HEROIN DEATHS IN FORT COLLINS INSPIRE A NEED FOR NEEDLE EXCHANGE PROGRAM

With three reportedly heroin-related deaths in Fort Collins in the
past month, many have concluded that intravenous drug use is more
prevalent in Fort Collins than previously thought.

But even before those deaths, several Fort Collins local authorities
and a community support project have been on a collision course over a
plan to set up the city's first legal needle exchange. A coalition
spearheaded by the Northern Colorado AIDS Project says the reality of
drug use demands the program be implemented for health reasons.
Opponents of the plan are concerned the initiative would encourage and
facilitate drug use, and tarnish the image of the city.

In 2010, Colorado lawmakers added an exemption into the state's drug
paraphernalia law that allowed counties to legally adopt syringe
exchange programs. Boulder County jumped at the chance and now has
their program fully out in the open (it ran covertly for 22 years
prior to the law change), and Denver programs are following suit.

Larimer County was tipped as the next logical location for a Syringe
Exchange Program. But very little has happened thus far. There is no
official needle exchange, and public conversation around the topic has
been almost non-existent, some activists complain.

Jeff Basinger, executive director of the Northern Colorado AIDS
Project, has ideas why no one is talking.

"It's the attitude that drug use is bad," Basinger said. "Drug users
are bad, and if you provide a needle exchange for them, then the
problem is just going to get worse."

Basinger said for a needle exchange to become a reality, multiple
entities must be on board.

"We need approval from the local board of health, and we have been
hosting those conversations since July," Basinger said. "We've met
three times and provided them with information."

The Larimer County Board of Health's own strategy for 2011 includes a
goal to reduce blood-borne disease transmission among intravenous drug
users.

But another key player is Larry Abrahamson, the Larimer County
District Attorney, who has, according to Basinger, "philosophical concerns."

"The needle exchange program is primarily a Department of Health
initiative," Abrahamson said in a voicemail message. "Which is
basically more of a health concern than a public safety concern at
this point, so we are not taking any formal position."

The D.A. also believed Fort Collins' size didn't make it an obvious
target for the program.

"I think it's probably utilized more effectively in areas where they
have maybe a lot of hepatitis as a result of dirty needles or HIV
spread, or something like this, in larger jurisdictions," he said. "I
don't see necessarily that as an issue here. From our perspective it
hasn't risen to the level of a public safety concern that we would
necessarily be taking a strong stand on at this point."

All of this has lead to a situation that Basinger describes simply as
a, "political minefield." Pushed further, he explained that the needle
exchange debate illuminating issues that Fort Collins authorities seem
to be in denial about, such as, "social injustice, poverty, racism,
homophobia, drug use, homelessness, illiteracy. Poverty is over 20
percent in Larimer County, illiteracy is over one-in-five people, it's
insane. There are some real issues here in Fort Collins, but people
don't like to talk about them because it's such a fabulous place to
live."

An equally desirable place to live that does have a needle exchange is
just down the highway in Boulder. Boulder's needle exchange has been
running for more than 20 years and the city was the first in the state
to take advantage of the change in the law.

Carol Helwig, the Boulder County HIV/STI Outreach Coordinator, said
there are practical reasons why development of a program has been slow
in Fort Collins.

"First of all, the paraphernalia law has been there prohibiting
progress," she said. "And then after the change in the law it takes a
long time to build stakeholder support and to get all of your ducks in
a row. Getting on an agenda for a local board of health takes time,
it's a big process."

Boulder County also had the approval of the local district attorney
and other law enforcement entities, something Helwig saw as pivotal.

"We've benefited from their cooperation, support and understanding, "
Helwig said, adding that he also saw the court system in Boulder as,
"very progressive and not interested in prosecuting non-violent drug
offenses in a criminal fashion, but rather taking a public health
issue approach with the cases."

Helwig said people are already driving down to the Boulder needle
exchange from Greeley, Fort Collins and other northern Colorado areas.
Some of Helwig's clients took part in a focus group to discuss their
feelings about the service.

One said, "It's just an awesome program, I wish it could be everywhere
in every city. You can't stop people from doing what they're doing but
you can reduce the harm."

Outside Colorado, SEP (Syringe Exchange Programs) have been around
since the 1980s, and there is plenty of data available about them. A
report found on the Center for Disease Control website states, "An
impressive body of evidence suggests powerful effects from needle
exchange programs. Studies show reduction in risk behavior as high as
80 percent, with estimates of a 30 percent or greater reduction of HIV
in IDU."

According to the CDC, "the cost per HIV infection prevented by SEP has
been calculated at $4,000 to $12,000, considerably less than the
estimated $190,000 medical costs of treating a person infected with
HIV."

Advocates are sure to cite such statistics as they mount pressure on
the Larimer County Board of Health. Adrienne Lebailly, a board of
health member, said changes are coming soon.

"Probably early 2012 there will be some sort of decision," she said.
"We also have to consult with other entities, including the District
Attorney (Larry Abrahamson), aE& who would prosecute people charged
with crimes, along with local law enforcement. It's going to focus
more on the City of Fort Collins Police, rather than the County
Sheriff, as the NCAP offices are physically located within the City of
Fort Collins Police's jurisdiction."

Making matters more difficult for the NCAP program is the division
that exists on the board of health. Lebailly's prognosis wasn't good.

"I would say it's split, and I don't know how it's going to go."