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El Paso County residents turn to Denver or Pueblo for clean syringes 

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click to enlarge Brian Brewer organizes supplies at Access Point Pueblo, a syringe access program. - FAITH MILLER
  • Faith Miller
  • Brian Brewer organizes supplies at Access Point Pueblo, a syringe access program.

El Paso County officials haven’t just said they don’t want a syringe access program (otherwise known as a needle exchange) here — both the Board of County Commissioners and county Board of Public Health voted, most recently in 2017, to put an end to conversations entertaining the possibility. Despite some turnover since then, health workers aren’t much closer to persuading elected leaders to implement a program.

“It’s a hard fight in El Paso County, for some reason,” says Jessica Kobylinski, the director of regional programs for the Southern Colorado Health Network, which has advocated for the region to join communities across Colorado and the nation in providing clean syringes for people who inject substances such as meth and heroin.

Drug users in El Paso County who need clean syringes to avoid contracting hepatitis C, HIV/AIDS and other blood-borne diseases, must go to Denver, Pueblo, or another county with a syringe access program. But traveling between counties is not always easy for those in the throes of addiction, who may not have access to vehicles or bus fare, and may only have a few hours after injecting before they begin to experience the violent sickness and crippling psychological lows that accompany withdrawals.

Still, data from the two nearest large syringe access programs, Access Point Pueblo (run by the Southern Colorado Health Network) and the Harm Reduction Action Center in Denver, show that some El Paso County residents are willing to go the distance.

Since the Pueblo program opened in 2014, it’s recorded 37 clients from El Paso County out of more than 2,000 unique clients. (ZIP codes are self-reported.) The Denver program, which is larger, has recorded 62 El Paso County clients since 2012.

While those numbers may not seem especially significant, Colorado Springs clients who pick up syringes in Pueblo often are bringing them back to friends, notes Brian Brewer, syringe access program manager for the Southern Colorado Health Network.

“One of those individuals could be picking up for five other individuals,” Brewer says. People can normally receive 40 clean syringes each time they visit, he says, but those who bring back used syringes to dispose of at the facility can receive up to 70 each — providing an incentive for people to clean up their communities and protect those in parks and public places from getting inadvertently pricked. Some of those people might visit the facility multiple times a month.

“I think 37 is a large number, but I don’t think it even is the tip of the iceberg for the number of folks that inject substances in El Paso County,” Kobylinski says.

Those who can’t get clean syringes from Pueblo or Denver reuse them, or even use those they find discarded, increasing the risk they will transmit viral diseases. Hepatitis C, in particular, is a risk factor for those reusing needles, as the virus can live in a discarded syringe for weeks.

Advocates of syringe access programs say they’re frustrated that El Paso County is the only large metropolitan county in the state without a program. According to the Centers for Disease Control and Prevention, these programs have been shown to decrease the risk of infection and disease; increase entry into substance use treatment; reduce needle-stick injuries for law enforcement and members of the public; reduce overdose deaths; and save public health dollars.

Though El Paso County leads the state for the number of fatal overdoses, with 169 in 2017, and has experienced an increase in reported cases of hepatitis A and hepatitis C, the opposition to such a program here doesn’t show signs of shifting.

Case in point: An April 21 Gazette article about the lack of a syringe access program drew scores of angry comments online.

“Denver has free needle exchanges. Denver also has a ton of recreational pot shops. Signs advertising this should be posted under bridges,” one person wrote.

click to enlarge Access Point allows clients to take up to 70 clean syringes each time they visit. - FAITH MILLER
  • Faith Miller
  • Access Point allows clients to take up to 70 clean syringes each time they visit.

“That is like saying a condom exchange would help curb sexual assault! Enabling bad behavior in no way helps to curb it,” wrote another.

Newly elected Commissioner Cami Bremer isn’t comfortable with the idea. “Drug use is a complex issue, and one that cannot be solved in a single solution,” she wrote, suggesting the county “remain focused on prevention strategies that have long term, sustainable results.”

Judy Solano, founder and CEO of the Southern Colorado Harm Reduction Association, admits she also used to be skeptical of “harm reduction” — the idea that since you can’t completely stop someone from using drugs right away, you should instead implement strategies like syringe access to keep them as safe and healthy as possible until they’re ready to seek treatment.

“If you’d have told me two years ago that I’d have been running a needle exchange, I would have been asking you, ‘What are you smoking?’” Solano said at a recent conference on opioid addiction.

But Solano’s experience as an emergency room nurse, and her own son’s struggle with addiction, changed her philosophy. And in 2017, Solano opened a syringe access program. Since then, the Southern Colorado Harm Reduction Association has offered clean syringes to hundreds of clients in Pueblo, a handful of whom come from El Paso County.

Still, Solano says those who only see an organization giving out free paraphernalia are missing the point.

“We have had an opportunity to create a safe, compassionate environment where clients can come in, receive all their supplies. But it’s more than that,” she says. “We offer an entry point to services.”

The center offers free naloxone, an opioid reversal drug; peer coaching; free testing for hepatitis C and HIV/AIDS; case management; AcuDetox, a form of substance use treatment using acupuncture; and free snacks, clothing and hygiene supplies.

The syringe access component is crucial, Kobylinski says. Clean syringes provide a strong motivation for clients to visit harm reduction centers, and from there, they can gain access to naloxone, life-saving fentanyl test strips, mental health services and substance use treatment.

Without the ability to give out clean needles, health programs are hard-pressed to get clients in the door. While Kobylinski and her colleagues can distribute clean needles in Pueblo, Denver, Grand Junction and Fort Collins, they can’t use the same proven method of building clients’ trust in El Paso County.

“When [syringes] are easily accessible, I [the client] can go into an organization that also has the ability to address my hepatitis C, to address my HIV, to give me overdose prevention materials ... see if I have Medicaid or access to behavioral health,” Kobylinski says. “This buffet of services we have to offer is wasted in El Paso County because we just don’t have the draw to get people in.”

The El Paso County Board of Health first blocked the creation of a syringe exchange program in 2013 with a 6-2 vote, and moved 5-4 in 2017 to stop hearing presentations on the subject before scheduling a vote, after the board of commissioners issued a resolution opposing such a program.

That’s despite the fact that the CDC provides funding for syringe exchange programs, noting that they represent “an effective component of a comprehensive, integrated approach to HIV prevention” and are associated with reduced risk of hepatitis C infection.

If El Paso County were to implement such a program, Kobylinski says, the burden wouldn’t fall on taxpayers.

“We have the funds,” she says. “We have the grants, we have the supplies, we have the connections... We’re just asking for the permission to do it.”

Mary Steiner, community program manager at Pikes Peak Community Health Partnership, believes the issue could go before the health board again as people become more educated about syringe access programs. She notes that a cost-benefit analysis conducted last year showed that such a program would return $8.91 for every $1 spent.

In the meantime, clients who want clean needles will have to go elsewhere.

“I think that a good argument could be made that El Paso County needs to be responsible for our citizens,” Steiner muses, “and not pawn it off into somebody else’s backyard because we don’t want to deal with it.”

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