A look inside Pasco’s syringe exchange
Pasco’s new syringe exchange collected 980 dirty needles in May, its first full month of operation.
That number reached 7,530 for June. By September, 16,970.
The surge stunned Blue Mountain Heart to Heart HIV/AIDS Support Services, the Walla Walla nonprofit that debuted the exchange in April with support from the Benton-Franklin Health District.
Blue Mountain’s exchange in Walla Walla, which opened in 1998, also hit 17,000 in a month this year.
In short, it took Pasco just five months to reach a level of service that took Walla Walla 20 years to achieve. Even more startling: Pasco is open for four hours on Fridays, while Walla Walla is open four days a week, for a combined 32 hours.
Tri-City’s demand figures to be higher. With a population approaching 300,000, the Mid-Columbia has more than four times as many residents as its eastern neighbor.
It’s unclear where the ceiling lies, but it’s clear the Tri-Cities was overdue, said Blue Mountain officials. And it’s clear that there’s an even larger audience for the service. Most of the exchangers served in Pasco are homeless.
The numbers suggest the Tri-Cities needs to expand, which is why the health district is on the prowl for funds to open a second location.
“We are very interested in bringing it to Benton County,” said Dr. Amy Person, the Mid-Columbia’s public health officer.
Before April, Tri-Citians had no place to safely exchange dirty syringes. Residents who wanted to swap needles drove to Walla Walla or Yakima.
Getting them off the road was one of the reasons Blue Mountain came to Pasco. But treating drug users where they are, and reducing the harm associated with drug use, is the primary mission.
The benefit to public health
At syringe exchanges, anonymous “exchangers” trade used syringes for fresh. In the three decades since the first exchanges opened in the U.S., they have racked up a record of promoting public health.
They’re credited by health experts — including the Centers for Disease Control — with reducing the transmission of Hepatitis C, HIV and injection-site infections. The programs urge drug users into treatment and reduce the number of discarded needles in the community. By extension, the public, police, firefighters and medics are less likely to encounter dirty needles, or be pricked by accident.
The Harm Reduction Coalition, a nonprofit that advocates for syringe exchange programs, links a substantial drop in new infections of Hepatitis C and HIV in communities where drug users can access clean supplies.
In Pasco, Blue Mountain offers supplies and, for those who are interested, connections to treatment, testing for HIV and Hep C , condoms and free doses of naloxone, the widely distributed countermeasure that reverses opioid overdoses.
It does not provide drugs or a place to use them. But it is a judgment-free zone where workers are quick with a smile and assistance for those living on the edge. Melissa Cross and Raul Morales are the Walla Walla-based outreach crew, ferrying between Walla Walla and Pasco in a specially equipped van.
Soon, they’ll add Asotin and other rural stops to their route.
The pair are proud of the relationships they’re building in Pasco, and of the results. To date, 60 Pasco clients have self-reported that they used naloxone to reverse overdoses. Overdoses kill one in seven victims on average. Those 60 doses have saved about nine lives.
“When someone is dead, they can no longer get into treatment,” Cross said.
Exchangers benefit from reduced exposure to disease and infection, and fewer emergency room visits. The community benefits when exchangers get treatment, and when those who are infected with HIV and Hep C get treatment and in theory avoid risky behavior that spreads disease.
The next step
After just five months of operation, it’s too early to say with certainty if Pasco is making the community safer. But the numbers tell health officials the need is not limited in Pasco.
The vast majority of the Pasco exchangers live in the Tri-Cities. Visitors remain anonymous, but are asked to say where they live if they want naxolone. Most take the offer.
About a third live in Kennewick and a quarter in Richland. The rest are from Pasco, with a smattering coming from West Richland, Starbuck, Othello, Burbank and Dayton.
This summer, the health district and the Benton County Gang and Crime Prevention Initiative asked the Benton County Commission to award $113,356 from its multimillion dollar crime-fighting reserve to open a syringe exchange. The exchange would reduce crime rates, promote treatment and protect law enforcement and firefighters from needle stick injuries, they argued.
The commission said no, choosing instead to use the unexpected windfall from a voter-approved sales tax to support programs for at-risk youth and families, an emergency communications tower at Red Mountain and other programs.
The health district isn’t giving up.
After being turned down by the commission, Person said the district is pursuing grants and partnerships to press ahead.
Person said the Tri-Cities was fortunate that Blue Mountain Heart to Heart secured a grant to open the Pasco exchange. The health district doesn’t have the money to set up a second shop.
“There is a great need,” she said, citing the rapid rise in use at Pasco.
The health district continues to update the Benton-Franklin Board of Health, which consists of the commissioners of both counties, about its plans in a bid to build support in the future. The education is working, with several members expressing degrees of support when the board last took it up, on Oct. 17.
Benton County Commissioner Shon Small, chair of the bi-county board, said he’s interested in seeing fewer needle-stick injuries to police, medics and fire-fighters. Small is running for re-election against Benton Public Utility District Commissioner Lori Sanders in the Nov. 6 election
Franklin County Commissioner Brad Peck, who sits on the health board, said people still complain about the Pasco exchange. He’s no longer a skeptic and even wants to see clients firmly pushed toward treatment.
“We should never lose sight of the focus of the mission,” he said.
Rick Dawson, the health district’s manager of surveillance and investigation, said the Pasco exchange is by all accounts a good neighbor. The district inspects the area three times a week to check for discarded drug paraphernalia.
There hasn’t been a single find since April, he said.
Fighting the opioid epidemic
Experts say syringe exchange programs are a key weapon in the fight against the opioid epidemic.
The Washington State Opioid Response Plan says the programs are a way to distribute naloxone to users and to serve as a low-barrier setting to begin addressing drug addiction.Iit even suggests adding family planning services at exchange sites.
In 2017, Benton and Franklin counties reported 20 deaths from opioids, and local hospitals reported 64 opioid-related admissions. The average stay was 4.3 days, and it cost taxpayers nearly $1.6 million, according to discharge data compiled by the Washington State Department of Health cited by the local health department.
Statewide, there were 693 opioid deaths for a rate of about 10 per 100,000, according to the opioid response plan.
Officials attributed 290 deaths to heroin and 120 to fentanyl.
The health district said Benton County has one of the highest rates for opioid overdoses of the state’s larger counties, citing a non-public community health assessment tool it uses. It also has one of the highest prescription rates — 102 prescriptions for opioids for every 100 residents.
The reasons are unclear and under evaluation by state regulators, Dawson said.
“We have over-prescribing in our community,” he told the health board. “We have some pretty large issues here.”
The Pasco exchange is changing its hours to 11 a.m. to 2 p.m. Fridays at 412 W. Clark St.