What is the Syringe Exchange Program?

Syringe exchange is a public health program for intravenous drug users.  It is an important component of a comprehensive set of programs designed to reduce the spread of HIV/AIDS and other blood borne infections among injection drug users, their families and communities.  The program provides new, sterile syringes in a one-for-one exchange for used, contaminated syringes.  Important risk reduction information is provided and a social worker is available to help drug users get into drug treatment and health care programs.  Other services include counseling and testing for HIV infection, immunizations, distribution of condoms and safe disposal of contaminated equipment.

Syringe Exchange Program

Location:  Cowlitz County Health Department

Hours:  Thursdays between 1:00 p.m. and 4:45 p.m.

Walk-in clinic is in the west corner behind the building.   

Related Health Department Web Links

• 2005 Syringe Exchange Program Annual Report

• Communicable Disease

• Hepatitis A

• Hepatitis B

• HIV/AIDS

• HIV/AIDS Case Management

• Sexually Transmitted Infections

Related Outside Websites

• CDC's Health Information Database

General Information:

• Harm reduction coalition

• North American Syringe Exchange Network

• Avert

• UCSF, Center For AIDS Prevention Studies

• Drug Policy Alliance

More detailed information:

• Harm Reduction Journal

• The Dogwood Center

Other sites in the Northwest:

• Tacoma-Pierce Syringe Exchange program

• Seattle - King Syringe Exchange program

• Blue Mountain Heart (Walla Walla and Columbia Counties)

• Portland:

• Outside In

• Multnomah County Health Department

• Harm reduction zone

Research:

• IDU-HIV Prevention: Syringe Exchange Programs

• Assessing & Improving Syringe Exchange Programs

• Syringe Exchange Programs: Lowering the Transmission of Syringe-Borne Diseases & Beyond

• HIV Prevention Programs & Policies Targeting Injection Drug Users

• IDU & Syringe Exchange Programs: Important Research for Your Community

• Needle & Syringe Exchange Programs: A review of the evidence

• Return Rates for Needle Exchange Programs: A Common Criticism Answered

• The Role of Needle Exchange Programs in HIV Prevention

• Why Syringe Access Programs?

• Syringe exchange not associated with social network formation: results from Baltimore

• Letter to the Honorable John P. Walters, Director, Office of National Drug Control Policy

• Needle Exchange Programs: Part of a Comprehensive HIV Prevention Strategy

• Research Shows Needle Exchange Programs Reduce HIV Infections Without Increasing Drug Use

• Legal Strategies for Syringe Exchange Programs

• Health & Human Services News

What services are provided by Health Department professionals for Cowlitz County?

• Discourages reuse, sharing and improper disposal of dirty syringes.

• Encouraging exchange of dirty syringes for clean ones.

• Providing assistance to access drug treatment.

• Promoting good health standards.

• Helping obtain medical coverage, dental care and survival essentials.

• Teaching how to avoid abscesses and exposure to communicable diseases.

• Providing Hepatitis A & B vaccines for clients.

• Instilling a sense of self-worth.

Accomplishments

Data from the Syringe Exchange program shows clear evidence that it is making important contributions to the public health of Cowlitz County and surrounding communities.  Since 2000, the program has collected over a half a million (590,863) dirty syringes and distributed slightly more clean syringes, keeping all members of the community safer from infectious diseases such as HIV and Hepatitis.  Although the program has not previously collected information that can be connected to individuals, which would allow us to report on the number of people served by the program, we can report that the program has served 4,105 visitors since 2000.  With upgrades to our data system, we will soon be able to more specifically describe the population of community members served by the syringe exchange.  The visitors to the program have received the following support and referral services:

• 3,010 referrals to drug treatment

• 2,986 HIV tests

• 29,548 condoms

Concerns

An independent panel convened by the National Institute of Health in l997 concluded that syringe exchange does not increase needle injecting behavior among current drug users and does not encourage others to begin using drugs.  More recent studies confirm these findings.  In fact, they show that syringe exchange programs attract injectors who are at high risk.  Syringe exchange programs encourage drug users to go into treatment and provide avenues for them to access treatment.

Legal Issues

The syringe exchange is legal.  The broad authorities of RCW 70.05.070 state, “The local health officer, acting under the direction of the local board of health, shall (3) control and prevent the spread of any dangerous, contagious or infectious diseases that may occur within his or her jurisdiction and (9) take such measures as he or she deems necessary in order to promote public health”.  The Cowlitz County Board of Health approved the syringe exchange on August 30, 1999. 

On May 7, 1991, Superior Court of Washington State to Spokane County and issued a case law decision that states:  “The Plaintiffs have the power and authority pursuant to the Constitution and statutes of the State of Washington, Article II, Section 11, RCW 70.05.060 and .070, and RCW 70.24.400 (3) (b) (v) (12), to take such measures as they deem necessary to control and prevent the spread of HIV infection within the jurisdictional boundaries of the Spokane County Health District including the needle exchange program provided for by the Plaintiff District’s resolution.”  Since this was a Washington State Superior Court decision, and not a municipal or district court, the ruling is generalized for other counties in Washington, to include Cowlitz County’s syringe exchange.

Legal Sale of Syringes at Pharmacies- see section(3) 

Risk Reduction Tips

• Never reuse or share needles, water or drug preparation equipment.

• Use a new needle every time you inject.

• Get new needles from a reliable source (pharmacy or syringe exchange).

• Use clean water.

• Use a new disinfected container ("cooker").

• Use a new filter ("cotton").

• Clean the injection site with an alcohol swab.

• Safely dispose of syringes after one use.

Needle Disposal Information 

• Purchase a SHARPS container at a local pharmacy.  

• Some pharmacies sell mailers to send back the needles to the manufacturer.

• Make your own container: Use a rigid plastic container such as a plastic milk jug, Purex jug or a plastic 2 liter pop- bottle with a lid. Put a label on the container that says SHARPS DO NOT RECYCLE - (see example)

• Ask the pharmacy if you can drop the SHARPS container you purchased from them at their site.

• Used needles disposed at no charge: Solid Waste Disposal Site. Located at 85 Tennant Way, Longview. Open 7 days a week 7:30 am to 5:30 pm.  You SHARPS container will not be returned to you.

•   IDU's can visit the Cowlitz County Syringe Exchange site at 1952 9^th Ave. in Longview 

• Thursdays - 1:00 pm to 4:45 pm to exchange dirty needles on a one-for-one basis.