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Presentation Minutes

Tacoma Needle Exchange/Dave Purchase Project - http://www.nasen.org/

  • Hanna Carol-Day, Tacoma Needle Exchange – hanna@nasen.org
  • David Venes ( davidv@nasen.org ), Paul LaKosky (paul@nasen.org )and Laura Reynolds ( laura@nasen.org ) are all here too
  • History –
    • Was the first needle exchange in the US – established in 1988
    • Founded by Dave Purchase (thus the Dave Purchase Project – it all makes sense now. –ed)
    • 30 years of harm reduction
    • Use original model – bring used needles to receive new needles (like an exchange, maybe. –ed)
  • Harm Reduction – a practical and respectful approach
    • Harm reduction accepts that drug use is part of our world, and seeks to minimize harmful impacts.  It uses no condemnation, and is non-judgmental and users non-coercive tactics
    • Affirms dignity of people, even when using drugs
    • Doesn’t minimize the harm and dangers of drug use
  • Program benefits
    • Reduces disease – 20% less HIV in communities with needles exchanges (reason enough to have a needle exchange. –ed)
    • Saves on incarceration and healthcare (again, reason enough to have a needle exchange. –ed)
    • Less syringe litter (on its own merits, a great reason to have a needle exchange. –ed)
    • Free syringes reduced reuse and sharing (wow, these are all great reasons – hard to imagine how needle exchanges can still be controversial. –ed)
    • Offer screening for HIV and Hepatitis (hard not to like this one too –ed.)
    • Distribute naloxone to allow people to have a better chance of surviving an overdose (another amazing service – ed.)
    • Referrals to healthcare – including abstinence-based and medication assisted treatments (boy that sounds like the right thing to do –ed.)
  • Tacoma Needle Exchange offerings
    • Provide clean injection equipment – critical in preventing infections and transmission of disease
    • Community syringe pickup and disposal – we’ll clean up a site littered with syringes. 
    • Overdose prevention education
    • Naloxone distribution – offered to anyone in the community – community organizations, law enforcement, friends or family.  Tacoma Fire Department can even provide a Narcan kit to folks.
    • Provide safe sex supplies
    • Wound care kits
    • Referrals to Substance Use treatment – both abstinence based and medication assisted
    • Education about harm reduction, safe practices
    • Deliver anywhere in Pierce County 5 days a week (or nearly 5 days a week, there were some specifics I didn’t get –ed.)
    • Care coordinator on site – Dave Venes (Yay David. –ed)
  • Local Impact in 2018
    • Exchange 2.5 million syringes (is it just me, or is that a bit of a jaw-dropping number of syringes. –ed)
    • 12,000 transactions
    • Over 3,000 naloxone kits – allowing 735 overdose reversals (again, wow, what a positive impact.-ed)
    • Distributed 2,825 fentanyl test kits
    • Provided 124 HIV/Hepatitis C (HCV) tests
    • Provided 512 healthcare kits
  • Locations
    • Tacoma Pierce County Health Department Parking Lot  – Pacific and 37th – open M, W, F - 11am-4pm
    • Central Tacoma - The Corner of 14th and G Street in Tacoma, WA 98405 – open M, T, Th, F - 10am-1pm
    • Puyallup Tribal Exchange - East Portland Ave. and East Wright Ave. Tacoma, WA 98404 – open Saturday 11am-2pm
    • Deliveries – call 253-381-5229 – available many days from 9-1pm
  • Contact Information
  • Bruce - How do you deal with the concept that you are enabling this community?  Hanna – we aren’t enabling.  Our model says this is part of our world, and since it is happening, we can help them be safer in this process.  And, by building relationships, when they are ready to change, we are ready to help.  Paul – many arguments can be made against the needle exchange – none are based in fact.  No data says it facilitates drug use – all the data says it helps keep people safe and alive until they are ready for services.
