Modesto Needle Exchange saving lives one needle at a time

etracy@modbee.comJuly 12, 2014 

  • AT A GLANCE

    •  The Modesto Needle Exchange started operating in February 2013 in Mono Park with about a dozen clients. A year later, in response to neighborhood complaints, the operation was moved to an industrial part of the airport neighborhood where on Tuesday more than 200 clients were served.

    •  The exchange can operate legally as a result of Senate Bill 41 (Leland Yee, D-San Francisco), which allows physicians, pharmacists and sanctioned needle exchange programs to provide up to 30 sterile syringes to injection drug users to prevent the spread of diseases such as hepatitis C, HIV and AIDS.

    •  Until the Modesto Needle Exchange is state-certified, Dr. Marc Lasher must oversee each event.

    •  Prior to the law’s enactment in 2012, only local governments could give authorization to operate a syringe exchange program. The Stanislaus County Board of Supervisors nixed a proposal for a program in 2008 despite recommendations from a civil grand jury and county health professionals.

    According to studies compiled by the California Department of Public Health:

    Heroin use has increased steadily since the mid-2000s statewide, but particularly in Stanislaus County, where it’s beginning to rival methamphetamine use. The percentage of people entering drug treatment programs in Stanislaus County who named heroin as their drug of choice increased from 22.6 percent in 2008-09 to 31.2 percent in 2012-13.

    A study of 81 cities around the world compared HIV infection rates among injection drug users in cities that had syringe exchange programs with cities that did not. In the 29 cities with programs, HIV infection rates decreased by an average of 5.8 percent per year. By contrast, in the 52 cities without programs, HIV infection rates increased by 5.9 percent per year.

Modesto Needle Exchange volunteers are continuing their efforts to become state-sanctioned, in part by training to distribute to heroin users a prescription drug administered by health care professionals to counter the effects of opioid overdose.

More than a dozen people gathered around a folding table on Daly Avenue in the industrial portion of the airport neighborhood last week to watch Dr. Marc Lasher demonstrate how to use the opioid antagonist Naloxone.

“You could save the life of a fellow addict,” he told the group. “Believe me, a lot of other people aren’t going to be caring about that, but you know that your lives are worth something and your friends’ lives are worth something.”

Lasher told the group to never shoot up alone, taught them to turn the subject of an overdose on his side to avoid aspirating and gave a quick lesson in cardiopulmonary resuscitation. He told clients of the needle exchange to call 911 if there are no positive results after administering Naloxone.

“You do not have to say it’s a heroin overdose,” he told them. “If you do, you’ll probably get three police officers … before you get an ambulance.”

A civil law that went into effect in October allows Lasher to issue standing orders for the dissemination of the drug and for the addict to possess it without fear of civil or criminal liability.

Tuesday’s “overdose prevention workshop” was also a lesson for Modesto Needle Exchange’s two primary volunteers, Brian Robinson and Justin Johnson. They plan to apply for state certification in the fall, which would allow them to operate the exchange independently of Lasher. He and Dallas Blanchard operate the Fresno Needle Exchange but have volunteered their time for nearly a year and a half to help get Modesto’s up and running.

But Robinson and Johnson are facing an uphill battle. They both are new to the grant-writing process. Their first attempt at obtaining one failed, so they are still receiving supplies from other entities like the San Francisco AIDS foundation.

The application for state certification is lengthy, with requirements that include a needle-stick injury protocol, statistical tracking of people served and needles dispensed, and providing directly or referring to a number of services, such as substance abuse treatment programs and HIV screening.

Since the exchange began operating in early 2013, it has experienced pushback from law enforcement who respond to complaints of dirty needles discarded in the neighborhood. Needle exchange volunteers have accused law enforcement of capitalizing on the weekly exchange to target drug users while they are gathered to get “medical services.”

In February, volunteers responded to some of law enforcement’s concerns by moving from Mono Park to an industrial area of the airport neighborhood, farther from homes and areas where children play and learn.

But new ownership last month of a former meat factory across the street has brought new complaints.

Ontel Security Services and Art Dunn Alarm Co. are charged with warding off crime near the vacant three-story, 234,131-square-foot building.

“We have found needles on the property, remnants of them using meth and other items on the property, trash all over the property, which didn’t use to be a problem until this started,” said Ontel chief of security David McCann. “And now they feel that they can park on the property. It’s bringing a lot of problems to the area.

“The new owner just bought the building; they are very concerned about it from the crime aspect because, once they get the building fixed, there are going to be employees’ cars parked here,” McCann said. “He’s worried about damage, vandalism, things like that.”

Art Dunn and his wife, Kim, talked to Lasher on Tuesday about some of the issues, including parking on their client’s property.

Even after volunteers walked up and down both sides of the streets collecting trash on Tuesday, Dunn said he found a dirty needle wrapped in tissue paper.

Not everyone is bringing back their dirty needles before getting a new pack of 30. One woman on Tuesday said she didn’t bring hers because she heard people were getting arrested with them. A 21-year-old man participating in the overdose prevention workshop tried to pocket a pack of syringes while volunteers were watching Lasher demonstrate CPR.

Robinson said what happens in and around the area after the exchange is largely out of his control but he and the other volunteers try to mitigate problems to the best of their ability.

He started giving fewer syringes to people with no dirty needles to dispense and plans to change the layout of the exchange so that he is sitting eye level with the sharps container to get a better count on the number of needles coming in.

He also talks to needle recipients about the need to pick up after themselves and not use drugs in the area and will start advising them against parking near the factory. The exchange’s aim is harm reduction, preventing the spread of diseases like hepatitis C, HIV and AIDS.

“All we can do is be really diligent,” Robinson said.

Good relationships with neighbors and law enforcement will play an important role in obtaining certification from the California Department of Public Health.

After receiving the application, the department has 30 days to respond. If it is deemed provisionally appropriate, a 90-day public comment period is required before certification is granted.

As part of the evaluation of each application, the department consults with local law enforcement, the local health officer and any neighborhood associations.

A syringe exchange program can be denied certification, “If evidence of projected harm to public safety, presented by local law enforcement official(s), is, in the department’s judgment, greater than evidence of projected benefits to public health,” according to the Public Health Department.

Bee staff writer Erin Tracy can be reached at etracy@modbee.com or (209) 578-2366. Follow her on Twitter @ModestoBeeCrime.

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