Starting a needle exchange program

[jaw93]

Hi all!

Im an MS1 looking to get involved in my new city. Addition and recovery services is something really close to my heart. I want to get involved and an area that interests me is a needle/syringe exchange program. The city that my school is in has a high homeless and drug use population and I feel like there is a need for preventative measures for addicts.

I was wondering if anyone has any experience starting an exchange program? ideally I would like to work with my university hospital because I know they don't have one but there are also many homeless shelter and low income clinics that I feel could reach at risk populations.

If any one has any advice it would be greatly appreciated. I hope this doesn't sound like a naive MS1 trying to bite off more than they can chew. I would like to work to help people in an area that has personally affected. Dealing with addiction in my family was one of the main motivators for me pursuing medicine and I feel fortunate to be in med school and would like to give back.

I look forward to hearing any feedback!!

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[Psai]

I'd see if there are any ID, primary care or EM docs interested in this topic and bring it up with them. Maybe you can get departmental support for your project and some money/manpower.

 

[jaw93]

I'd see if there are any ID, primary care or EM docs interested in this topic and bring it up with them. Maybe you can get departmental support for your project and some money/manpower.

I would love to do it through the emergency medicine department because I have an interest in EM and I've gone to a few EMIG events. I'm just not sure if there is a certain person (department chair etc.) that I should try first or just do a shotgun approach and seeing if there is any interest

 

[Psai]

Look at their website first and see if anyone published in that area or mentioned it. Then shoot them an email

 

[masaraksh]

eventually they'll come in for a 150k valve replacement and 6wks of vanc/amphoB and get a lot of clean needles.

 

[jaw93]

Haven't started one but have worked on one. Definitely a great idea in theory, but depending on where you live and the level of support you'll get from physicians/departments you want to work with, it might be more difficult than you think to get this rolling.

I'm sure you are aware of this part, but a needle exchange is more than just having needles to give out - you need qualified people to staff the exchange; resources to refer clients to or provide counseling, detox/rehab, medical care, etc.; continuous data collection and analysis, maybe some HIV testing available; etc. And of course, all this costs money. It's a lot to set up.

Congress just recently lifted the ban on federal funding for needle exchanges, and even now they only cover some of the costs, e.g. will pay for staff and counseling but not actual needles. In many (typically conservative) states/cities local funding is hard to come by as well, so you might need to rely on donations to keep it running. It can be tough to get grants to do stuff when it can't be sustainable in the long run (i.e. when you can't make enough money off it to keep it running after the initial influx of cash to get it started).

All that said, I don't think any of that makes it not worth doing. You'll just need some heavy hitters on your side to get it going. Good luck!

Thank you, wonderful insight!

My idea is to offer at least literature or counseling on proper needle care and information on what services are available for testing, rehab and detox. While I certainly support clean needles for disease prevention, ideally I would like to be able to impact the underlying addiction as well. Needle exchange is a way to reach people who may be in need of additional services and care.

In my research I did see the removal of the federal ban. I live in NY which supports NEPs. I think the largest barrier will be finding a qualified provider to oversee the operation because that is a requirement in NYS. There are addiction specialists who I am currently contacting who may be willing to help or at least point me in the right direction

Thank you for the information and kind words. It will be tough, but its not an impossible goal.

 

[cbrons]

Thank you, wonderful insight!

My idea is to offer at least literature or counseling on proper needle care and information on what services are available for testing, rehab and detox. While I certainly support clean needles for disease prevention, ideally I would like to be able to impact the underlying addiction as well. Needle exchange is a way to reach people who may be in need of additional services and care.

In my research I did see the removal of the federal ban. I live in NY which supports NEPs. I think the largest barrier will be finding a qualified provider to oversee the operation because that is a requirement in NYS. There are addiction specialists who I am currently contacting who may be willing to help or at least point me in the right direction

Thank you for the information and kind words. It will be tough, but its not an impossible goal.

First off, you mean qualified physician (not provider, which is a political word). Second, its "close to your heart"?

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[jaw93]

First off, you mean qualified physician (not provider, which is a political word). Second, its "close to your heart"?

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The law, as I understand it, states that someone with the authority to prescribe or distribute hypodermic needles can oversee the program. I believe that NPs and pharmacists have that authority so I stand by the term "provider."


Drug addiction and recovery is something that has personally affected me. Some one in my family struggled with a heroin addiction. It was a challenging time for me and my family, and was one of the driving motivators for me entering medicine. Helping those who struggle with addiction and recovery is something that is important to me. Not every social and cultural problem has affected me so intimately so I would describe it as an issue that is close to my heart.

 

[cbrons]

The law, as I understand it, states that someone with the authority to prescribe or distribute hypodermic needles can oversee the program. I believe that NPs and pharmacists have that authority so I stand by the term "provider."


Drug addiction and recovery is something that has personally affected me. Some one in my family struggled with a heroin addiction. It was a challenging time for me and my family, and was one of the driving motivators for me entering medicine. Helping those who struggle with addiction and recovery is something that is important to me. Not every social and cultural problem has affected me so intimately so I would describe it as an issue that is close to my heart.

So you are going to ask an NP (who requires physician supervision in New York) to unilaterally oversee your hypodermic needle program? Ever consider the liability their supervisor takes on?

 

[jaw93]

So you are going to ask an NP (who requires physician supervision) to unilaterally oversee your hypodermic needle program? Ever consider the liability their supervisor takes on?

No, you are probably right I won't ask an NP. I have much greater access to physicians at my university. But for the sake of completeness, NP is an option.

Also, more and more states are allowing NPs to practice and prescribe independent of physician oversight. Last time I saw it was 21 states

 

[cbrons]

No, you are probably right I won't ask an NP. I have much greater access to physicians at my university. But for the sake of completeness, NP is an option.

Also, more and more states are allowing NPs to practice and prescribe independent of physician oversight. Last time I saw it was 21 states

New York aint one of those states bud. Most of the states that do have very few doctors available, and it is not safe for NPs to practice without supervision.

 

[jaw93]

New York aint one of those states bud. Most of the states that do have very few doctors available, and it is not safe for NPs to practice without supervision.

You are right NYS doesn't allow independent NP practice. Debating the benefits and downside of NP independence doesn't help me further my project and isn't something I'm interested in doing

 

[cbrons]

Calm down, dude. I know this is one of your pet issues but there's no need to get worked up about a single word in OP's post they probably used without a second thought and has hardly any bearing on what they're trying to get out of this thread.