Allegheny County Council, upset with its lack of involvement with the region’s sole needle-exchange program, rejected earlier this month a health-department bill that would put stricter regulations on the program, further lengthening a debate that started more than a year ago.
The program in question is managed by Prevention Point Pittsburgh, a small, privately funded organization in Oakland that has been running in accordance with Allegheny County Health Department guidelines since 2002. The organization swaps clean needles for dirty ones to help curtail blood-borne infections including HIV and hepatitis C, which can be spread when drug users share needles.
“Needle exchange is critical,” says Prevention Point Pittsburgh Executive Director Renee Cox. “The crux of our service is to keep drug users as healthy as possible until they can get help for their addiction.”
Since the spring of 2006, some members of county council have asked to play a more significant role in providing more stringent guidelines for the non-profit program, while others have questioned the legality of it altogether.
According to Allegheny County Councilor Mike Finnerty (D-Scott Township), chairman of Allegheny County’s Health and Human Services Committee, council’s unanimous vote on July 10 against the health department’s latest bill was not meant to outlaw the program; instead, it was just an attempt to restructure guidelines so that council can have more say in regulating it.
“We don’t have any problems with the way [the needle-exchange program] is operating now,” Finnerty says. “We’re not trying to put the needle exchange out of business. [Council] just wants to be more involved in the process.”
State law prohibits the possession of needles without a prescription. But health officials in Pittsburgh waived the law by declaring a “public-health emergency” in Allegheny County because of the “high rates of HIV and hepatitis C infection in injection drug users.”
In March 2006, county councilor Vince Gastgeb scrutinized the needle-exchange program. He proposed an ordinance suspending “any and all needle exchange programs” until their “effectiveness, legality and utility” could be proven.
Fortunately for Cox, Gastgeb’s ordinance hasn’t shut down the needle-exchange program. “Prevention Point Pittsburgh is still permitted to legally operate in Allegheny County,” says Guillermo Cole, public-information officer for the Allegheny County Health Department.
According to Cox, Prevention Point Pittsburgh sees about 80 to 100 drug users each week, and the program has registered about 4,500 drug users since 2002. Cox’s program also provides case-management services and crisis counseling. She says the group has referred more than 950 people to drug treatment since 2002.
“Until we can eradicate drug use, this is a life-saving intervention,” Cox says.
Finnerty says councilors and health-department officials will meet soon to rewrite regulations so that the bill is more inclusive of county council.
“Right now there’s no reporting back to council in the wording of the Allegheny County Health Department’s regulations,” he says. “We want to know what’s going on.”
According to Finnerty, council has only “minor issues” with the latest bill, including some concerns about possible expansion of the program. Under the rejected bill, “they could put a needle-exchange program wherever they wanted without notifying us,” Finnerty says. “I wouldn’t want a needle-exchange across the street from me.”
Finnerty says some councilors also “raised red flags” about secondary exchanges, a practice many needle-exchange programs — including Prevention Point Pittsburgh — promote. A secondary exchange is when someone picks up needles for drug users other than themselves.
Finnerty calls it “problematic.” Cox calls it necessary.
“Secondary exchange allows us to expand our reach to many more high-risk clients who can’t reach us directly,” Cox says. “We’re trying to get clean syringes in the hands of more people.”
Finnerty says he hopes council will vote on a new bill in late September.
Cox is not worried that the needle-exchange program will be axed after a new ordinance eventually passes, but she hopes new regulations will help settle some financial problems that plague Prevention Point Pittsburgh, which is funded mainly through donations.
“We face chronic funding issues,” she says. Unfortunately, her wish might not be granted.
“We don’t supply funds for the needle-exchange program at the moment, and we don’t anticipate supplying funds in the future,” Finnerty says.