Bill allows counties to decide on needle exchange programs. What could it look like in Manatee?

After the success of a pilot program in Miami-Dade, state legislators passed a bill that would allow county governments across Florida to decide if a syringe or needle exchange program could legally operate within county limits.

While it’s not clear if a syringe exchange program would be started in Manatee County should the bill become law, local groups and at least one county commissioner said they would support the move.

Manatee County Commissioner Carol Whitmore,who is a nurse, said the concern for public health after Manatee County became known as the epicenter of the opioid epidemic in Florida “begs for us to look at” implementing a needle exchange program.

“I do fully support something like that if the county could do it,” Whitmore said.

“Because syringe exchange programs are still relatively new, particularly in Florida, many unknowns remain locally,” said Joshua Barnett, Health Care Services Division manager for Manatee County. “But there are 320 legal syringe exchange program operation nationally. ... We have the opportunity to learn from things that promoted their success and inhibited their success.”

The bill to expand the Florida Infectious Disease Elimination Act (IDEA) pilot program passed the Senate unanimously May 2. It previously passed in the House, with just two representatives voting against it.

While Gov. Ron DeSantis has not signed the bill into law, he has reportedly told a sponsor of the bill that he is likely to sign it, according to the Herald/Times Tallahassee Bureau.

Under the bill, a program’s focus would be on preventing the transmission of disease from intravenous drug use.

Needle exchange programs already exist across the country. But in Florida, the only legal needle exchange is currently in Miami-Dade County, home of the IDEA Exchange pilot program. It’s a place people can go for HIV testing, to get connected with social services and drug treatment programs and to receive naloxone, which reverses the effects of opioid overdoses.

Should one come to Manatee, what could it look like?

By legislation, a Manatee County program would be similar to the IDEA Exchange pilot program.

To meet the legislative requirements, county government must enlist the county health department for consultation and contract with a hospital, health care clinic, medical school, licensed addition receiving facility, or 501(c)(3) HIV/AIDS organization to provide the services. Educational materials are required to be handed out with each needle, which would be exchanged on a strict one-for-one basis.

Barnett said multiple focus groups made up of people who live and work in Manatee County found participants were in favor of a syringe exchange program that met some conditions. Those included preserving anonymity, mobility and that the program be a place for an exchange of syringes and needles, not sanitation.

The program would be required to annually report statistics like the number of participants, number of dirty needles received and clean ones distributed, as well as the number of people who seek testing and drug counseling while visiting the exchange.

Focus group participants said mobility was important to avoid the stigmatization a stationary location could bring, according to Barnett. Group participants noted that if a stationary location is along the route to places users frequent, it’s more likely they would be seen or recognized, which might deter them from using the program.

So determining one or more locations would include finding a balance between where resources need to be located to ensure access and the community’s concerns, Barnett said.

“We know, based on overdose data, there are a number of injection drug users that we never see in treatment and may not overdose,” said Barnett, a trained epidemiologist who formally monitored quality and treatment outcomes of various community-based supportive services within the Delaware Division of Substance Abuse and Mental Health. “So exchange programs provide access to engage those individuals proactively and equip them with education and support specific to their motivations for recovery.”

“We know they’re using so why don’t we adapt to instill motivation to change and hope for recovery in the precise moment they’re not injecting and they’re not overdosing,” Barnett said.

Julia Negron, co-founder of Suncoast Harm Reduction Project, said with few services in the area, the exchange would be a “one-stop shop” for health and wellness.

While Negron’s organization could not operate the exchange, she said they could partner with them. She said the bottom line is outreach and to start talking about implementation. She noted it would take some networking to find the right entity to run the program.

The entire program will rely on grants and donations, as no county funds could be used to operate the program.

Abby Shockley, the new executive director for Drug Free Manatee, said the organization would be willing to take part in conversations about a needle exchange program in Manatee County.

Though they have not spoken to the county about it, Melissa Larkin-Skinner, CEO of Centerstone of Florida, said they are not opposed to a program in Manatee and would be willing to partner with the county if one is approved.

Negron moved to Florida five years ago from California, where needle exchange programs exist. She said Florida needs to catch up on supporting initiatives like this.

“They’re a central place for people struggling with addiction and illness where they can get involved without judgment and get resources that are helpful to them,” Negron said. “It’s more than just an exchange for injection drug users, it’s a place of health, wellness and healing.”

Barnett said, based on his conversations, some residents feel that the approval of a needle exchange program is more likely to happen in Manatee County now than just a few years ago.

Though she admitted to being skeptical at first, Gerri Stanhope, of local group No Longer Silent, said she hopes a needle exchange program can be done in Manatee.

“I think it’s a great idea. When I first heard about it I thought, ‘That’s crazy,’ just like I thought (naloxone) was crazy,” Stanhope said.

But Stanhope realizes not everyone is on board with the idea. She said some who are against it see the needle exchange as a gathering place for those who use drugs.

“But that’s the kind of stuff that keeps the stigma going and keeps people from asking for help,” Stanhope said.

Negron is also used to the public push-back on these types of initiatives. It happened with the widening of naloxone availability, too.

She said she expects needle exchange programs to face the same challenges.

This story was originally published May 9, 2019 at 5:00 AM.