Heroin Deaths in Fort Collins Inspire a Need for Needle Exchange Program

With three reportedly heroin-related deaths in Fort Collins in the past month, many have concluded that intravenous drug use is more prevalent in Fort Collins than previously thought.

But even before those deaths, several Fort Collins local authorities and a community support project have been on a collision course over a plan to set up the city’s first legal needle exchange. A coalition spearheaded by the Northern Colorado AIDS Project says the reality of drug use demands the program be implemented for health reasons. Opponents of the plan are concerned the initiative would encourage and facilitate drug use, and tarnish the image of the city.

In 2010, Colorado lawmakers added an exemption into the state’s drug paraphernalia law that allowed counties to legally adopt syringe exchange programs. Boulder County jumped at the chance and now has their program fully out in the open (it ran covertly for 22 years prior to the law change), and Denver programs are following suit.

Larimer County was tipped as the next logical location for a Syringe Exchange Program. But very little has happened thus far. There is no official needle exchange, and public conversation around the topic has been almost non-existent, some activists complain.

Jeff Basinger, executive director of the Northern Colorado AIDS Project, has ideas why no one is talking.

“It’s the attitude that drug use is bad,” Basinger said. “Drug users are bad, and if you provide a needle exchange for them, then the problem is just going to get worse.”

Basinger said for a needle exchange to become a reality, multiple entities must be on board.

“We need approval from the local board of health, and we have been hosting those conversations since July,” Basinger said. “We’ve met three times and provided them with information.”

The Larimer County Board of Health’s own strategy for 2011 includes a goal to reduce blood-borne disease transmission among intravenous drug users.

But another key player is Larry Abrahamson, the Larimer County District Attorney, who has, according to Basinger, “philosophical concerns.”

“The needle exchange program is primarily a Department of Health initiative,” Abrahamson said in a voicemail message. “Which is basically more of a health concern than a public safety concern at this point, so we are not taking any formal position.”

The D.A. also believed Fort Collins’ size didn’t make it an obvious target for the program.

“I think it’s probably utilized more effectively in areas where they have maybe a lot of hepatitis as a result of dirty needles or HIV spread, or something like this, in larger jurisdictions,” he said. “I don’t see necessarily that as an issue here. From our perspective it hasn’t risen to the level of a public safety concern that we would necessarily be taking a strong stand on at this point.”

All of this has lead to a situation that Basinger describes simply as a, “political minefield.” Pushed further, he explained that the needle exchange debate illuminating issues that Fort Collins authorities seem to be in denial about, such as, “social injustice, poverty, racism, homophobia, drug use, homelessness, illiteracy. Poverty is over 20 percent in Larimer County, illiteracy is over one-in-five people, it’s insane. There are some real issues here in Fort Collins, but people don’t like to talk about them because it’s such a fabulous place to live.”

An equally desirable place to live that does have a needle exchange is just down the highway in Boulder. Boulder’s needle exchange has been running for more than 20 years and the city was the first in the state to take advantage of the change in the law.

Carol Helwig, the Boulder County HIV/STI Outreach Coordinator, said there are practical reasons why development of a program has been slow in Fort Collins.

“First of all, the paraphernalia law has been there prohibiting progress,” she said. “And then after the change in the law it takes a long time to build stakeholder support and to get all of your ducks in a row. Getting on an agenda for a local board of health takes time, it’s a big process.”

Boulder County also had the approval of the local district attorney and other law enforcement entities, something Helwig saw as pivotal.

“We’ve benefited from their cooperation, support and understanding, ” Helwig said, adding that he also saw the court system in Boulder as, “very progressive and not interested in prosecuting non-violent drug offenses in a criminal fashion, but rather taking a public health issue approach with the cases.”

Helwig said people are already driving down to the Boulder needle exchange from Greeley, Fort Collins and other northern Colorado areas. Some of Helwig’s clients took part in a focus group to discuss their feelings about the service.

One said, “It’s just an awesome program, I wish it could be everywhere in every city. You can’t stop people from doing what they’re doing but you can reduce the harm.”

Outside Colorado, SEP (Syringe Exchange Programs) have been around since the 1980s, and there is plenty of data available about them. A report found on the Center for Disease Control website states, “An impressive body of evidence suggests powerful effects from needle exchange programs. Studies show reduction in risk behavior as high as 80 percent, with estimates of a 30 percent or greater reduction ofHIV in IDU.”

According to the CDC, “the cost per HIV infection prevented by SEP has been calculated at $4,000 to $12,000, considerably less than the estimated $190,000 medical costs of treating a person infected withHIV.”

Advocates are sure to cite such statistics as they mount pressure on the Larimer County Board of Health. Adrienne Lebailly, a board of health member, said changes are coming soon.

“Probably early 2012 there will be some sort of decision,” she said. “We also have to consult with other entities, including the District Attorney (Larry Abrahamson), … who would prosecute people charged with crimes, along with local law enforcement. It’s going to focus more on the City of Fort Collins Police, rather than the County Sheriff, as the NCAP offices are physically located within the City of Fort Collins Police’s jurisdiction.”

Making matters more difficult for the NCAP program is the division that exists on the board of health. Lebailly’s prognosis wasn’t good.

“I would say it’s split, and I don’t know how it’s going to go.”

© 2012 Jamie M. Bradley All Rights Reserved

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