Needle exchange
Charles Krupa, Associated Press

Cowlitz County is one of 12 Washington counties with a needle exchange, and its program is not dramatically different from the others — except in one respect.

It’s apparently the only one with an ax over its head.

In Grays Harbor County, citizens mostly support the syringe exchange as a crucial service for people ravaged by addiction, said Karolyn Holden, the county’s public health director.

“We’ve occasionally had a citizen unhappy with (the syringe exchange program), but it’s never risen to a level of controversy,” Holden said last week. “People see it as an opportunity ... to outreach for those who might not get help otherwise.”

In Whatcom County, the syringe exchange attracts little attention, said Nancy Polin, nursing supervisor for Whatcom’s needle exchange.

“I would say people don’t even know we have an exchange, and it’s been going on for 18 years,” Polin said. “People who dislike the exchange are out there, but as far as actual political pushback, there’s none.”

Dr. Alan Melnick, health director for Clark County, is confused by his northern neighbors’ distaste for the needle exchange.

“I think there’s a lot of misinformation out there,” he said. “I’m trying to understand what the cons are. Hearing some of the (arguments) in Cowlitz County, they didn’t make sense to me. It’s kind of like getting into a debate about immunization, the cons there don’t make a whole lot of sense to me, either.”

Cowlitz County commissioners are scheduled to decide Tuesday whether to continue the county’s 17-year-old program. With that decision looming, The Daily News looked at the syringe exchange programs in Clark, Grays Harbor, Skagit and Whatcom counties for similarities and differences.

Methods

Although there are many similarities in these counties’ programs, each has slight variations.

Skagit might have the most unconventional syringe exchange. According to Assistant Director of Skagit County Public Health Bob Hicks, Phoenix Recovery has a large van that travels to sites throughout the county to swap dirty for clean needles (The Cowlitz exchange is in a fixed location). Hicks said the on-the-road exchange has been a huge help in preventing disease in a faster and more cost-efficient manner.

“It’s really mobile,” the assistant director said. “We’d normally have to have six different buildings to do this, but instead, there’s six different sites that are provided, free of charge, for us to do this.”

Commissioner want the Cowlitz exchange to become a true one-for-one exchange. But Whatcom County is moving in the opposite direction. Last month it dropped any one-for-one concept and adopted a “needles as needed” policy, where customers can get up to 100 clean syringes, though clients still need to turn some needles in, according to nursing supervisor Nancy Polin.

Polin said that the new method is an attempt to further curb bloodborne diseases. Whatcom will decide whether or not to keep with this method. She said she hopes it will.

“You get more clean needles out,” Polin said. “It’s more user-friendly and more people come to the exchange. The more clean needles, the less Hepatitis C and HIV.”

Clark and Skagit counties also supplied drug users with naloxone, commonly known as Narcan, at their exchange sites. This drug can reverse the effects of an opiate overdose, and both counties said they’ve seen the drug save many lives.

Melnick said Clark County’s needle exchange has had over 500 reported overdose reversals since 2014, and Hicks counted around 111 reversals in Skagit in a similar timespan.

According to Holden, in Grays Harbor, distribution of methadone and Suboxone, which help people stay off opiates, reduced the amount of syringes exchanged in 2016 in the county by 16 percent.

“I believe people are able to access treatment more easily, and they’re also getting treatment that’s more effective than just abstinence,” Holden said of Grays Harbor’s needle exchange.

Dian Cooper, director of the Family Health Center, which helps run Cowlitz County’s needle exchange, said their program does not distribute Narcan yet, but they’ll be getting a supply within 30 days.

Public reaction

In Cowlitz County, the needle exchange has proven controversial, with many citizens and city and county officials voicing their distaste for the program. The program is blamed for the prevalence of discarded needles, enabling abusers and failing to document its claimed benefits in curbing disease and drug addiction.

State Rep. Brian Blake, D-Aberdeen, said although there have been plenty of people upset about littered needles throughout Grays Harbor, he wasn’t aware of any organized movement to shut down the exchange.

Hicks echoed Blake’s statement. According to the assistant health director, local churches, senior centers and the Salvation Army in Skagit support the mobile syringe exchange by letting the program’s van use their property.

Melnick, who was at the June Board of Health meeting in which the Cowlitz County commissioners issued their demands for reforms in the Cowlitz exchange, said he was deeply worried about the safety of his neighbors to the north if the commissioners shut down the needle exchange.

“I’m really concerned about what’s going to happen in Cowlitz County. This is a population where HIV and Hepatitis C is a real concern. Having an HIV outbreak would have a huge cost to the community.”

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