Florida Republicans Approve Miami Needle-Exchange Program : Shots - Health News Florida has struggled for years with opioid overdoses — and the highest rate of HIV infection in the U.S. Lawmakers now hope needle exchanges and a "harm reduction" approach could help save lives.
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Key Florida Republicans Now Say Yes To Clean Needles For Drug Users

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Key Florida Republicans Now Say Yes To Clean Needles For Drug Users

Key Florida Republicans Now Say Yes To Clean Needles For Drug Users

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RENEE MONTAGNE, HOST:

And in Florida, a new law will make it easier for drug users to trade dirty needles for fresh ones and help prevent the spread of HIV and hepatitis C. Republican lawmakers there supported the law legalizing these exchanges after years of saying no. A pilot project in Miami was one factor that won them over. Sammy Mack of member station WLRN went there to learn more about the project.

SAMMY MACK, BYLINE: There is a green van parked on the edge of downtown Miami on a corner shadowed by overpasses. Until this new Florida law, it was the only program in the entire state allowed to hand out clean needles as a way to test the idea for five years. And that's where I first met one of the clients.

ARROW: I'm Arrow.

MACK: Nice to meet you.

ARROW: Pleasure.

MACK: Arrow - he actually has heavy black arrows tattooed on his arms. He said he's been using heroin since the '70s and slept under the overpasses nearby.

ARROW: Now I can shoot with a clean needle every time.

MACK: Arrow was wiry and a little twitchy. We're not using his full name because he uses heroin. Florida has a huge heroin and fentanyl problem. When people share needles to inject those drugs, it puts them at high risk for spreading HIV and hepatitis C. Florida has the highest rates of HIV in the country - has for years. Arrow told me he and his friends always put the drugs first. Clean needles were an afterthought.

ARROW: If I didn't have any of my own, I had to try to clean out the ones that I had. Every once in a while, I did use someone else's. And that was a thrill ride wondering whether or not I was going to catch anything. But I'm blessed. I'm 57, and I don't have anything.

MACK: The needle exchange also offers testing for HIV and hepatitis C. That's how Arrow knew he was negative. The pilot program connects people to medical care and drug rehab. Arrow wasn't so interested in that part.

ARROW: Yeah. I'm not a recovering addict. I don't go to them damn meetings.

MACK: Southern states account for more than half of all new HIV diagnoses in this country. And many of those states don't allow clean needle exchange. Republican State Senator Rob Bradley first voted against needle exchanges six years ago.

(SOUNDBITE OF ARCHIVED RECORDING)

ROB BRADLEY: You're trying to make sure the person has a clean needle, which is outweighing the idea of the person breaking the law.

MACK: This is the main objection from conservative lawmakers. They fear these programs support illegal drug abuse. But public health workers say needle exchanges minimize harm to people who are vulnerable and often hard to treat. That's why Florida Democratic State Senator Oscar Braynon kept introducing needle exchange bills despite years of failed votes.

OSCAR BRAYNON: We're ground zero, the South is, for some of the opioid addictions, for the AIDS epidemic, because we haven't been doing those things that help stop that.

MACK: Decades of research show needle exchanges do prevent the spread of viruses in injection drug users. In 2016, Miami-Dade County got permission to try it for five years. The data collected from this pilot exchange has been a key to winning over skeptics.

BRAYNON: And that's because the numbers don't lie.

MACK: In just three years, the program has pulled more than a quarter-million used needles out of circulation. And it's prevented more than a thousand overdoses by handing out Narcan, the drug that reverses overdoses.

BRAYNON: We are actually stopping the spread of HIV. We're actually reducing the overdoses. We are saving the state and saving the county money.

MACK: Braynon says there were still compromises to get it through. Mainly, counties have to opt in and find a way to pay for it without using state or local money. In Miami, the pilot exchange gets support from private donors. A lot of Republicans who started out against the exchanges had a change of heart this year, like Rob Bradley?

(SOUNDBITE OF ARCHIVED RECORDING)

BRADLEY: I just want to say when I started my career in the Senate, I voted against the pilot project, and I was wrong.

MACK: To be clear, it's really unusual to hear an elected official in Tallahassee say they've been wrong.

(SOUNDBITE OF ARCHIVED RECORDING)

BRADLEY: And the results speak for themselves. It's very good public policy.

MACK: Bradley and the rest of the Florida Senate voted unanimously in favor this year. The Florida House voted overwhelmingly for it, too. It's almost a year before I see Arrow again.

ARROW: I woke up, and I'm still breathing.

MACK: It's a good way to wake up.

ARROW: Yeah.

MACK: If it weren't for the arrow tattoos, I wouldn't have recognized him at first - clear skin, a little meat on his bones. He looks healthier.

ARROW: Yeah. ACC East - this is the HIV building.

MACK: He has an appointment with a doctor he met through the needle exchange.

UNIDENTIFIED PERSON: Deep breath.

MACK: He looks better, but it's been a rough year for Arrow. Last May, his girlfriend died, and Arrow started taking more drugs than ever. Arrow says he doesn't remember a lot from this period, but he does remember using so much heroin he ran out of fresh needles, so he grabbed other people's used needles, and he got HIV and Hep C.

UNIDENTIFIED PERSON: Exhale.

MACK: The program threw him one more life raft - an inpatient drug treatment bed. At the appointment, he shows his doctor a string of key chains from Narcotics Anonymous clipped to his waist.

ARROW: Sobriety - my chain of sobriety. I got 30 days, 60 days and 90-day chips.

MACK: Arrow's HIV is under control, and medication cured his Hep C. Not every person who uses new needle exchanges in Florida will necessarily get this far. Relapse is really common among heroin users. Arrow - he's focused on staying sober one day at a time, and he's starting to want new things. For NPR News, I'm Sammy Mack in Miami.

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