Second needle exchange program launches at Richmond free clinic with RPD support

The Health Brigade, formerly the Fan Free Clinic, is offering what it calls a comprehensive harm-reduction program. It will have HIV and hepatitis C testing, referrals to substance abuse treatment and other services alongside the clean syringes that the clinic will give away in exchange for used ones.

The program will operate from 5 to 8 p.m. Mondays and from 1 to 4 p.m. Fridays. No one showed up for a clean needle on Monday, according to a clinic official.

“Years of comprehensive harm reduction programs throughout the United States has shown that harm reduction programs reduce the risk of HIV and hepatitis transmission, and increase safety for first responders, law enforcement and community members,” the Health Brigade said in a news release.

“Additionally, the data also show that harm reduction programs increase the likelihood of someone entering treatment and do not increase drug use. Health Brigade’s harm reduction program is designed and implemented using long-established best practices.”

Deaths and overdoses from drugs that are often injected, such as heroin and fentanyl, have plagued the region in recent years. Richmond, Henrico County and Chesterfield County were among five Virginia localities with the most overdose deaths last year, and the region’s hospitals accounted for almost 20 percent of the state’s emergency room visits because of the drugs.

The first needle exchange opened this year in Wise County in Southwest Virginia, another area hit hard by opioid addiction.

The program is authorized by state legislation that went into effect in July 2017, but a requirement that local law enforcement sign a letter of support for any program launch has stalled efforts to get programs up and running.

Capt. Emmett Williams, commander of special investigations for the Richmond Police Department, was skeptical of the program when he was first approached to consider signing off on the initiative in February.

But after researching the history of harm-reduction programs, attending webinars and conferences, and speaking with fellow officers in a North Carolina city with a similar program, he changed his mind.

“I started to look at it as a health problem,” Williams said. “It’s not a policing problem.”

One of the program’s main purposes is to combat the spread of hepatitis C — a viral infection that inflames the liver — and HIV, a serious immune deficiency virus that causes AIDS.

Both are commonly spread when injection drug users share dirty needles. New reports of hepatitis C in 18- to 30-year-olds more than doubled in five years, from 1,059 in 2012 to 2,141 in 2017, according to data from the Virginia Department of Health.

Higher hepatitis C rates are considered a precursor to a potential spike in HIV cases.

According to Williams, the agreement between the Health Brigade and the Richmond police won’t change the way that police officers operate in the area.

“[Participants in the program] don’t get free passes,” Williams said. “It wouldn’t impact us and the way we do our business.”

The program requires participants to have a state identification card and it will be an opportunity for drug users to be directed to resources for recovery, he added. It will also protect the health of the law enforcement officers who come into contact with drug users and dirty needles, and commonly suffer from accidental pricks, Williams said.

“The chief was very forward looking,” Williams said, referring to Richmond Police Chief Alfred Durham signing on to the letter of support for the program.

Many other police chiefs in Virginia are more reluctant to enter into an agreement with a needle exchange program.

Dana Schrad, executive director of the Virginia Association of Chiefs of Police, said she has heard from many police chiefs who are concerned about putting officers in a position where they may have to agree not to arrest people who possess illegal drugs.

“The issue becomes, not so much opposing health officials handing out clean needles,” Schrad said. “The issue then becomes whether the agreement goes so far as to create safe places to utilize what otherwise would be illegal drugs.”

Tim Jones, chief of police in Roanoke and a member of Gov. Ralph Northam’s advisory commission on opioids, has refused to support a program in his jurisdiction because he doesn’t believe there is enough data on how it affects law enforcement and social services.

“The research is only on the medical side of it,” Jones said.

He fears that the programs will attract drug users from outside of the jurisdiction and will create unintended, additional strain on city resources. Jones said he’s contacted law enforcement officials in other localities that have launched similar programs and has heard of problems arising.

Jones also doesn’t agree with any request for law enforcement to forgo enforcing the law.

“I understand the health-related issues associated with heroin and opioids,” Jones said. “Everybody is willing to help and wants to help. … I’m not sold [on the program] as it is currently packaged. … Don’t infuse law enforcement in the middle of it.”

Jones said that he will monitor how the program does in Richmond and that it will serve as a marker as he evaluates a potential harm-reduction program for Roanoke.

In addition to the public health aspect of the programs, another main component is referral to recovery resources.

John Shinholser, president of the McShin Foundation, a Henrico-based peer-to-peer addiction recovery organization, supports the idea of needle exchange programs, but believes that Virginia’s approach places too many barriers on the service, such as requiring a state ID.

“They’re making it hard for the addict to show up and swap needles,” Shinholser said. “You have a service that can actually reduce transmitted diseases, that can actually increase recovery, that can actually increase public safety. … These people in charge water down their capacities.”