El Paso County and Colorado Springs are again being urged to join many other cities in the state in adopting a needle exchange program to combat the opioid epidemic.
Advocates have questioned the absence of a needle exchange in El Paso County, with some calling last week for a renewed push to create one here — as has been done in Denver, Aurora, Boulder, Longmont, Lakewood, Lafayette, Fort Collins, Pueblo and Grand Junction.
Exchanges accept used needles from drug users and offer sterile, unused needles in return — all without the threat of prosecution. Many also offer testing for sexually transmitted diseases and referrals to drug treatment services.
Usually, they also distribute naloxone — a powerful opioid antidote that can reverse the symptoms of an overdose and save the life of someone who stopped breathing due to prescription painkillers or heroin.
“It’s extremely important,” said Mary Steiner, head of Community Health Partnership’s Coalition for Prevention, Addiction Education, and Recovery.
“It’s an evidence-based practice, in terms of reducing the rates of communicable disease and being able to get people into treatment.
“It’s not just some random idea. It’s sound public health.”
The pleas reignited a contentious issue that for years has increasingly divided the El Paso County Board of Health.
In 2013, the board voted 6-3 against the creation of a needle exchange off 8th Street in Colorado Springs amid concerns it would increase illicit drug use.
Four years later, in late 2017, a slim majority of board members instructed county health officials to drop the subject and not pursue the creation of a needle exchange at a new location on Colorado Springs’ west side, amid those same concerns.
That 5-4 decision effectively snuffed the proposal and for a time quieted calls for the Pikes Peak region to implement such a program.
On Wednesday, needle exchanges were brought up again at a conference by Community Health Partnership’s coalition — a leading advocacy group seeking to curb an epidemic of prescription painkiller and heroin use that has killed hundreds of people across El Paso County and thousands more statewide during the last two decades.
At the conference, the leader of an exchange in Jefferson County called such programs a proven way to reduce overdose deaths and the diseases that accompany intravenous drug use.
From 2016 to 2018, the number of people served by the program grew from 92 to 541, said Chris Hammond, a registered nurse who oversees the program.
In 2016, the program gave out 16,449 needles and received 11,926 in return. Last year, that had grown exponentially, with 265,555 needles handed out and 235,398 returned.
Without the exchange, Hammond said, those people would still have used illicit drugs. But those needles would have ended up in unsafe places — in trash cans, city parks and parking lots, for example.
The program also handed out 881 naloxone kits, of which at least 141 were used to revive someone who had overdosed, Hammond said.
Afterward, at least one El Paso County Board of Health member said she wants to “get the conversation going again,” and plans to once again push for the county to green-light such programs, though no local organizations have announced a desire recently to run such a program.
“The thing about public health is you can’t force it,” said Kari Kilroy, a longtime member of the board. “It’s a lot like addiction — if someone isn’t ready to stop their addiction, you can yell at them, you can scream at them, you can tell them it’s the wrong thing to do and it’s not going to change anything.
“It’s similar with public health. And if our community isn’t ready for it, we can yell and say ‘science shows, statistics show,’ and it’s still not going to change their minds. So I think we keep trying, though. It is the right thing to do, as far as public health goes.”
The Centers for Disease Control and Prevention touts such exchanges as a proven means to reduce overdose deaths, as well as needle stick injuries among firefighters and law enforcement.
Drug users who visit syringe exchanges are five times more likely to enter substance abuse treatment, and they’re also more likely to reduce or stop injecting those drugs, according to the agency.
Also, the CDC says such exchanges can be vitally important in reducing the spread of blood-borne diseases that are commonly spread by intravenous drug use, such as hepatitis C and HIV.
In El Paso County, that’s been a growing public health concern, especially when it comes to the spread of hepatitis C.
Last year, 697 people were found to have chronic infections of the disease, which if left untreated can cause liver cirrhosis. That’s double the number of people from just five years ago, and nearly 30 more cases than in 2017.
“It’s a door into treatment, and it cuts off the secondary epidemics of infections disease, “said Rob Valuck, director of the Colorado Consortium for Prescription Drug Abuse Prevention.
The Board of Health has new members since rejecting a needle exchange, but whether it is more receptive to the idea is unknown.
Two seats have changed hands since the board’s 2017 decision. Gone are former Manitou Springs City Councilwoman Coreen Toll, an advocate for exchanges, and former El Paso County Commissioner Peggy Littleton, an opponent.
In their places are Fountain City Councilman Sam Gieck and newly elected Commissioner Cami Bremer — both of whom oppose exchanges.
Gieck said he fears such exchanges will inundate the community with more needles and pose a hazard to nondrug users.
“I’m not comfortable with it,” Gieck said. “To me, we’re not helping ourselves by doing that.”
Bremer, who also briefly attended last week’s conference, said she does not support the concept of needle exchanges, but added her mind is not made up. “I need to do a good deal more research on it,” she said. She left before the Jefferson County official’s presentation about that county’s exchange, because she had to attend another meeting.
“If you think about it, if you want an activity to stop, or you want inhibit it or restrict it, you tax it. If you want something to continue, you subsidize it,” Bremer said.
“I am inclined that it does not seem to be a good fit for our community. It essentially, in that context, becomes a subsidy and it does not curb the behavior.”
Valuck, however, said insinuations that such exchanges promote drug use are flat-out false. And he said not having a syringe exchange is only making the opioid situation worse.
“It’s contributing to the epidemic here,” Valuck said.