It's Time Florida Starts Saving Lives

Florida, due to its lack of action on the matter, has 30 years of data and success rates around the country and around the world to verify that Needle-exchange programs work as they take yet another year to make a decision to start one.
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Florida is not an early adapter. Most of the time, our state takes a "wait and see" attitude regarding nearly any health policy, social program or economic strategy that has been attempted by another state's legislature. In some cases, no amount of positive data on a successful program is enough to convince our leadership to move in the path of innovation, regardless of the possibility of lives or money saved.

One such innovative program has saved at least hundreds of thousands of lives, millions of dollars and is older than CD's, cellphones, home computers, Katy Perry and Flo Rida, but you won't see a state-wide needle exchange program in Florida.

It's not for lack of trying. Bills proposing needle-exchange programs (NEP's) have been attempted for the last three years, but never got to the governor's desk. IN 2013, HB735 (Pafford) died in the Judiciary committee and SB0808 (Margolis) got to the Senate floor, but died on the calendar awaiting a vote.

After that session, Rep. Mark Pafford (D-West Palm) filed again, but HB491 died in the Senate in Messages after passing the House floor. and SB0408 (Braynon) died along with it. In 2015, HB479 (Edwards) died in Government Operations Subcommittee while SB1040 (Braynon) died on the Senate floor calendar while the House called a premature end of session.

But the real question is: how many Floridians have died since needle exchange programs first came to the US in the 1980's?

The bills floundered, but it was not for lack of bipartisan support. After the 2013 session, Health Policy Chair Aaron Bean(R-Fernandina Beach) told the media, "We had it, we researched it. It doesn't sound like a conservative idea -- at first, but it is backed by the Florida Medical Association and would be 100 percent funded with private money, and that combination sold me."

It may not have appeared conservative to Sen. Bean at first glance, but the concept had had conservative support from the beginning. The very first national needle-exchange program was championed by the highly conservative UK Prime Minister, Margaret Thatcher. She looked at the data and decided it the program was necessary to prevent an HIV epidemic amongst British addicts. In England, only 1% of addicts contracted HIV since the program started. American addicts have fared much, much worse.

Especially in Florida.

Today, there are more than 90,000 needle-drugs users, 19% with HIV and at least 23,000 with hepatitis-C. Considering the lifetime healthcare cost of more than $600,000 for HIV patients and $300,000 for those with Hep-C, the impact to the state is tremendous, since street addicts rarely have health insurance and often seek treatment in emergency rooms or in Medicaid-based clinics.

Add the problem of reduced LIP(Low Income Pool) funding this year and additional reductions on the horizon, and it's not too hard to see a storm of crisis coming to the state budget and to hospitals caring for indigent addicts.

Florida, due to its lack of action on the matter, has 30 years of data and success rates around the country and around the world to verify that Needle-exchange programs work as they take yet another year to make a decision to start one. Currently, there are 35 states with NEP's, and they exist in one form or another in almost every country in Europe, Australia and New Zealand. They know that avoiding hundreds of thousands of dollars in healthcare costs by offering a one dollar syringe is a no-brainer.

Almost any question or concern can be answered by the data. For those who think that offering clean needles facilitates heroin use, there is no data that an addict ever stopped using drugs due to dirty syringes. The choice of whether or not to use while tempting HIV or Hep-C infection doesn't seem to come up to addicts. According to a 2012 report by the Florida Department of Health's Bureau of HIV/AIDS, 29% said they reuse the needles from the last injection, a 64% reported that used a needle previously used by someone else.

There are even statistics about unexpected consequences. A report from the American Journal of Public Health in 2000 took notice that some states with NEP's saw a reduction in crime.

This week, TIME magazine, a long-time conservative publication, published an article called, "Needle-Exchange Programs Could Prevent HIV Outbreaks, Experts Say."

In 1990, I was working alongside HRS in South Florida trying to control the HIV epidemic. The idea of a needle-exchange program was batted about and then forgotten, while some activist groups actually went so far as to distribute the syringes in communities around Miami-Dade and risk arrest to save fellow Floridians. Maybe 2016 will be the year that Florida's legislature wakes up and smells the rationale behind the compassion of a needle-exchange program and the ability to save lives and healthcare funds before another year of suffering and death occurs.

It's an idea whose time had come many years ago, but it's never too late to save lives.

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