Seattle’s needle exchanges offer direct path to beating addiction
Needle exchanges are often a point of political contention in Seattle, seen by some as a means to actively enable drug use. Even so, the services they provide go far beyond the needles themselves.
“We have two [needle exchange] programs in Seattle right now,” said Caleb Banta-Green, the principle research scientist at UW’s Alcohol and Drug Abuse Institute. “But they now both offer treatment medications on-site the same day, and that’s buprenorphine.”
Buprenorphine is a fairly recent development in the world of addiction treatment. It’s a pill users can take once daily to reduce physical dependence on opiates, decrease overall cravings, and at certain doses it can even suppress withdrawal symptoms. Treatment medications like buprenorphine also “reduce the chance of an overdose death by 50 percent.”
But do drug users at needle exchanges even want this help? According to Banta-Green, they overwhelmingly do.
“We’ve done research over the last couple of years,” said Banta-Green. “We’ve (surveyed) over a 1,000 people in 2015 and 2017 at syringe exchanges, and we’ve asked them: ‘Do you want to stop or reduce your opiate use?’ 78 percent of people say yes. ‘What services would you want if they were easily available?’ 70 percent want treatment medications.”
Banta-Green went on to set the scene for this demand, using an example from right in the heart of Seattle.
At the Belltown Public Health Syringe Exchange on 4th Avenue near Blanchard, they opened on January 17, 2017. They opened their doors, they had no idea if anybody wanted their services or not, and they were full in 12 weeks. People were lining up two hours early to try to get access to treatment medication. So, the demand far surpasses the supply. I can’t even tell you the percentage of people who want these services, because we know we can’t even meet demand yet.
The biggest barrier between these people and these medications, though, is the maze that is the health care system, according to Banta-Green.
“People don’t want to inject heroin — they’re addicted to heroin, they use it so they don’t go into withdrawal and feel terrible, and fundamentally, the reason they use heroin is it’s easier to get than treatment medication,” Banta-Green laid out.
That’s where needle exchanges come in to play. Not only do they vastly decrease HIV rates, “it’s a process of working with people over time, gaining their trust, and helping them feel respected and not judged.”
That trust and respect in turn helps build a path toward recovery, especially as opiate overdoses have remained consistently high — around 700 a year — over the last decade in Washington.
“(Treatment medications are) the way to bend the curve in terms of overdose deaths. We have to get these treatment medications out to where people are,” said Banta-Green. “We need communities to be demanding this and want this.”
For communities that feel inundated with drug users, Banta-Green argued that needle exchanges offering treatment medications are that much more important.
“What I hear from communities is ‘we’re overrun already with this problem, what can we do about it?’ My point is, people with opiate disorders use opiates every day. By doing nothing, you’re perpetuating them using heroin. By bringing in treatment services, you’re moving them into safe, oral medications that are taken once a day.”
The goal is the same for safe injection sites, which won a major victory in court Thursday. Similar to needle exchanges, the eventual objective is to get medications like buprenorphine offered at yet-to-be-established safe injection sites in Seattle.
“What we’re finding is that when we actually make those services available and word starts spreading, the demand increases even more. Word spreads very quickly,” Banta-Green said.
According to Banta-Green, the infrastructure and money for this exists. It’s merely a question of meeting the massive demand the city has seen for these medications.
“We’re not trying to push people into care — we’re trying to push care out to people,” he added.