Syringe/needle exchange

  1. Hi all! I am a public health nurse whose health department is about to start a syringe access/needle exchange program for intravenous drug users in our area. The intent of the program is to provide a harm reduction approach to IV drug use. Program participants can bring in their used works and needles for safe disposal (keep those neeedles off the sidewalks!) and exchange them for sterile things. We will also be providing HIV and Hep C testing along with active referrals to mental health providers, rehabs, and other substance abuse treatment services to participants ready to stop using. We will provide Narcan training too (some pharmacies in our area will provide Narcan on standing orders without rx to people who ask for it). I know it isn't quite the same as traditional addictions nursing, but I am curious if any of you have ever worked in a place that provided services like that and what your experiences were like. I've read stories from lay people who have worked in syringe access/harm reduction, but I am having trouble finding nursing perspectives. Thanks for your stories if you've got em!
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  2. 16 Comments

  3. by   yhl1975
    Bless you! I am RN in Alcohol/ Drug outpatient full for profit setting Manhattan /Quince NY
    We are doing outpatient detox for Alcohol and non IV users "non- complex" cases, sent by union, ACS,TASK, Federal probation, HR and Self referrals. My primary job is health assessment and "pre psych assessment", referrals to XRAY for "TB clearance" /PPD testing/infection control "collaboration " with Health department regarding TB/smoking sensations /education/referrals to acute care settings/ first help and Vivitrol administration. All our staff got Narcan training by NY education department in 2015 .
    Program participants can bring in their used works and needles for safe disposal (keep those needles off the sidewalks!) but we will not exchange them for sterile. The policy is education regarding immediate detox/rehab and Vivitrol/ methadone/suboxone .
    Patient could get a referral for HEP C/B HIV follow up- we "collaborate" with www.ryancenter.org/

    I understand "harm reduction" policy in Health Department, but our private owners decide what is mandatory by OASIS and we do what they decide for us.
    In order to help the clients, it is better to meet with private owners of "OASIS" programs in you area, so you could provide real help and education.
    Thank you!!
    Good Luck!
  4. by   CBlover
    OP, may I ask, are you in the US? I am going to google this topic, but as of right now I'm quite flabbergasted. As yhl1975 said, I can see disposing of them, but you all are giving them more needles!?
  5. by   CBlover
    I just looked it up. I'm educated now. Wow.
  6. by   yhl1975
    I am RN from Israel and before my employment in OASIS , patient never got free condoms, in all 3 clinics that I am covering patients got them, it took 2-3 month to convince our management to put free condoms for patients near the entrance!!!
    I understand your " quite flabbergasted" filling.
    Welcome to substance abuse/alcohol treatments for medicate clients, it is so sad.
    What ever you will do , good luck, nurses always helped to improve regulations and rules for patients.
    Good Luck!
  7. by   CBlover
    Quote from yhl1975
    I am RN from Israel and before my employment in OASIS , patient never got free condoms, in all 3 clinics that I am covering patients got them, it took 2-3 month to convince our management to put free condoms for patients near the entrance!!!
    I understand your " quite flabbergasted" filling.
    Welcome to substance abuse/alcohol treatments for medicate clients, it is so sad.
    What ever you will do , good luck, nurses always helped to improve regulations and rules for patients.
    Good Luck!
    Yea. Learned something new today! Thanks for sharing!
  8. by   abbnurse
    Quote from CBlover
    OP, may I ask, are you in the US? I am going to google this topic, but as of right now I'm quite flabbergasted. As yhl1975 said, I can see disposing of them, but you all are giving them more needles!?
    Flabbergasted about the syringe/needle exchange? (This is an honest question, not being snarky. I just want to clarify.) Your city/ town doesn't have a program like this? I was under the assumption that such programs are common.

    ETA: Keep up the great work, SiwanRN and yhl1975!
    Last edit by abbnurse on Feb 19, '16
  9. by   CBlover
    Quote from abbnurse
    Flabbergasted about the syringe/needle exchange? (This is an honest question, not being snarky. I just want to clarify.) Your city/ town doesn't have a program like this? I was under the assumption that such programs are common.

    ETA: Keep up the great work, SiwanRN and yhl1975!
    Did you not read my post(s)? I was just asking bc I've never heard of it and thought it was pretty interesting. Is that ok with you? I just was at first surprised needless are handed out to drug users. But I see the purpose.
  10. by   yhl1975
    We can learn from each other, no need to feel uncomfortable.
    " not every person and not every situation gets me at my best"
    Yes new needles could be suplied to IV user and to family members.
    The main idea is to prevent hepatitis/ hiv/other blood related infection. And of course it would be weird, why "Health Department" not preventing IV use, but "loose money" for chronic users.
    All this Idea to "treat by methadone/suboxone" and change old needles for IV users ,all instead of prevention drug/alcohol use in primary care .
    https://www.health.ny.gov/professionals/narcotic/

    https://www.health.ny.gov/profession...d_regulations/

    Syringe Access and Disposal

    Syringe Exchange Programs


    Expanded Syringe Access Program (ESAP)


    Safe Sharps Disposal

  11. by   abbnurse
    Quote from CBlover
    Did you not read my post(s)? I was just asking bc I've never heard of it and thought it was pretty interesting. Is that ok with you? I just was at first surprised needless are handed out to drug users. But I see the purpose.
    No need to be defensive or sarcastic. My question was an honest one, as was yours. I meant nothing by it other than what I asked.

    Our needle / syringe exchange program is a " one for one", up to 500 syringes and needles. Clients can also obtain rapid HIV and also Hepatitis C testing, safer injection education, safer sex education, and referrals to treatment services/health services.

    The program has been well received, but was certainly not without challenges while being organized and implemented.

    Again, thanks for the great work, previous posters !
  12. by   SiwanRN
    Thank you everyone for your responses thus far! To answer a previous question asked of me, I am in the United States. It's probably going to take awhile for our program to get off the ground because there really isn't any advertising (yay, politics), but some other syringe access programs in the area will start referring to us soon for their clients who live in our area but travel a long way to get to these other programs. Ultimately it's not a competition, just an additional tool in the toolbox to address the problems of rising drug overdoses and HIV/Hep C rates in my area.
  13. by   abbnurse
    Quote from SiwanRN
    Thank you everyone for your responses thus far! To answer a previous question asked of me, I am in the United States. It's probably going to take awhile for our program to get off the ground because there really isn't any advertising (yay, politics), but some other syringe access programs in the area will start referring to us soon for their clients who live in our area but travel a long way to get to these other programs. Ultimately it's not a competition, just an additional tool in the toolbox to address the problems of rising drug overdoses and HIV/Hep C rates in my area.
    Thanks again for your hard work! Rising rates of overdoses and new Hep C / HIV infections have been a significant concern in my city as well.

    Hang in there! In my area there also isn't much advertising, and in fact, there has been rabid opposition to the program..... but the word will spread quickly amongst the "community of people in desperate need of kindness" (which is how one of the MD's working with the program described it).
  14. by   Bowie21
    This is my dream job! SiwanRN, I've been volunteering at a needle exchange in the south for a few years. I'm about ready to finish my accelerated BSN and am finding it really difficult to find public health jobs down here. Am probably relocating up to the DC area to find a public health job. It's so tough to be in an area where public health nursing would make such a positive difference, but it is not invested in or supported.

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