Harm Reduction Syringe Exchange Program

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Harm Reduction Syringe Exchange Program

• A.G. (Sonny) Leeper
• Captain, Albuquerque Police Department
• Aleeper1_at_comcast.net

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New Mexico Harm Reduction Act of 1997

• Mandates that the New Mexico Department of Health
  shall establish and administer a harm reduction
  program for the purpose of sterile hypodermic
  syringe and needle exchange
• Started February 2, 1998 with 24 people

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N.M. Harm Reduction Act Section 6

• Immunity from criminal liability
• 24-2C-6 (1997)
• Exchange or possession of syringes in compliance
  with HRP shall not constitute a violation of the
  Controlled Substances Act for a participant in
  the program or a private provider whom the
  department contracts with to operate the program

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Purpose

• Reduce the number of used syringes in parks, and
  on the streets
• Refer participants to needed resources
• Move participants through the stages of change
  toward treatment and abstinence

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Enrollment Eligibility

• New Mexicans 18 years of age and older
• A person enrolling in the program must be a
  current injection drug user

• The participant must be given a valid Yellow ID
  Card with an individualized identification code
  with an expiration date 1 year after enrollment

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New Mexico

• 1994 to 1997 street based seroprevalence study
• 1003 IDUs in New Mexico
• .5 HIV positive
• 61 Hepatitis B positive
• 82 Hepatitis C positive

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Why needle exchange is important to law
enforcement Personnel

• In 1995 almost 25,000 inmates in State and
  Federal prisons were known to be infected with
  HIV, Hepatitis B, or Hepatitis C
• 82 of injection drug users in New Mexico have
  Hepatitis C
• The recidivism rate among drug users is more than
  80

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Importance to Law Enforcement Continued

• Post testing on blood stored a New York City
  blood bank
• HIV introduced to New York around 1976
• 9 in 1978
• 26 in 1979
• 38 in 1980
• Plateau in 1984 - 55 to 60

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Risk to Law Enforcement

• It is estimated that a needle stick injury occurs
  every 30 seconds.
• 89 of all healthcare workers who have HIV-AIDS
  and Hepatitis contracted the deadly disease due
  to accidental needle sticks.

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June 2004

• 8200 people are enrolled statewide
• Approximately 4000 are active participants
• Over 5 million needles exchanged since 1998
• 2 million of those in 2004
• 99 collection rate
• Over 30 sites statewide
• Only 1 are on the street in transition

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Needle Stick Diseases

• Hepatitis
• Diphtheria
• Typhus
• Herpes
• Malaria
• HIV
• Malaria
• Tuberculosis
• Spotted Fever
• Syphilis

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Needle Stick Diseases (cont.)

• There is no vaccine available for Hepatitis C and
  no effective drugs to prevent the onset of the
  disease once exposed
• Hepatitis C is a major cause of chronic liver
  disease
• Hepatitis C is now the leading cause for liver
  transplants in the US according to the NIH

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Needle Stick Diseases (cont.)

• Of all the blood borne pathogens that can be
  transmitted with needle sticks, HIV, HBV
  (Hepatitis B), and HCV (Hepatitis C) pose the
  greatest risk.
• Once stuck with an infected needle there is a 30
  chance of contracting HBV and a 10 chance of
  contracting HCV
• Up to 30 thousand a year for medicine to treat
  HCV

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Hepatitis in New Mexico

• 19,970 New Mexicans have tested positive for
  hepatitis C
• CDC estimates there are 32,000 New Mexicans that
  have hepatitis C
• There is no vaccine for Hepatitis C

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Harm Reduction Site

• No using on or near the site
• No dealing or buying any drugs on or near the
  exchange site
• No alcohol or drugs at or near the site

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Officer Safety

• A high risk of transmission of infectious disease
  exists when personnel have contact with the
  following groups
• Illegal drug users
• Prostitutes
• Persons who state that they have Hepatitis B or
  C, or HIV

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Personnel at Risk

• Sworn Police
• Criminalistics personnel
• Evidence Technicians
• Service Aids
• F.I. Techs
• Reserve Officers
• School Detectives

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At Risk Situations

• Anytime body fluids are present
• BODY SEARCHES
• Crime Scenes
• Searching personal effects ( purses, bags,
  backpacks, etc.)
• Extrication at auto accidents

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Safety Precautions

• Wear gloves to reduce risk of a sharps stick
• All evidence or evidence that is suspected of
  being contaminated must handled only when using
  appropriate PPE
• Needle exchange reduces the chance of the needle
  being infected

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QUESTIONS