On vacation, most people look forward to the sights, sounds and tastes of a new city. Dr. Hansel Tookes looks for the needle exchange clinic.
Over the years, the 35-year-old University of Miami doctor remembered his favorite parts about every clinic he visited, cataloging them for the far-off day the practice was legal back home in Miami.
The IDEA exchange, at 1636 NW Seventh Ave., is in the heart of the University of Miami health district and Overtown, which Tookes said has been ravaged by the heroin epidemic.
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The clinic, housed in two beige storage containers, with air conditioners so new there are still bits of packing plastic on them, will open its teal doors on Thursday, World AIDs Day. The University of Miami will operate the clinic, which will have a mobile unit, through private funding; no taxpayer money will be used for the project.
Needle re-use is a common problem in the drug-using community; it can spread disease and cause infections and death. A study co-authored by Tookes at Jackson Memorial found that treating patients with bacterial infections as a result of dirty needles costs about $11.4 million a year.
Most people who inject drugs don’t always use sterile needles, according to a new CDC Vital Signs report. The report shows the number of people who use needle-exchange programs, which are legal in dozens of states, has jumped from one-third to more than half in a decade.
Cutting down on the re-use of dirty needles can lessen the spread of diseases like HIV, the virus that causes AIDS, a growing problem in Miami-Dade. The Centers for Disease Control’s 2015 numbers show Miami at the top of the list, again, for new HIV infections. Not only is the county No. 1 in new infections, the rate is double to triple that of other major metropolitan areas.
“This is 1990s evidence-based health policy that we’re implementing in Miami in 2016,” Tookes said.
At the IDEA exchange, the containers offer two choices for participants. Inside one, they can trade out needles, as well as pick up related items — cotton balls, tourniquets, cookers and sterile water — for injecting the drugs safely. Staffers have bandages and antibiotic ointments on hand, too, to care for the infections and abscesses dirty needles can cause.
In the other trailer, participants can get linked to substance abuse counseling and medical care at a UM clinic two blocks away, or be tested for diseases like hepatitis C and HIV. The clinic is the only place in the county where the test results are not logged for research purposes.
“We want people to feel safe using our program,” said Tookes.
Instead, participants get a unique number on an ID card so staff can keep track of their records internally. The other side of the card is printed with the Florida statute that makes carrying needles legal.
The main idea is preventative health services with dignity, Tookes said.
“These people are so stigmatized, and this gives them humanity,” he said.
To advertise the opening, IDEA volunteers walked the neighborhood giving out donated sandwiches, blankets and fliers about the new program.
Inside the office, Tookes ran his hands through the cardboard boxes of new antibiotic ointments, tourniquets and biohazard containers for used needles.
Weeks from now, another box will hold Naloxone, the drug that saves narcotics users from their overdoses. Soon, the clinic will give away the life-saving drug as part of its overdose prevention outreach.
“I really wanted [IDEA] to be a program where people could get anything,” Tookes said. “One thing I noticed in San Francisco is if they had fruit, they gave fruit to the people who came by, or soap, or food for their dogs.”
But first, the basics. Tookes pointed to a box filled with gold-wrapped condoms and said, “That’s the biggest part of HIV prevention.”
Sexual transmission is still the most common way of getting the virus.
Now, the pressure is on for Tookes and his team to show those results in real life. The IDEA exchange must collect data and prove that the clinic works.
“When we prove that we’re effective, this program will be able to spread to other parts of the state that need it,” Tookes said. “It really needs to spread.”
Though Gov. Rick Scott signed the bill into law in March, the bill came with strings. No public money can be used for the program, so Tookes and his team had to fundraise the hundreds of thousands of dollars they needed.
If everything goes well, and they lock down a steady stream of funding, IDEA could be the start of a statewide shift in public health policy.
“Hopefully this will symbolize a change in how we treat people who are suffering with substance abuse disorders in our community,” Tookes said.
WANT TO HELP?
To make a donation to Florida’s first needle exchange program in Miami-Dade County: https://advancement.miami.edu/netcommunity/sslpage.aspx?pid=1634