Health department rolls out this program to help drug users in rural parts of Whatcom

A total of 79 people in the more rural parts of Whatcom County received new, sterile needles through a health department program that traveled to them this summer.

The Whatcom County Health Department took its Syringe Services Program, which is based in its North State Street clinic in Bellingham, on the road as a test run from June to September.

The program helps intravenous drug users trade in their used needles, and provides other health and social services.

A total of 13,260 needles were collected and exchanged for new ones during the pilot run of the mobile service from June to September.

A quarter of the people who used the mobile service hadn’t previously gone to the Bellingham clinic, according to Cindy Hollinsworth, manager of communicable disease and epidemiology for the Whatcom County Health Department.

Seeing its impact in what public health officials said are underserved areas, the department decided to continue its mobile outreach.

“The biggest factor in our decision to keep the program going is that we know we are reaching people we have never reached before,” Hollinsworth said to The Bellingham Herald in an email interview.

“Some of these clients are telling us that transportation has been a barrier for them getting to Bellingham, so the new mobile sites allow them to access our prevention services,” she said.

To reach them, the mobile exchange goes out to Maple Falls and Birch Bay for two to three hours a day, one day a week for each community.

Ferndale is soon expected to be the third location.

Hollinsworth said people are directed to the mobile sites by word of mouth, including through service providers.

The health department isn’t revealing the location of the mobile service in those communities.

“We want our clients to have safe and private access to the health care services we provide, so that’s why we aren’t widely publicizing the locations,” Hollinsworth said.

Until the mobile service started in 2019, the needle exchange occurred at the Bellingham clinic for a few hours, twice a week.

The health department has been renting a van to use for the mobile service.

It plans to buy a transit van for about $50,000, and then spend $40,000 to customize it if a grant comes through.

The department wants to fully equip the van so it can also provide a mobile medical response in the event of an earthquake or outbreak, officials said.

Exchange history

The Whatcom County Health Department started the needle exchange in Bellingham in August 1999. The confidential service is free to those who use it.

In the decade ending in 2018, the number of people served has jumped by 268% — climbing from 219 to 806, according to health department data.

The demand is a sign of the nationwide public health crisis that is opioid addiction, public health officials have said.

Opioids include prescription pain relievers — such as oxycodone, hydrocodone and methadone — and heroin, which is illegal.

Addicts use the needles to inject themselves with heroin, and most heroin users said they abused prescription opioids prior to using heroin, Whatcom public health officials have said.

The rise in the number of people who died from opioid overdoses, nearly 400,000 from 1999 to 2017 in the U.S., occurred in three waves, according to the Centers for Disease Control and Prevention:

The first started with increased opioid prescriptions in the 1990s.

That was followed by a sharp and rapid rise in heroin use and overdoses starting in 2010.

The third wave began in 2013 with a surge in deaths caused by synthetic opioids, particularly illicit fentanyl.

In Whatcom County, there were 7.83 deaths that involved opioids per 100,000 residents, which was below the statewide rate of 10.09 per 100,000, according to the Alcohol and Drug Abuse Institute at the University of Washington.

That data covered 2015 to 2017, and showed a 38% increase in such deaths in Whatcom County compared to 2002 to 2004.

Needle Exchange 1
About 1,000 used needles sit in a bin at the Syringe Services Program office at the Whatcom County Health Department in 2016 in Bellingham. Needle exchange program participants can exchange used needles for new, sterile ones. The health department is expanding the program to include a mobile service that goes out to Maple Falls, Birch Bay and, soon, Ferndale. Staff The Bellingham Herald file

Helping residents

The idea behind the Syringe Services Program here and elsewhere is to help people use drugs as safely as possible by giving them clean needles and clean supplies — so they’re not sharing contaminated equipment — in order to prevent the spread of diseases such as HIV and hepatitis C among drug users and their loved ones.

Such programs also work to curb serious infections caused by people injecting with dirty needles or in unsanitary conditions, officials said.

People also can get tested for hepatitis C and HIV; receive information about health care, including sexually transmitted infections; and talk to a substance-abuse counselor.

“This is harm reduction at its most basic. Of course, nobody wants anyone to use drugs or inject drugs,” Hollinsworth said.

The hope is that more contact with health providers could one day lead to drug users deciding to get help.

“We are also building new relationships with people in our rural communities,” Hollinsworth said. “When we increase consistent access to treatment locally, we’re building trust with clients, and that increases the likelihood that our referrals link clients with treatment and other services that can improve their long-term health.”

The CDC said that new users of needle exchanges were five times more likely to get drug treatment and three times more likely to stop using drugs than people who don’t use exchanges.

Hollinsworth said that a big piece of the program is educating people about how they can prevent an overdose and distributing naloxone, which is medication that reverses opioid overdoses.

“Death can occur from overdose, and it can also occur from infections from poorly sanitized needles,” Hollinsworth said.

From June to September, the Whatcom County Health Department gave out 54 naloxone kits through its mobile syringe service, and 85% were refills because people used it or gave away the naloxone.

A federal grant pays for the naloxone kits.

Kie Relyea has been a reporter at The Bellingham Herald since 1997 and currently writes about social services and recreation in Whatcom County. She started her career in 1991 as a reporter and editor in Northern California.