Meeting People Where They Are: The Needle Exchange Program

The best outcomes in public health often happen when we meet people where they are.

Our NEP staff - Chris Serio-Chapman, Derrick Hunt and Lamont Clark.

At 10 a.m. this morning, I witnessed a part of life that many of us shy away from.  I spent time observing the work Health Department staff do within our harm reduction program.  Within the confines of a small camper on a street corner in Southwest Baltimore, two staff members attended to drug injecting users exchanging dirty needles for clean ones.  There was a steady stream of clients – men, women, young, old, black and white.  Some were regulars who chatted for a bit and then went about their day, while others were in and out in less than five minutes.

 

One of the clients, a woman just a year older than me, shared she had ongoing liver disease, diabetes and MRSA.  She also shared symptoms that made us suspect her diabetes was not under control and we convinced her to follow up with her clinic.  Another young lady listed a bunch of STI’s she had been treated for and was concerned she might have HIV.  We were testing her for HIV on the spot.

Our Needle Exchange Program (NEP) is the cornerstone of BCHD’s Ha­­­rm Reduction Program. NEP is an evidenced-based intervention program that provides clean needles to injection drug users in return for used syringes, which are discarded. The purpose of the program is to reduce the frequency of infections passed through the use of unclean needles, infections that include HIV and hepatitis C. 

The time I spent on the van gave me a more personal glimpse of the ravages of drug abuse in our city.  Our program, run by Chris Serio-Chapman and her staff, is the only confidential needle exchange program in the country.  The success of the program has been documented: when the program began in 1994, it is estimated that approximately 650 incident cases of HIV in Baltimore were caused by injection drug use, representing 60.3% of reported HIV.  Sixteen years later, the number of new HIV infections caused by injection drug use dropped to 177 new cases per year, representing a 29.5% decrease in the proportion of new HIV diagnoses caused by injection drug use.

One of the many reasons we’ve been successful is the attention paid to doing things that are evidence-based and evaluating the work we do to make sure we’re getting the outcomes that will best improve the lives of the people we serve.  An even more important reason is the dedicated staff that we have.  In addition to Chris, I got to talk with Derrick Hunt and Lamont Clark about their experience with the program and how we could help people on the road to recovery. 

I also had the pleasure of observing the skill with which they were able to engage individual clients by meeting them where they were. NEP has been extremely successful in this regard, currently operating at 17 locations around the city. Since 1994, more than 9 million clean syringes have been distributed to clients, and more than 10 million contaminated needles have been properly destroyed since it was started.

For more information about Baltimore’s needle exchange program, including our location sites and times, please see our website. For the latest NEP updates, be sure to “like” their Facebook page.

Take Care, Baltimore.