Florida Politics

Needle exchange program pioneered in Miami-Dade may soon grow to other Florida counties

Florida is poised to reverse a longstanding ban on needle exchanges and allow counties statewide to approve their own programs, after state House lawmakers voted nearly unanimously for the proposal and sent the bill back to the Senate for final approval.

The legislation — CS/HB 171 in the House and CS/SB 366 in the Senate — would expand a pilot needle exchange program in Miami-Dade that state lawmakers approved for a five-year test run in 2016. That program has allowed injection drug users to trade dirty needles for clean ones without cost, distributed overdose-reversing naloxone and connected users to wound care and drug treatment.

More than 250,000 needles have been collected since the pilot program began, and the program has signed up more than 1,000 participants since the end of 2016. It has also reversed more than 1,000 overdoses through naloxone it distributes to those served, and the county’s number of opioid-related deaths has dipped despite a rise in those numbers elsewhere across the state.

The bill, which would require county commissions to approve any programs in their jurisdiction, would mean that counties where local officials are opposed are still unlikely to see any programs. But officials in several larger urban counties, including Broward and Palm Beach, have already signaled interest.

Rep. Shevrin Jones, D-West Park, a co-sponsor of the bill, told lawmakers Wednesday night that the proposal had helped prevent hundreds of overdose deaths and helped curb HIV outbreaks in the county.

“This program has and is still saving lives,” he said.

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In clearing the House by a 111-3 vote, the long-proposed measure to permit needle exchanges cleared a critical hurdle — the Legislature’s lower chamber has historically opposed efforts to allow such programs since the pilot program was first proposed seven years ago.

Lawmakers had been initially concerned that providing clean needles would enable more drug use rather than less, despite similar programs in other states that had had positive results. But as opioid deaths and injection drug use rose, the Legislature signed off on allowing Miami-Dade to try out such a program as a preventive measure that could fend off diseases spread by reused needles and encourage users to tap into treatment and testing.

This year, the bill also had the backing of Speaker José Oliva, R-Miami Lakes, who changed his personal position on needle exchanges after visiting the Miami-Dade program’s Overtown clinic late last year. He told reporters earlier in the session that he still had concerns but had been swayed by the results coming out of the program, provided that the legislation required future programs to use only private funds.

The House on Wednesday took up the Senate’s bill, but amended the proposal to reflect two of the main differences in its own version: prohibiting county funds from being used to operate such programs, and being stricter in enforcing a requirement that dirty needles be exchanged on a one-to-one basis for clean ones.

The Senate will need to decide whether or not to accept those changes when the bill is sent over, though it is expected to take up the changes, said Hansel Tookes, the University of Miami doctor who runs the pilot program and has spearheaded the effort to bring needle exchanges to Florida. The legislation could be heard as early as next week.

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As the bill passed the House late Wednesday night, Tookes was watching in the gallery with a small group of advocates, including mothers Cindy Dodds and Joy Fishman, who had lost their sons to drug use. Also with them in the gallery was advocate Julia Negron, who has pushed for needle exchange programs where she is based in Sarasota.

As they waited for lawmakers to take up their bill, Fishman and Dodds spoke quietly.

“This is one more tool in our toolbelt,” Dodds said of needle exchanges.

Fishman also cast the bill as a way to save lives like that of their sons.

“Today, he would be treated with much more compassion and dignity,” she said. “That’s what the needle exchange does.”

Before lawmakers voted, Tookes and his colleagues were recognized by Jones on the floor for their work. Tookes reflected on the opposition the program had faced when he first came to Tallahassee in 2012. Since then, he said, he had been encouraged by how willing people had been to reconsider their positions, “that people were able to learn about it.”

“It makes me proud of government,” he said.