County Syringe Exchange Program seeing positive results

For the first time since the Flathead County Syringe Exchange Program launched nearly six months ago, the Flathead County City-County Health Department has started taking in more syringes than it is giving out — a significant accomplishment for the young initiative that provides an avenue to disease prevention, addiction treatment, and more.

According to Shawna Himsl, an HIV prevention specialist with the health department who heads the program, the accomplishment is one of many that show the program is garnering positive results since its inception in April.

The exchange is essentially a wrap-around service for anybody who is using injectable drugs. The department takes in used syringes from clients and provides clean ones in an effort to halt the spread of critical diseases, including Hepatitis C and HIV, which can often occur through the sharing or reusing needles.

At first blush, Himsl acknowledges the concept of a syringe exchange program may seem uncomfortable to many. But she said the exchange, more than anything, is a way to build trust with patients, with the ultimate goal to help users get treatment for their addictions.

“Anytime you can build a relationship with an ostracized community is an opportunity,” Himsl said. “As we build trust with people we are able to connect them to primary care and other social services. That’s the main goal of this program, to form that relationship.”

According to the Centers for Disease Control and Prevention, the opioid crisis has fueled a dramatic increase in infectious diseases associated with injection drug use. Reports of Hepatitis C cases rose 3.5-fold from 2010 to 2016, and the majority of new cases are due to injection. The center lists Montana as one of the 38 states “experiencing or at-risk of significant increases in hepatitis infection or an HIV outbreak due to injection drug use following CDC consultation.”

The website also states “syringe services programs reduce HIV and HCV (hepatitis C) infections and are an effective component of comprehensive community-based prevention and intervention programs that provide additional services.”

The syringe exchange program is supported by an annual HIV prevention grant given to the Flathead City-County Health Department by the state Department of Health and Human Services.

The services are 100% confidential and anonymous.

So far, nearly 100 clients have utilized the exchange. Most more than once. And of those who come in, Himsl said most report using methadone, methamphetamine and heroin.

Himsl, and the Centers for Disease Control and Prevention, point out the goal is for patients to use a new syringe every time they use. For some, that is once a day. For others, that’s multiple times a day. She said it is typical for patients to also give some of their clean syringes to friends or family who use, who may be hesitant to come to the health department themselves.

The program has distributed 4,400 syringes and received back 3,800 total over the nearly six months, but last month was the first month the program started bringing in more syringes than it distributed. Overall, Himsl said program participants are reporting a decrease in sharing and have not reported an increase in using. Multiple clients have reported using less.

“The reality is drug use is a problem in our valley and almost everyone knows someone who has used or is using. This program is still young, but is already producing some good results,” Himsl said. “One of the concerns about this program is that people thought it would encourage people to use more. Since we have started, not one person has indicated that they are using more.”

THE PROGRAM provides multiple insights and benefits aside from the syringe exchange itself.

In addition to providing syringes, Himsl has also given out hundreds of hygiene packets and fentanyl testing strips. She said multiple patients have brought back strips that have tested positive for fentanyl in Flathead County.

While Montana officials have pointed to a steady decline in opioid use, they have simultaneously expressed concern over a rise in fentanyl. The synthetic opioid pain reliever is 50 to 100 times more potent than morphine and recent cases of fentanyl-related harm, overdose and death have been linked to illegally made fentanyl, according to the Centers for Disease Control and Prevention. It is sold through illegal drug markets for its heroin-like effect and can be mixed with heroin and other drugs, with or without the user’s knowledge. The center reports more than 28,000 people died from overdoses involving synthetic opioids other than methadone in 2017.

In a recent interview regarding the history of opioids in Northwest Montana, Jon Ebelt with the state Department of Health and Human Services stated officials “are concerned about the increase in heroin and fentanyl deaths.”

Hillary Hanson, public health officer for the Flathead City-County Health Department, said the program is just one way the department is looking to address the county’s ongoing issues with substance use. She points to the community health assessment conducted every three years by the health department, North Valley Hospital, Kalispell Regional Healthcare and the Flathead Community Health Center that shows drug use is a prevalent problem in the Flathead Valley.

“This data is utilized to determine priority health issues in our community. Substance use continues to be a priority area and we, as the health department, are always seeking ways we can provide services to address priority health issues,” Hanson said. “It is our goal to meet people where they are at and be there for them when they are ready to move forward with recovery.”

The relationship puts health department officials in a unique position to link clients to needed services. These range from HIV testing to behavioral health counseling, primary-care providers and more, many of which are available in the same building as the health department.

According to Himsl, the program is one way to get ahead of what has the potential be an epidemic, if intravenous drug users who are HIV-positive start sharing needles.

“HIV isn’t very prevalent here right now, but if that happened we would have a real problem,” Himsl said.

And should HIV or Hepatitis C become widespread, the cost to taxpayers could be significant.

“These diseases are expensive to treat. People who get HEP-C, 85% of them will experience some kind of liver failure or disease and other side-effects,” Himsl said. “Many of these folks probably have Medicaid, so it’s a cost to the taxpayers.”

Kalispell Police Chief Doug Overman added the program has benefits from a public safety standpoint.

“Occasionally needles get left in open spaces, exposing community members, children and our officers to disease,” Overman said. “We’ve found them in parks and school grounds. It’s important to have a safe place to dispose of used needles.”

Overman said his first recommendation for those using drugs is to seek treatment through chemical dependency clinics and other means. But if that is not an option, residents need to dispose of their needles in a responsible manner and keep used needles away from the general public.

For more information regarding the Syringe Exchange Program, call 406-751-8256.

Reporter Kianna Gardner can be reached at 758-4439 or kgardner@daliyinterlake.com