The situation on Miami’s streets is grave, and similar conditions can be found throughout Florida. Fifteen Floridians die every day from an overdose. This epidemic requires bold responses.
A bill is pending in the Legislature (S 800/H 579) that would permit all counties in Florida to offer syringe-exchange programs.
In 2016, lawmakers passed the Infectious Disease Elimination Act, authorizing a five-year pilot syringe exchange program at the University of Miami. As faculty at the Miller School of Medicine, we are proud of the university’s leadership in what has been a highly effective, front-line intervention for people who use drugs.
The results of the IDEA Exchange in Miami leave no doubt about the importance of passing this bill. In just 13 months, the IDEA Exchange has tested hundreds of people for HIV and Hepatitis C, helping them into care and providing access to medications to halt the transmission of disease. These are essential services in a state with one of the highest rates of new HIV infections in the nation.
A critical part of the IDEA Exchange’s mission is making sure that naloxone is available to people who use drugs, their families and others who are likely to witness an overdose. Naloxone is a safe, easily administered medication that can almost instantly reverse the effects of opioid overdose. As Human Rights Watch has documented, syringe exchanges are one of the best ways to get naloxone into the hands of people who need it the most.
With its mobile van, IDEA has been able to do extensive street outreach, offering naloxone kits and other health services without judgment and always with a kind word. This process gives people who are using drugs the opportunity to ask for help getting into treatment — when they are ready. Because people must bring a needle to receive one, the IDEA exchange has removed more than 100,000 dirty syringes from the streets of our city. All of this has been accomplished without increasing crime or drug use, and without state funds.
The program is serving people who have fallen on hardship, including doctors, nurses, lawyers, students, musicians and entrepreneurs. One of them is Arrow, who lives under an overpass in Overtown. He has saved dozens of people with naloxone distributed by the IDEA Exchange and is considered a hero among his neighbors who sleep near him on the street, whom he considers his family. The IDEA Exchange is the only place where Arrow and the many others overcome by addiction are treated with dignity and can still feel like human beings.
There have been 387 lives saved from opioid overdoses since IDEA began distributing naloxone last April. That’s not just a number — to many Floridians it means a son, a daughter, a husband, a wife or a friend.
But in many of Florida’s other 66 counties, the opioid epidemic is worse than in Miami-Dade. Fentanyl deaths in the state increased by 97 percent between 2015 and 2016. The State Medical Examiner’s report for 2016 shows that in 24 counties, death rates from fentanyl were equal to or higher than in Miami-Dade, with the most in Duval County. In Manatee County, deaths from fentanyl analogues or derivatives, in 2016 were double the number in Miami-Dade. In 2016, Palm Beach County had the highest number of heroin-related overdose deaths.
Recognizing the importance of expanding IDEA’s services statewide, state Sen. Oscar Braynon, D-Miami, and Rep. Shevrin Jones, D-West Park, introduced legislation that would permit all Florida counties to establish pilot programs under the IDEA Exchange model.
Florida faces an overdose epidemic that is taking an estimated 15 lives each day. In the next few weeks, the Legislature has the opportunity to make sure that every county in the state has the tools to address this public health crisis and save lives. Every week that we wait means another 105 lives not saved.
Dr. Hansel Tookes is assistant professor of medicine at the University of Miami’s Miller School of Medicine. He is the founder and medical director of the IDEA Exchange. Felicia Knaul, Ph.D., is professor of public health sciences at the Miller School of Medicine and director of the Institute for Advanced Study of the Americas.