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Needle exchange program begins with few takers By Peter Wong of the Mail Tribune After its noisy birth more than two months ago, Jackson County and a local drug treatment agency have quietly begun a needle exchange for intravenous drug users. The program, which county commissioners approved on a 2-1 vote Oct. 20, began without fanfare at the end of December. "We have given out a few, but not many people have turned out," said Hank Collins, county health and human services director. "We hope the word will spread." He said one site for weekly exchanges is on private property in west Medford, and the program is seeking other sites in White City and Phoenix or Talent. He and others involved said that disclosing more details would deter some of the people they are trying to reach. The program seeks to reach addicts by word of mouth, for instance asking clients of drug treatment programs to spread the word. The county is running the program through OnTrack Inc. of Medford, which counsels and treats people for alcohol and drug abuse. Because of a federal ban that dates back to 1988, the county itself cannot run a needle exchange program because it receives federal grants. The program involves two workers from each agency. "Our intermediate goal is to reduce harm," said Rita Sullivan, OnTrack's executive director. "Our ultimate goal is to get the people engaging in that behavior (drug usage) off the streets and into treatment." She referred to the health of intravenous drug users -- and innocent bystanders -- who risk infecting themselves by using or touching contaminated needles. Among the infections people can get from blood from contaminated needles are hepatitis C and the human immunodeficiency virus (HIV), for which there are no cures. Though the program drew criticism before commissioners approved it for a two-year trial, it actually is an extension of what OnTrack already has done. That effort, which goes back a decade, did not involve needles for intravenous drug users. But workers offered them packets containing bleach for them to sterilize needles and information about how they should protect themselves against infection and where to obtain treatment for their drug addiction. Sullivan said the original effort aimed to thwart the spread of HIV among intravenous drug users and their sexual partners. HIV causes acquired immune deficiency syndrome (AIDS), which robs the body of its natural defense against disease. "I think it was very successful, based on the number of people who have entered treatment as a result of those contacts on the street," she said. "We have had an interest in that kind of outreach since then -- and we have learned a lot about how to do it safely." Collins said participating workers, including volunteers, must be immunized against hepatitis A and B, work in pairs, and dispose of used needles in special "sharps" containers without touching the needles. The new program includes a clean needle, which is exchanged for a used needle, as well as information about infection and treatment. Workers will ask new clients whether that information led to their decision to seek treatment. Officials are consulting with focus groups consisting of addicts and former addicts, as well as methadone program clients making the transition from heroin addiction. The groups advise health officials about types of needles and times and locations of distribution. Sullivan and Vicki Barbour, manager of the county public health division, said the groups also raised concerns about potential police involvement. Some of the used needles have residue of illegal drugs and could subject those exchanging them to prosecution. "They were concerned that it not be a setup for police," Barbour said. "Through other people, we are reaching some people who themselves are not comfortable coming in. But we definitely have more work to do in getting the word out." Sullivan said OnTrack workers have established relationships and built trust with a number of intravenous drug users. "We have to keep a low profile and not put the consumers in the limelight," she said. "They have to know who you are and you have to build a relationship with them. We feel that because we are connected with a treatment program, we can encourage those relationships." Barbour said health officials met with the sheriff, district attorney and police chiefs to discuss their intentions. "In other communities, it has been their experience that there has not been a lot of harassment" from police, she said. The needle exchange program in Jackson County is one of nearly 100 nationwide. The first one began in 1988 in Tacoma, Wash., also headquarters for the North American Syringe Exchange Network, which links programs in the United States and Canada, and which is supplying the needles for the local program. Intravenous users of illegal drugs have been targeted for such programs because of the rising incidence of hepatitis C, which damages the liver and cannot be cured. The number of Jackson County residents testing positive for hepatitis C antibodies during the first half of 1999 jumped 300 percent over the number for the same period in 1998. The cost of a needle exchange program has been estimated at $9,400 for each infection prevented, far less than the $119,000 estimated for the lifetime care of someone infected with hepatitis or HIV. "From my perspective, the saddest thing is that we are finding infection in more and more people who have many years of recovery behind them," Collins said. "Only now are they being diagnosed with hepatitis C." 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