Determined to reduce the spiraling number of new HIV infections in South Florida, the Florida House sent a bill to the governor Wednesday that will create a pilot program in Miami-Dade County to allow drug addicts to exchange their dirty needles for free, clean ones.
For four years, Sen. Oscar Braynon, D-Miami Gardens, sponsored the bill but was unable to get it through both the House and Senate. But this year — with blood-borne diseases among intravenous drug users rising in Florida — he and House sponsor, Rep. Katie Edwards, D-Plantation, were able to win bipartisan support.
“It took a while for us to get people to understand what this program did,” Braynon said.
The state leads the nation for new cases of HIV/AIDS with the number of infections rising each year, even as it drops nationwide. Experts contend the increase is due in part to the explosion of intravenous drug use, including heroin addiction.
The HIV epidemic is most severe in Miami-Dade and Broward counties, which have the highest rates of new infections per 100,000 residents of any area in the country, according to state and federal data. A study done at Jackson Memorial found treating patients with bacterial infections as a result of dirty needles costs about $11.4 million a year.
The pilot program will be run through the University of Miami, which will be allowed to circumvent the state's drug paraphernalia laws and use a mobile unit to reach addicts, encouraging them to replace dirty needles for clean ones. The effort will include helping people find drug treatment and counseling programs. The university is responsible for finding the money to pay for the program so there is no cost to taxpayers.
The measure, SB 242, won approval in the House Wednesday, 95-20. It had previously cleared the Senate, 37-2.
Opponents argued the program could make it easier for addicts to get access to drugs but proponents said the main goal is to prevent the transmission of HIV, AIDS, viral hepatitis and other blood-borne diseases by offering addicts clean needles.
Rep. Michael Bileca, R-Miami, was the only lawmaker to speak against the bill Wednesday. He objected to the provision that allows the needle exchange to occur through a mobile unit, and not at a fixed site where addicts could be encouraged to get counseling and treatment. Bileca was one of 20 Republicans who voted against the bill, including two others from Miami-Dade County, Rep. Manny Diaz Jr. and Rep. Carlos Trujillo.
But Rep. Julio Gonzalez, a conservative Republican from Naples who is an orthopedic surgeon, countered that a mobile unit is necessary because an addict’s world is “a very, very horrible place,” and they are often unable to "leave that world to go someplace else to go get a needle to protect themselves."
He described treating HIV patients at Jackson Memorial with GI tracts “riddled with infection” so severe they they couldn't digest food. Veins were so damaged by their intravenous drug use that medical personnel could not find a vein.
“This is a very palpable, very real, very threatening disorder that threatens not only the lives of people that are affected but their families, their communities, our budget," he said.
Edwards noted that the bill includes a requirement that the program refer addicts to treatment programs.
Dr. Hansel Tookes, a resident physician of internal medicine at Jackson Memorial, who treats HIV patients, brought the idea of needle exchange to Braynon.
"This all came about because we were seeing more and more people entering the hospital with [bacteria-related infections]. If we can decrease any HIV cases in Miami, we've done the community a service."
He cited Scott County, Indiana, which saw an explosion of 140 HIV diagnoses tied to drug use in just a few months, prompting the governor to declare a state of emergency and launch a needle exchange program.
"Before the perfect storm happens where we have a situation like Indiana, I'm really happy we're able to bring back this proven, evidence-based public health effort to prevent an epidemic of unknown proportions," Tookes said.