  • Carolyn – I appreciate this great work.  You always hear this is so controversial – do you bump up against laws or policy decisions that make your work harder to do?  Paul – recently there has been a lot more pushback.  There are distribution and drug paraphernalia  laws – sometimes for needles. (paraphernalia is an odd word – back in the day, the Romans used the word – from the Greek words para (beyond) and pherne (dowry)-  to identify the goods a wife brought with her to a marriage that were her own.  These items were “beyond the dowry” – the dowry being a gift from the bride’s family to the husband.  In the 15th Century, the English apparently felt trusting women with much of anything was a bit too generous, and limited the legal possessions of women – paraphernalia - to just the small personal articles – like a dress or jewelry. It wasn’t until the 18th century that paraphernalia is used to describe equipment, as in “Bridles, Saddles and other equestrian paraphernalia”.  And then somehow  “drug paraphernalia” became a thing – and now when we hear paraphernalia, we think bong instead of choice pieces of furniture. –ed.).  The supreme court says that the Public health department can authorize needle exchanges for health reasons.  Some policies come up, and we fight back against them
  • Al – if I show up and am high, and I want 50 needles, can I get 50 needles.  Paul – we’d like to give people what they need, and trust that they know what they need.  Fiscally, that doesn’t work.  If you come and get 50 and exchange 50, that is fine.  If you got 50 last week and don’t’ have them and come to get 100, we’ll give you 10, and a safety pack, and you have to come and exchange.  We’ll give 10 a day until the needle exchange is open again.  Al – so you don’t give them out willy-nilly.  Paul - We use the exchange model – one clean one for a dirty one.  We get blamed for dirty needles, so we work hard to prevent that
  • Theresa – I want to talk about a benefit they don’t talk about.  I live across from their G street site.  Before they started coming, there were needles everywhere.  When the van is there, the community is calmer.  There was a lot of blowback when they came, but the way they run it is well done.  We recommend welcoming the needle exchange with open arms. 
  • Maureen – I knew Dave Purchase – one of the things that allowed it to happen was the support of the chief of police.  As we look around at the county, at communities responding to Martin vs. Boise (https://nlchp.org/homeless-persons-cannot-be-punished-for-sleeping-in-absence-of-alternatives-9th-circuit-decision-establishes/ ), and homelessness, it is an opportunity to engage when neighbors express concerns – the needles are always the first complaint – needles by their house or school or park.  Hanna – we work to get our name out there and let folks know about the services we provide.
  • Brendon – what is your viewpoint on safe injection sites.  Bruce – any plans for them?  Paul – Pierce County Council has passed a budgetary restriction that if the health department engages in discussion of injection sites, the health department will lose funding.  Safe injection spaces work – 30 years of evidence – not one person has died in a safe injection space.  But, they only work in a particular context.  Save injection is different from a “safe consumption” space, which means smoking, snorting or injecting.  Safe injection is injection only.  Safe consumption needs fume management and such.  Will one come tomorrow?  No.  ever?  Not sure.  It needs a lot of research – you need a lot of injection users – sites have to be near where people use.  Personally – I support them – but they need research and proper community engagement.  They do reduce deaths. 
  • Bruce – goal to reduce death or use? Paul – both.
  • Al – Are you in discussions with safe streets and other groups to get the message out?  Paul - we are trying to engage the community and get more feedback on how to provide services.  The presence of a syringe exchange reduces litter on the street.  Does that matter when a parent’s child finds one?  No.  all homeless aren’t drug users, and all drug users aren’t homeless.  Many of our exchange folks are homeless, and many are not – it is the whole spectrum.  Homelessness does not equal drug addiction.
  • James – delivery, what do you deliver?  Paul – we deliver harm reduction supplies and naloxone anywhere in PC.  Dennis picks up the phone and then delivers. Call by 11am for delivery that day.
  • James – if you use 311 to complain about needles, does that go to you?  Paul – yes. 
  • Questions - a friend runs a Portland needle exchange.  Do you allow folks from other agencies to come out and volunteer?  Paul – yes, but they need training.  We are careful about what situations we put volunteers into. 
  • When you said Vancouver, did you mean Vancouver Washington or Vancouver British Columbia? Paul – British Columbia.
  • Hanna- one new thing we are doing – once a month on the first Thursday, we are doing overdose prevention and distribution of naloxone at the Stability Site.  That was exciting to get started. 
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