one, those individuals are going to wind up sharing a single clean needle, raising the likelihood of infection.
Caleb Banta-Green, a research scientist with the University of Washington’s Alcohol & Drug Abuse Institute, agreed that a one-for-one syringe exchange is not always practical.
“While policies such as exchanging syringes one for one make sense theoretically, i.e., used syringes have ‘value’ and are therefore more likely to be returned, in reality they can create a barrier to people getting the syringes they need.” Banta-Green wrote in an email Thursday. “Specifically, the clean syringes they need to prevent abscesses and the spread of infectious disease.”
There is nothing in state law that requires syringe exchange programs to require a one-for-one needle exchange.
“I am in agreement that people shouldn’t share syringes and we shouldn’t have policies that will increase the chances of sharing syringes,” Banta-Green added. “It’s not a good idea to keep reusing syringes.”
Olympia resident Jessica Archer, a parent of two children, ages 2 and 5, said she is bothered by EGYHOP’s practice of having its mobile volunteers provide access to free, clean syringes without a one-for-one exchange.
Archer said she appreciates Thurston County’s work in reducing the risk of HIV and hepatitis to IV drug users. But she added that other groups distributing needles without the strict requirement of a one-for-one exchange are fueling the likelihood of additional dirty needles discarded on streets, playgrounds and public parks.
Archer said she became interested in the subject last summer, when her 2-year-old fell while playing in Bigelow Park and landed “about six inches from an uncapped needle.”
During the summer, commercial businesses in downtown Olympia and people who use public parks began to notice an increase in the number of discarded dirty needles. In August, the Olympia Parks and Recreation Department began keeping statistics on such — as of mid-October, the tally was 269. Members of the Downtown Ambassadors encountered 69 discarded needles in downtown Olympia in July. They encountered 135 in August.
Olympia and Thurston County officials met Monday to discuss the region’s growing IV drug use epidemic, which has been fueled by the availability of cheap heroin. They also discussed the swelling problem of discarded needles.
Archer, who attended Monday’s meeting, said she was surprised it took repeated prodding by one Olympia city councilmember for anyone to finally acknowledge that other organizations distribute clean syringes downtown besides TCSEP.
Joe Avalos, chemical dependency program manager for Thurston County Public Health and Social Services, acknowledged during Monday night’s meeting that EGYHOP distributes clean syringes in its outreach work downtown.
Avalos said TCSEP, which has been distributing clean syringes downtown since 1993, has no relationship with EGYHOP or the People’s Harm Reduction Alliance. Murphy said the PHRA purchases its needles or gets them through donations and provides them to EGYHOP volunteers.
Avalos has repeatedly cited the effectiveness of TCSEP in helping serve as a point of contact with the region’s IV drug users, to help recruit them into treatment. He also has said the number of dirty needles the syringe exchange takes from users is greater than the number of clean needles it distributes.
In 2012, TCSEP collected 950,000 used syringes, and provided about 914,000 clean ones. In the first six months of 2013, it collected more than 600,000 used syringes and provided more than 570,000.
Studies show needle-exchange programs do not cause an increase in dirty needles being discarded in public places, Banta-Green said.
Murphy said the People’s Harm Reduction Alliance distributed about 3 million syringes in King, Kittitas and Thurston counties in 2013. The PHRA, in turn, collected about 3.5 million syringes last year, he said.
Silvestro and Murphy said Thursday that the EGYHOP’s outreach efforts might serve a different client base than those served by the TCSEP. Murphy also pointed out that EGYHOP’s harm reduction efforts for IV drug users includes the distribution of free naloxone. Naloxone, which also goes by the brand name Narcan, is a medication that acts immediately to reverse the effects of overdoses from heroin and other opioids. First-responders in Thurston County also carry the medication to reverse overdoses when they respond to emergency calls.
In 2013, EGYHOP clients reported 500 uses of naloxone to reverse opioid overdoses in the three Washington counties it operates in — King, Thurston and Kittitas, Murphy said. “It is a matter of life and death,” he said.
But Archer said more transparency and accountability is needed in Olympia concerning how many needles are distributed locally by EGYHOP through the PHRA. She said that just last week, she encountered a dirty syringe near the swings at Madison Elementary School near where her son attends preschool.
“All these syringes have unintended victims and community-wide impacts,” Archer wrote in an email Wednesday.
Murphy and Silvestro said they would be happy to show anyone in the community the proper way to collect and dispose of discarded needles. Murphy said EGYHOP volunteers continually collect discarded syringes, and that is one of the reasons downtown police leave them alone. In addition to the small number of EGYHOP volunteers who make syringes available to those who want them, they also, seven days a week, provide emergency supplies, including food and first-aid kits, to homeless and low-income at-risk populations downtown.
Murphy suggested that one way to reduce the number of discarded needles would be to decriminalize possession of needles as “drug paraphernalia.” He said IV drug users sometimes discard needles because they are afraid of being arrested or cited if they have one in their possession.
During Monday night’s meeting, Avalos suggested the county is taking steps to combat discarded needles. An employee from Thurston County demonstrated how to properly dispose of them. And Avalos said that in addition to a syringe receptacle that will be placed outside the needle exchange, a second box where members of the public can dispose of them will be placed in a yet-to-be determined location.
Avalos said he shares Archer’s concerns about discarded needles, but he hopes syringe programs don’t take the blame for the underlying problem — the influx of cheap heroin flooding not only Thurston County, but the entire state.
“People are not using drugs because they have access to needles,” Avalos said. “People are using more needles because they have access to more drugs.”
Archer, who identified herself as a member of a group called Concerned Olympians, said she will continue to organize around the issue. She said education is vital, and she wants to enlist the Olympia Public Schools to educate young people about the dangers of discarded needles and what to do if they encounter them.
Archer also said she is working with state Sen. Karen Fraser, D-Thurston County, to see if something can be done to address the state’s growing heroin problem. In a phone interview Thursday, Fraser confirmed she met with Archer and several members of the Olympia City Council this week. Fraser said she is looking into the issue.
“The information on what’s going on is shocking,” Fraser said of the meeting. “It ruins people’s lives.”Jeremy Pawloski: 360-754-5445 firstname.lastname@example.org