Minnesota’s only needle exchange drop-in center closed its doors last week after more than a decade of helping drug users find treatment and prevent disease. The program, called Access Works!, fell victim to economic hard times and federal anti-drug policies.
Some of those policies, which ban the use of government funds to exchange used needles for clean ones, have recently been revisited by Congress and are the subject of a lively debate on Capitol Hill. But local needle-exchange activists say it is doubtful that congressional action will be able to save the struggling organization.
In 1996, Sue Purchase and Toni St. Pierre began a needle exchange out of the trunk of Purchase’s car. They called themselves “Women with a Point,” and their goal was to reach women who were using needles to inject drugs. With rapidly rising rates of HIV among injection-drug users, Purchase and St. Pierre gave women clean needles to help them avoid HIV and helped many of them — homeless and without resources — find support.
Those humble beginnings would grow to become Access Works!, a storefront needle exchange in Minneapolis’ Loring Park neighborhood.
For more than a decade — and until this month — the organization served people that many organizations would not: drug users, many struggling with lifelong addiction and homelessness. With a mission “to improve health and reduce harm to people impacted by the use of drugs through support, intervention, education, and disease prevention,” Access Works! traded used needles for clean ones, conducted HIV and Hepatitis C testing, taught overdose prevention, held support groups and connected users with chemical dependency treatment experts.
With minimal staffing and volunteer support, Access Works! exchanged nearly 400,000 needles last year.
Since the advent of needl-exchange programs in the state, Minnesota saw the number of people infected with HIV through needle use drop from 61 in 1992 to a low of 3 in 2005. In 2008, the most recent year for which data is available, Minnesota saw 13 cases of HIV where the route of infection could be traced to needle use — less than a fourth the rate seen in early- to mid-1990s.
Despite its apparent success, however, Access Works! went into hibernation on July 24. They will maintain their nonprofit status and website, but the needle exchanges and the services are discontinued.
Lauri Wollner, executive director, says the organization got hit hard in the economic downturn.
“All of the private funders we used to get money from are all broke,” she said. “We are definitely not a touchy-feely kind of social service as far as the public goes.”
Wollner says the nature of the work makes it hard to find private contributions, as donations to help people currently using drugs can be difficult to come by.
“Government funding is great, but it only pays for overhead,” says Wollner. “And overhead is about all the government will pay for.
Since 1988, Congress has added language to the Labor and Health and Human Services appropriations bill that disqualifies organizations from using federal funds for needle exchanges.
“The federal ban has had a long-term impact,” says Wollner. “We spend almost $40,000 a year on needles and about $5,000 a year on disposal [of used needles].”
President Obama and Democratic members of Congress said they wanted a repeal of the needle exchange ban, but the devil has been in the details.
As Mike Lillis at the Washington Independent reported last week, the House passed a bill that lifts the ban on funding needle exchanges, but the final watered-down bill will offer little help for programs like Wollner’s.
In the House bill, the restrictions are so tight that most needle exchanges in urban areas would essentially be unable to operate.
“[T]he bill … prohibits needle exchanges within 1,000 feet of universities, pools, parks, video arcades ‘or an event sponsored by any such entity,’” notes Lillis.
A Senate version of the bill retains the ban on needle exchanges. But needle-exchange supporters will have to wait until September when the Senate and House meet to reconcile the two bills. It’s during that process that ban opponents are hoping to remove the restrictions in the House bill and eliminate the outright ban in the Senate version.
Wollner says the economy was to blame for Access Works! closing more than any other factor. However, a change in federal funding policies could help several smaller exchanges currently being started by activists in Minneapolis, as access to social services money could open up if the ban is rejected by Congress.
For now, those that relied on Access Works! services will have to find help elsewhere.
“The impact has been huge already,” says Wollner. “People are sad and scared.”
Wollner said that because people generally showed up at Access Works! on a walk-in basis and many are transient, there’s no easy way to let people know where else to find services.
“There are few smaller exchanges starting up,” she said. “People just have to know to call around and ask their friends.”
She said even in the last hours of the organization, people were showing up. “Last Sunday I was in cleaning out the building, because we had to be out of there last week, and four people came by looking for exchanges.”
Without Access Works! Wollner said, “they are going to have to take care of each other.”
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