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7.19.2016

Grant from M·A·C AIDS Fund Will Help Launch Needle Exchange Program

To help slow the spread of infectious diseases among intravenous drug users, the M·A·C AIDS Fund has awarded the University of Miami Leonard M. Miller School of Medicine a $100,000 grant to operate a needle exchange program that will be the first of its kind in Florida.

With the grant, the M·A·C AIDS Fund becomes a founding donor of the exchange since the passage of the Infectious Disease Elimination Act (IDEA), which was signed into law by Florida Governor Rick Scott in March after a five-year legislative battle inspired by former Miller School students.

The pilot program allows intravenous drug users to exchange used syringes for clean ones at specified clinics in different neighborhoods or via a mobile unit. Sharing used needles greatly contributes to the spread of HIV, hepatitis C, and other diseases, but researchers have found that needle exchange programs are effective in reducing the spread of disease.

“At our core, the M∙A∙C AIDS Fund is committed to confronting the HIV and AIDS epidemics in communities at the highest risk,” said Nancy Mahon, Senior Vice President for Global Philanthropy and Corporate Citizenship at The Estée Lauder Companies Inc. and Global Executive Director of the M∙A∙C AIDS Fund. “Needle exchange programs like this halt new infections, period. There is still work to do, but providing sterile syringes and supportive services to IV drug users is a solid step in order to begin saving lives.”

The bill authorizes the Miller School to conduct a five-year exchange program on a pilot basis within Miami-Dade County. The idea of providing clean needles in exchange for dirty ones is not a new one; the infection-control practice is already in place in 35 other states. Florida had remained one of only 15 states in the country without a legalized program, despite numbers that revealed a pressing need.

According to the Centers for Disease Control and Prevention, heroin use has not only risen sharply in Miami-Dade County, but Florida now ranks as the No. 1 state overall in new HIV infections. The state also has the highest number of chronic hepatitis C cases. Those unenviable rankings, combined with the success of similar exchange programs in other states, finally convinced Florida legislators to pass the bill allowing a pilot project at UM.

In addition to exchanging needles, participants will be educated on safer injection techniques and offered immunizations, as well as viral hepatitis and HIV testing. Other key activities will be to get the drug users into treatment and link those who test positive for HIV or hepatitis to health care – with the goal of reducing the spread of these diseases. Organizers are hoping to launch the project in October.

The program, tentatively named the IDEA Exchange, was developed by Hansel Tookes, M.D., M.P.H. ’14, a third-year internal medicine resident at Jackson Memorial Hospital, whose research inspired the initiative. Published in the journal Drug and Alcohol Dependence in December 2011, while a second-year medical student, Tookes found that the number of publicly discarded needles on the streets of Miami was eight times higher than in San Francisco, a city with twice the number of injection drug users and long-established needle exchange programs.

In 2012, Tookes and Chanelle Diaz, M.D., M.P.H. ’16 (a resident in primary care and social internal medicine at Montefiore Hospital), working with Marek Hirsch, M.D. ’13 (a psychiatry resident at Harvard South Shore), and Dyani Loo, M.D. ’13 (a psychiatry resident at the University of New Mexico), began advocating in Tallahassee. Tookes and Hirsch also wrote a supporting resolution for a statewide needle-exchange law that was adopted by the Florida Medical Association. The first bills were sponsored in the spring legislative session of 2013.

In 2015, Tookes and Diaz published the results of a second study in PLOS ONE, an online journal from the Public Library of Science. The report revealed the high cost to taxpayers when drug users are treated for infections resulting from the use of dirty needles — sometimes for weeks or months — as inpatients at Jackson Memorial Hospital.

“Dr. Tookes was extraordinarily persistent in pursuing the initiative to translate research findings to policy and practice for more than four years,” said José Szapocznik, Ph.D., Chair Emeritus of the Department of Public Health Sciences, Honorary Founding Director of the Miami Clinical and Translational Science Institute and Co-Director of the Florida Node Alliance, National Drug Abuse Treatment Clinical Trials Network at the University of Miami Miller School of Medicine.

Now that the bill has passed, Tookes will remain actively involved, and says there will be a need for public health and medical student involvement.

“The early investment in the IDEA Exchange from M∙A∙C AIDS Fund is a tremendous vote of confidence in the importance of the work we have done to get this legislation passed in Florida, and work we will do to ameliorate the devastating impact HIV has on our community,” said Tookes. “It is only with the support of philanthropic leaders such as M∙A∙C AIDS Fund that we will be successful in implementing and broadening our efforts.”

“Because the legislature does not permit the use of state or municipal funds, all the funds for the initiative will have to come from the private sector,” said Szapocznik. “We are grateful to the many individuals who have already stepped forward to support the establishment of Florida’s first syringe exchange program, and thus stop the spread of the epidemic among our more than 10,000 intravenous drug users.”
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