A little harm reduction goes a long way

Does Tulsa need a needle exchange?

The Oklahoma State Department of Health only tracks acute hepatitis C cases, “which makes no damn sense,” said Samantha Young of Health Outreach Prevention Education, Inc. (H.O.P.E.), an HIV, hep-C, and STD testing clinic in Tulsa.

“In 2016, we did 716 hep-C tests—we had 122 come back positive,” Young said. “It’s huge.”

Hepatitis C is spread through blood contact—primarily intravenous drug use, improperly sterilized medical equipment, needle stick injuries, and transfusions.

After all, this is Larry Clark’s Tulsa—methamphetamine and heroin are affordable and prevalent, and overdoses are surging. Clark said in an interview with Marc Maron last year that he sees even more drugs here now than in the days of creating “Tulsa.” The introduction of OxyCotin in 1996, and other pain relieving drugs, lead to an uptick in needle use as some pharmaceutical companies encouraged doctors to take a different approach to pain by not worrying so much about addiction. 

But humans have been injecting themselves since the 19th century, when Alexander Wood, a physician who theorized administering an opiate closer to a nerve might enhance pain relief, invented the hypodermic syringe. As soon as this metabolizing cheat was perfected, it made its way to the masses and infiltrated pop culture.

If more and more people are using drugs and our society wishes to reduce drug abuse and the amount of harm resulting from it, how do we do that? 

Needle exchange facilities are one way. They reduce the most detrimental effects from IV drug abuse by providing two resources to addicts: education and sterile, single-use needles. 

“Needle exchange is the most cost effective public health intervention since the Heimlich maneuver,” said Dr. Peter Davidson, assistant professor of medicine at UC-San Diego. “A needle costs 10 cents; HIV costs $618,900 over
a lifetime.” 

Needle exchanges work on premise that you get one clean needle for one dirty needle—an exchange—so there are zero additional needles on the street. In fact, in cities with needle exchanges, drug users have incentive to collect used syringes from public places. So, you have less hazardous paraphernalia in your parks and streets, fewer incidents of blood-borne diseases like hepatitis, and exchange sites often have medical professionals and counselors available, too, who can lead addicts into treatment when they’re ready.  

“It doesn’t lead to more people using drugs,” said Davidson.

The H.O.P.E. testing clinic distributes kits with cookers, alcohol prep pads, tourniquets, cotton filters, sterile water, and bleach—everything you need to safely inject, except the needle. H.O.P.E. is legally constrained from distributing needles. Samantha Young thinks a needle exchange would be a great thing for Tulsa. 

“They’re providing a place for people to dispose of old needles,” Young said. “You get rid of biohazard by having it burned.” 

Taking your rig to the needle exchange would be infinitely better than flipping it out your car window into the QT parking lot.

In Oklahoma, the evangelical desire to impose codes of morality on our public battles with rationalist approaches—like whether or not teens should be taught abstinence or safe sex—harkens back to our Puritan roots, and we’re still suffering that hangover.

“I’m not a moralist … I can see the wisdom in a needle exchange,” a local pharmacist (who wished to speak without attribution) told me.

The legality of purchasing needles from a pharmacy without a prescription for steroids, allergy drugs, or insulin is on a county-by-county basis in Oklahoma, with no statutes against it in Tulsa County. CVS has a no-syringes-without-a-prescription policy; Walgreens’ website claims needles are available without a prescription. 

However, when I asked for a pack of 10 1cc allergy syringes at the Walgreens at 15th and Yale, the pharmacist refused to sell them to me, saying that it was up to her discretion.

I asked a local attorney his opinion of the potential liability of selling needles at pharmacies to people without a prescription.

“A seller arguably should not be allowed to provide needles to people sans prescription, etc. because the seller could possibly be on notice that the needles would be used for purposes that could cause harm to another,” he said. “It’s not a particularly strong argument but it could and likely would survive a motion to dismiss in state court in Oklahoma.”

The closest needle exchange to Tulsa is in Fayetteville, Arkansas.