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City-Sanctioned Needle Exchange Program Strives to Reduce Blood-Borne Illness

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(Sacramento, CA)
Wednesday, February 1, 2012

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Gail Wally drives an unmarked van full of supplies for injecting narcotics. It's part of her job, and it's perfectly legal in the City of Sacramento.

WALLY: "I was doing it when it was illegal, because I think there's such a thing as bad law(s)."

Gail works with Harm Reduction Services. Her task is to give out clean needles to drug users and take their dirty ones. The idea is not to stop drug use, but to help them prevent the spread of disease.

WALLY: "We don't push our values on them. Whatever they do, that's their business. We just want to make sure they're safe."

Today, she travels with Sonny Iverson, a 30-something outreach worker from an organization called WIND Youth Services.

IVERSON: "I think a lot of the homeless unfortunately are doing drugs and stuff like that. And you know, a lot of times I think it's just to cope with the situation. If I was homeless, I'd be doing drugs too."

About 10 years ago, Iverson was himself a homeless IV drug user. He says that's how he got Hepatitis C. He's trying to prevent the same infection in others. In California, about 60% of Hep C and 20% of HIV infections are associated with IV drug use. 

The van's first stop is the loaves and fishes homeless shelter in Sacramento, where people trickle over with bicycles and leashed dogs. Sonny gathers information but takes no names.

IVERSON: Drug of choice? Heroine, speed, pills, all or none of it?

Gail hands out brown bags of legal goods.

(sound of bag)

WALLY: "You want ties?"

No matter what the client's appearance or demeanor, she never shows a hint of anxiety or hesitation.  She says part of the job is informal education.

WALLY: "You have to clean the site...It keeps you from getting absesses. Do you need a cooker, or?"

Harm Reduction Services provides HIV testing and other services, and it takes in thousands of syringes yearly to prevent litter and the danger of accidental needle sticks.  One woman named Dee helps them keep the homeless camp where she lives free of dirty needles.

DEE"Rain, shine, sleep, I don't care. If you need a new needle come find me. Come wake me up. Because.. I had Hepititis C twenty-three years ago, from using needles. And I'm very, very adamant. Because a lot of drug addicts don't care."

Dee says for the most part, the drug users she knows along the American River now use their own needles, instead of taking the risk of sharing.

DEE: "Unless they're too lazy and too big of a hurry. You know, methamphetamine users always want to be in a hurry (laughs). You know, they want it now. And it's like, 'Well, hold on!'"

It's hard to tell from health data what the impact of needle exchange has been on Sacramento County disease rates. But a large body of evidence shows that needle exchange programs does help control transmission of HIV and other blood-borne illness. But that hasn't swayed some local governing officials.
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The issue of expanding access to clean needles has come to the Sacramento County Board of Supervisors a couple of times over the years. Back in 2005, this undersheriff opposed the non-prescription sale of syringes. 

UNDERSHERIFF: "I too have compassion and empathy for these folks, but the message they need to hear is, 'You have a critical need to make an absolute lifestyle change.' Anything other than that, anything that dilutes that message is putting them in harms way, or increasing the harm that they face."

City councils around the county were opposed to needle sales to drug users - expressing fears about decreased safety and property values. Dr. Glennah Trochet was Sacramento County public health officer at the time. She said the fears were not based on evidence.

TROCHET: "It does not increase drug use, it does not increase improperly discarded syringes, and it does not increase accidental needle sticks to law enforcement or waste management."

The county board voted against the non-prescription sale of syringes that day. And Sacramento remains one of a majority of counties in the Central Valley and the foothills that hasn't yet authorized needle exchange.  

But new laws this year move needle access legalization away from local politics. The state many now authorize programs in high risk areas, and pharmacies can now sell up to 30 syringes without a prescription.
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