On Thursday afternoons, as many as 95 people come to the health department on North State Street to trade in their used needles for new, sterile ones.
Each month, up to 23,000 needles are exchanged, even though the service for intravenous drug users is available for fewer than three hours each week in Bellingham.
Despite the limited availability, more than 250,000 needles were distributed last year through the Whatcom County Health Department’s Syringe Services Program.
The demand is a sign of the public health crisis that is opioid addiction, according to public health officials.
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“It’s an epidemic,” said Regina Delahunt, director of the Whatcom County Health Department.
Opioids include prescription pain relievers – such as oxycodone, hydrocodone and methadone – and heroin, which is illegal. Heroin use has risen sharply across the U.S., according to the Centers for Disease Control and Prevention.
When the physical addiction is present and there is no access to prescription drugs, heroin is the next step.
Cindy Hollinsworth, manager of communicable diseases and epidemiology for Whatcom County Health Department
The amount of prescription opioids sold in the U.S. has nearly quadrupled since 1999, the CDC said, yet there hasn’t been an overall change in the amount of pain Americans have reported.
“Three out of four new heroin users report abusing prescription drugs prior to using heroin,” said Cindy Hollinsworth, manager of communicable diseases and epidemiology for the Whatcom County Health Department.
“When the physical addiction is present and there is no access to prescription drugs, heroin is the next step,” Hollinsworth added.
Addicts are using syringes to inject themselves with heroin, driving a 152 percent increase in people coming to the county needle exchange program since 2010, officials said.
Last year, it served 674 clients.
In 2010, that number was 267.
And people ages 25 to 30 years old are the fastest-growing group using the exchange.
“The people that we’re seeing are young adults. It’s sad,” Delahunt told U.S. Sen. Patty Murray in July.
Murray, D-Washington, was in Bellingham to hear from health providers and advocates about what they faced in Whatcom County and what they needed to combat opioid abuse.
She also talked about new legislation meant to address the drug problem. President Barack Obama signed the Comprehensive Addiction and Recovery Act, which focused on opioids, in July, but it lacked needed funding.
Helping addicts, preventing spread of disease
The Whatcom County Health Department started the needle exchange in August 1999. The service is free and confidential.
On Thursday, Aug. 11, public health nurse Jessica McAllister stood in a room, pulling together supplies for distribution that day.
People can bring in as many as 100 used needles to trade for the same number of clean syringes. Contaminated needles are then disposed of safely.
The program also provides emergency syringes for people who don’t have them.
They also get items such as tourniquets, alcohol swabs, tiny cotton balls, bandages, bleach kits and cookers, which are small containers used for heating and cooking a drug.
“The clients who use the services are pro-safe injection,” Hollinsworth said, “and educate each other and encourage those who are not exchanging needles to come here and do so.”
Officials acknowledge that giving needles to drug users does raise eyebrows.
“Aren’t we telling them it’s OK to do drugs?” McAllister, coordinator of the Syringe Services Program, said of people’s concerns.
“It’s going to happen anyway,” McAllister said of drug use.
The idea, then, 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 – 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 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.
The hope is that more contact with volunteers and health providers could someday lead to addicts deciding to get help.
Studies have shown that needle exchange programs don’t increase intravenous drug use, officials said.
The program costs a little more than $50,000 a year, for supplies and staff. The state Department of Health also contributes $22,000 worth of supplies.
The program is paid for with $27,000 in state funding, with the rest coming out of Whatcom County’s budget. Volunteers help run the program every week.
Bellingham resident Julie Grace is among the exchange’s volunteers.
When she tells people about her volunteer service, everyone shares a story about a family or friend who has suffered because of addiction or overdose.
“The toughest thing is there’s such a limited time that we get to see clients. Sometimes they don’t come back and you don’t know what’s happened to them,” said Grace, who plans to study community health at Western Washington University. “You do start to worry about other people’s lives and if they’re OK.”
As demand for the existing needle exchange program grows, public health officials said they’re just starting to explore the possibility of a satellite program or a mobile exchange – going to other parts of Whatcom County to reach people who can’t get to Bellingham or don’t like the thought of walking into the health department.
“There’s definitely unmet needs out in the county,” McAllister said.
The Whatcom County Health Department offers the Syringe Services Program from 2:30 to 5:15 p.m. Thursdays at 1500 N. State St. in Bellingham. The service is free and confidential. People also can get tested for hepatitis C and HIV, receive information about health care and talk to a substance-abuse counselor.
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