The opioid crisis in the U.S. rages on, with no end in sight. More than 72,000 people died of drug overdose in 2017, up from 63,000 the year before. In Florida, experts estimate that 20 Floridians are dying from overdose every day.
Many of these deaths are unnecessary. From a public health perspective, we know what to do — we are just failing to do it.
Naloxone, for example, is not nearly as available in Florida as it should be. Naloxone is a safe, generic medication that when administered promptly can reverse the effect of opioid overdose, literally bringing someone back to life. Used for decades in emergency rooms and ambulances, it has no potential for abuse and can be administered by lay people with minimal training. But naloxone can only be effective if it gets into the hands of the people most likely to be at the scene of an overdose — people who use drugs, and their family and friends. The U.S. Surgeon General recently issued an advisory urging greater access to naloxone, but there are still too many unnecessary barriers.
Syringe exchanges are ideal sites for direct naloxone distribution, as people who use drugs go to exchanges to receive a range of health services in a non-judgmental setting. Syringe exchanges are saving an astounding number of lives every day. The University of Miami’s IDEA Exchange has reversed more than 700 overdoses since it began distributing naloxone in March 2017.
Yet resistance to syringe exchange programs blocks their expansion. Drug paraphernalia laws, lack of understanding of how exchanges work, stigma surrounding drug use and other factors prevent offering this proven public health service in many communities.
The IDEA exchange is the only such program in Florida, but Miami isn’t the only place where it is needed. According to the Centers for Disease Control, in 62 Florida counties rates of overdose death are higher than they are in Miami-Dade. In seven counties — including Franklin —people are dying of overdose at rates three times as high as in Miami-Dade.
In 2017, state Sen. Oscar Braynon and Rep. Shevrin Jones sponsored legislation to permit other counties to establish syringe exchange programs in conjunction with their local departments of health. The bill gained substantial support from law enforcement, but failed to get to a floor vote in the House. Some people think making syringes available to people using drugs enables their habit and threatens to bring more crime to the community. But the facts indicate otherwise.
After decades of research in the U.S. and globally, there is no evidence showing increased drug use in communities with syringe exchanges. Indeed, the opposite is true. Exchanges have a strong record of helping to bring people into treatment. They are also incredibly cost-effective, as clean needles cost pennies while drug-related infections cost millions in emergency room visits, medications and hospital stays.
This year, Sen. Braynon and Rep. Jones will re-introduce the bill to allow other Florida counties to start a syringe exchange. If it passes, by next year there could be better news to report.