Miami-Dade County

As national heroin rates surge, Miami-Dade still lacks a needle exchange program

Street addict shows his stash of needles in the overtown section of Miami.
Street addict shows his stash of needles in the overtown section of Miami. EL NUEVO HERALD

For the past three years, Florida’s Legislature has failed to pass a bill that would create a needle exchange program, leaving the state without a program to help drug addicts avoid exposure to disease through dirty needles.

But stark new figures released this week show heroin use is surging across the country and is up around 63% in the last decade, according to a new report by the Center for Disease Control and Prevention. In another recent study, doctors at the University of Miami and Jackson Memorial Hospital found that over one year, cases of infection at Jackson Memorial caused by injection drug use led to 17 deaths at a cost of $11.4 million, much of it borne by taxpayers.

State Sen. Oscar Braynon, D-Miami Gardens, who sponsored this year’s bill, said the legislation to authorize a five-year pilot program sponsored by UM was a logical step. The CDC figures only reinforced what he had already seen for years in his own South Florida district, he said.

“I’ve had all these areas in my district where heroin use was high, and it was being compounded by the spread of HIV and Hepatitis C,” Braynon said.

“We are killing people that are stuck on a life-debilitating drug, and now they’re getting diseases from that life-debilitating drug,” he added.

Florida bucks the national trend of a growing acceptance for needle exchange programs, even in GOP-controlled states that have traditionally opposed these efforts. After previously arguing that the programs would encourage drug use, some Republicans like Indiana’s Gov. Mike Pence are shifting their positions as research continues to conclude that needle exchanges are an effective way to prevent disease. An outbreak in HIV and Hepatitis C cases in Indiana earlier this year led Pence to issue an executive health order, launching a temporary program in part of the state in March. Many of the infections were linked to intravenous drug use.

Counties in Kentucky, Ohio and West Virginia also initiated needle exchange programs this year, as drug use fueled outbreaks of diseases like Hepatitis C and HIV/AIDS in those states as well.

While injection drug users remain at risk for HIV/AIDS by sharing needles —especially alarming in Miami-Dade County, which has the highest rate of new infections in the country — new research shows that these drug users are also at risk for common infections like sepsis or endocarditis, an infection in the heart.

Physicians at Jackson Memorial and UM tracked the number of people admitted to the hospital between July 2013 and June 2014 for infections related to intravenous drug use and found that nearly 5 percent of patients died during their hospitalizations.

“What was most upsetting is that these deaths are largely preventable,” said Hansel Tookes, a resident physician in internal medicine at Jackson Memorial and an author of the study. Tookes is a long-time advocate for needle exchange programs and has pushed legislators to approve the UM-sponsored pilot program.

A cost analysis also found these hospitalizations came at a huge price for taxpayers. In the one year of cases doctors looked at, the cost to treat the drug-related infections was $11.4 million. The vast majority of these patients are on Medicare and Medicaid assistance.

“We see these patients and how severe the infections are and how complicated the care is,” said Susanne Doblecki-Lewis, an assistant professor of clinical medicine at UM and a lead author on the study. But still, she said, the cost “is astounding.”

Not everyone is willing to wait for the state to sanction a program. George Gibson, a 48-year-old ordained pastor, began handing out needles himself two decades ago in Miami-Dade after getting a $1,500 grant from the North American Syringe Exchange Network. Since then, he has accepted donations of packaged syringes and sometimes uses his own money to continue distributing clean needles.

Dispensing needles remains illegal in Florida, but Gibson does it anyway, viewing his work as a type of civil disobedience.

“The reality is that everybody ain’t going to be holy,” said Gibson. “I’ve got to catch these people when they’re alive. I can’t do nothing when they’re dead.”

Daniel Raymond, the policy director at Harm Reduction Coalition in New York, which advocates for needle exchange programs across the U.S., said he remembers being a part of similar efforts at the height of the AIDS crisis in New York City, before the state legalized a program.

“We saw the need, and we felt like we needed to do something,” he said. “It’s a sign of desperation that people are willing to act in lieu of state legislation and do it themselves.”

While there’s support in the state Senate to pass the bill, said Braynon, the House left the proposal languishing in a committee so it never made it to a vote in either chamber. But despite opposition to the legislation, Braynon said he would continue to raise the issue.

“One hundred percent, I’ll bring it up at the next session,” said Braynon. “It’s a no-brainer.”