Even with the ban, state and local governments can sponsor the programs but in Florida, the issue of funding is irrelevant because drug paraphernalia is outlawed for use with illegal substances.
Pafford sponsored the bill after learning about the troubling results of the study, published by Hansel Tookes, a third-year student at UM’s Miller School of Medicine. The bill comes as legislators are also considering a measure that would prohibit the sales of certain drug paraphernalia such as bongs and pipes. A Senate version of that bill cleared a critical legislative panel this week.
In late 2010, Tookes and a team of students spent hundreds of hours scouring some of Miami’s most notorious spots for illegal drug use, interviewing 448 injection drug users who admitted to throwing away a total of 9,845 needles in the streets. Of those, they sold or shared 700 needles. In all, 95 percent of the used needles were discarded improperly, potentially exposing the users and others to blood disease. In comparison, 13 percent of used needles were tossed improperly in San Francisco. That city’s syringe access program, one of the largest in the nation, was launched in 1988. Last year, it distributed approximately 2.4 million clean syringes.
The risks are real: Injection drug users accounted for 8 percent of all new HIV infections in 2010 in the United States, according to the Centers for Disease Control and Prevention. But the needle exchange programs seem to be effective. A 2009 study in the Journal of Urban Health showed 12 percent of injection drug users in San Francisco were HIV positive. In Miami-Dade, the figure is almost double, with 23 percent of injection drug users estimated to be HIV positive.
In Baltimore, infection rates among injection drug users have fallen significantly since public health officials launched a needle exchange program 19 years ago. When they started, about 60 percent of all new HIV cases were among the injection drug population. Last year, that number was 15 percent, according the Baltimore City Health Department.
Between 2004 and 2012, the department issued 3,488,369 needles. It conducted 3,446 HIV tests and made 2,487 drug treatment referrals. The program is operated out of 35 Winnebagos,retrofitted with exam rooms, testing equipment and safe injection supplies.
“It took some time for the people to trust us,’’ said Chris Serio-Chapman, the department’s program director for community risk reduction services. “The idea is to go where they are at and to make them feel comfortable. In our conversations, we are asking our clients what can we do to help them and if they are ready for treatment.’’
In Florida, Tookes’ study -- published in the Drug and Alcohol Dependence medical journal in 2011-- presented the stark reality of illicit needle use in Miami, galvanizing the support of medical students and healthcare professionals across the state to bring needle exchanges to Florida. Among the supporters: the Florida Osteopathic Medical Association, the Florida Nurse Practitioner Network and the Florida Academy of Family Physicians.
“The Florida Medical Association supports this legislation, which addresses a serious public health issue and has the real potential to save taxpayer dollars,” said Timothy J. Stapleton, FMA executive vice president in a statement. “These medical students have done a tremendous job not only researching the issue and its impacts, but also promoting this non-partisan bill and garnering favorable support among community and medical stakeholders, lawmakers, and the public,”
Armed with the study results, Tookes and three other students – Marek Hirsch, Dyani Loo and Chanelle Diaz -- launched a grassroots campaign called The Florida Needle Exchange Initiative to lobby for legalization. Pafford and Margolis agreed to take it on.
Among the most powerful messages: The program saves lives and taxpayer money.
The cost of a needle is about 97 cents. The estimated lifetime cost healthcare for an HIV positive person runs about $400,000 to $600,000, according to amfAR, The Foundation for AIDS Research.
“The entire community is at risk when you are talking about discarded needles,’’ said Tookes. “There is overwhelming evidence that getting the needles off the streets reduces the transmission of diseases.’’
Miami Herald staff writer Mary Ellen Klas contributed to this report.