A local group is hoping to start a needle exchange program in Billings, and they’ve got both friends and foes.
Jace Dyckman, co-chair of the statewide HIV Prevention Community Planning group, said some community members have been asking for the service for years, believing it will provide some safety for loved ones who are drug-addicted.
A needle exchange offers clean needles for intravenous drug use and a safe place to dispose of dirty needles. Most programs also offer first aid supplies, information on how to reduce risk while injecting drugs, and referrals for health care and substance abuse treatment. Bozeman, Missoula and the Fort Peck Indian Reservation all have active needle exchanges.
But Billings law enforcement and other city officials aren’t so enthused, arguing an exchange could encourage illegal activity.
Dyckman says all Billings residents would benefit from a needle exchange, not just those using drugs.
By providing a safe place to dispose of dirty needles, Dyckman believes, an exchange would help cut down on the number of dirty needles littering the city, especially at North and South parks. (A seasonal parks employee at North Park said that on most days this summer, he found used syringes in the park.
Providing clean needles would help slow the spread of HIV and Hepatitis C, bloodborne pathogens that are frequently spread when people share needles, Dyckman said. New needles can be difficult to obtain at a pharmacy without a diabetes-related prescription.
And it would help establish trusting relationships between public health advocates and intravenous drug users, laying the foundation to get people into drug treatment more quickly, he believes.
Dyckman used meth for 20 years and has been sober for 14. He said he knows what it takes to get clean, and a bridge to services through a trusted intermediary — someone at the needle exchange — would help. Before the city can address local drug addiction, Dyckman and other proponents believe, it needs to push the problem into the open.
“The community in general forgets that a drug addict was actually somebody’s son or daughter that had a dream,” Dyckman said, but turned to drugs to cope during a time of struggle. “At some point that coping skill turned into an addiction. Now that addiction runs their life.”
‘Amnesty’ for drug users?
Billings police Chief Rich St. John said he understands the potential health benefits of an exchange, but that turning a blind eye to drug use is “counterintuitive for law enforcement.”
St. John said he has questions about how the programs have worked elsewhere, and would need to meet with the city and county attorney to discuss the issue locally, if the project gets that far.
A law passed this spring by the Montana Legislature exempts people administering a needle exchange from drug paraphernalia laws. But questions remain about how police would interact with those visiting an exchange, St. John said.
Steve Crawford, chief of police in Bozeman, said officers there have no agreement not to track people who visit the exchange, but that police also do not know when or where the exchange will take place. (Bozeman’s exchange is run from a mobile unit. The schedule is announced on a private Facebook page.)
Crawford said Bozeman police have not yet had any problems with the exchange.
But St. John remains concerned that such a program in Billings would provide “amnesty” for illicit behavior.
“At the end of the day, we are law enforcement, and it is against the law to do all of the stuff that we are talking about,” St. John said. “I don’t want to endorse anything that is going to facilitate illegal activity.”
Dyckman said he’s at the initial stage of planning for the proposed exchange. He’s made a pitch to a Southside Task Force meeting, handing out sharps containers to residents to encourage them to dispose of needles safely.
The next, and biggest, steps, are to find a local organization willing to sponsor such an exchange and to secure funding.
While Congress recently made it easier to use federal funds for needle exchanges, some restrictions remain, and Yellowstone County currently does not qualify.
That’s essentially because the problem isn’t growing quickly enough here, at least according to federal measures. In order to qualify for federal funds, a locality must demonstrate that it is experiencing or at risk of experiencing an increase in infectious disease rates that is clearly linked to IV drug use.
Yellowstone County has had three new cases of HIV this year and three new cases in 2016. For Hepatitis C, there were 14 new cases last year and five so far this year.
No state funding is used to support the existing needle exchanges in the state, according to the Department of Public Health and Human Services.
Dyckman is currently researching other funding sources.