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City’s needle exchange stars in new video on federal funding

  • Tim Purington, director of prevention services for Tapestry Health, stands in the needle exchange room Monday at the Tapestry Health office in Northampton.<br/>JERREY ROBERTS

    Tim Purington, director of prevention services for Tapestry Health, stands in the needle exchange room Monday at the Tapestry Health office in Northampton.
    JERREY ROBERTS Purchase photo reprints »

  • Tim Purington, director of prevention services for Tapestry Health, stands in the needle exchange room Monday at the Tapestry Health office in Northampton.JERREY ROBERTS

    Tim Purington, director of prevention services for Tapestry Health, stands in the needle exchange room Monday at the Tapestry Health office in Northampton.JERREY ROBERTS Purchase photo reprints »

  • Tim Purington, director of prevention services for Tapestry Health, stands in the needle exchange room Monday at the Tapestry Health office in Northampton.JERREY ROBERTS

    Tim Purington, director of prevention services for Tapestry Health, stands in the needle exchange room Monday at the Tapestry Health office in Northampton.JERREY ROBERTS Purchase photo reprints »

  • Tim Purington, director of prevention services for Tapestry Health, stands in the needle exchange room Monday at the Tapestry Health office in Northampton.<br/>JERREY ROBERTS
  • Tim Purington, director of prevention services for Tapestry Health, stands in the needle exchange room Monday at the Tapestry Health office in Northampton.JERREY ROBERTS
  • Tim Purington, director of prevention services for Tapestry Health, stands in the needle exchange room Monday at the Tapestry Health office in Northampton.JERREY ROBERTS

Northampton appears in a new film with urban centers Newark, N.J., Bridgeport, Conn., and New York City as much for what it has in common with those cities as for what it doesn’t. All have successful needle-exchange programs but only Northampton has a small-town feel.

“The Exchange,” a video released last month to advocate for reversing a ban on the use of federal funds for needle-exchange programs (also known as syringe services programs), opens with testimony from former intravenous drug users and interviews with clients and workers at Project Access, a syringe services program in gritty, inner-city Newark.

Next, the camera glides past picturesque leafy neighborhoods in bright sunlight before focusing on the familiar sight of King Street from the corner of Main Street, with the Hotel Northampton looming in the background.

“For anybody that doesn’t know Northampton, it’s a vibrant, middle-class community,” says Tim Purington, director of prevention services for Tapestry Health, as the camera follows him down Center Street to the program’s offices. “People are shocked to hear there’s a syringe-exchange program operating quietly downtown.” Clearly, the film’s promoters, The Foundation for AIDS Research (known as amfAR), recognize the need to debunk commonly held beliefs about intravenous drug use happening only in large cities if they are to raise broad public support for HIV and hepatitis C prevention.

“We wanted to put a human face on the importance of syringe-exchange programs,” said Chris Collins, vice president and director of public policy for amfAR. “We also want to advocate for the need to change the federal law, to allow public health to follow the science.”

The law Collins refers to, banning the use of federal funds specifically for needle-exchange programs, has been in effect more often than not since the programs began in the mid-1980s.

The video throws around some compelling numbers with public policy implications.

Researcher Don Des Jarlais, with the Baron Edmond de Rothschild Chemical Dependency Institute at the Beth Israel Medical Center, offers this startling statistic: The estimated lifetime medical cost of someone with HIV amounts to $488,000.

“A clean needle costs 10 cents, give or take a little,” Des Jarlais says in the video. “Every time we take a contaminated syringe out of the community, we’re reducing the chance that somebody new is going to get infected with HIV and we’re saving the public a tremendous amount of public money.”

To view the video, go to The Foundation for AIDS Research website.

A brief window

For one tiny window of time, from 2009-2011, Congress allowed the use of federal funds specifically for needle exchanges.

During that time, Tapestry and other programs around the country were able to use funding they were already receiving from the Substance Abuse Mental Health Services Administration specifically for their needle-exchange programs. Since 2011, due to state cutbacks and the federal ban, services have been reduced.

“At this point, our SSPs (syringe services programs) have a very limited budget,” Purington said of the program run by Tapestry since 1995.

Due to the federal ban, the program has cut one full-time outreach worker and a van. Two other full-time outreach staff lost their jobs as a result of state funding cutbacks, which also caused clinic hours to be reduced from 50 to 40.

“With people who are struggling with such a chronic addition, it’s really important to be there when they want the services,” Purington said. “If you wait 24 hours, their resolution to go into a program might have changed.”

Proponents also drive home the message that reversing the ban does not mean appropriating additional federal funds, but rather allowing local agencies already receiving these funds to use them as they see fit.

“An important thing to consider is that this costs zero,” Purington said. “We’re not saying to appropriate new funds for SSPs. We’re saying, allow the funds that the federal government is already spending to prevent HIV to be used for the most effective intervention that we have: syringe support programs.”

In the film, public health and law enforcement officials voice support for federal funding for needle exchange programs not only because they are more cost-effective than treatment in the long run. They also point to SSP’s ability to preserve public safety by keeping contaminated needles off the streets and to reach intravenous drug users with treatment options.

Given the overwhelming scientific support for such programs that backers cite, where is the opposition coming from and why?

“People raise concerns that SSPs could encourage drug use or lead to more crime in neighborhoods where the programs are located,” Collins said. “The evidence says something different.”

In the film, the police chief in Quincy agrees with Collins, saying, “A clean needle won’t lead someone to start using drugs who isn’t already.”

Closer to home, Purington contends that some who oppose lifting the ban do not base their opposition on science.

“It’s really a moral argument. They say, ‘You’re enabling drug users,’” he said.

Collins said his group plans to widely promote the video through Oct. 1 when Congress faces its deadline for the 2014 Appropriations Bill. He hopes to find help in that mission. “Any constituent can send it to their Congress member via the web,” he said.

Meanwhile, Purington is working on the state delegation, including Sen. Elizabeth Warren. “I’m very confident that Sen. Warren will be supportive,” he said. “I’ve met with her staff and given them lots of information.”

As for Tapestry’s moment in the spotlight: “It was fun,” said Purington of the filming in town last summer. “I was very impressed with the story. It did a great job of explaining what an SSP is and why your average citizen who has nothing to do with intravenous drug use should support it.”

Opposition to clean needles isn't even a "moral argument" at this point. Clean needles not only save lives of IV drug users, but may save the lives of, for example, the female spouse of an IV drug user or the child of a pregnant woman who is partnered with an IV drug user. To oppose clean needle programs is, if anything, immoral. Richard Brunswick, M.D., M.P.H.

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