Syringe Exchange in Western NC

The Needle Exchange Program of Asheville (NEPA) is North Carolina’s longest running syringe exchange program. Founded by Michael Harney and Marty Prairie in 1995, NEPA currently provides between 1500-2000 clean syringes a month to drug users and people without health insurance in Western North Carolina. The story of how the program started can serve as a resource to others who wish to implement syringe exchange programs (SEPs) in other parts of the state.

In 1993 Michael was hired as an outreach worker by Marty Prairie, former director of Project Safeguard at the Western NC AIDS Project. As he provided street outreach to people affected by HIV/AIDS, Michael noticed dirty needles being discarded in streets, parks and homes, creating a potential for accidental needle-sticks and the spread of diseases such as HIV and hepatitis. Michael mentioned his findings to Marty and they decided to look into starting a syringe exchange program in Asheville. Before they began, the two men traveled around the country to visit other SEPs and to learn how to run a successful program. The greatest lesson learned was how to reach out to law enforcement and the community in Asheville to gain public support.

“It’s important to build a case for these programs,” says Michael. “You can’t just come into a community and start sneaking around. Get on TV and radio; explain the biohazards of dirty needles in the streets. Show people that syringe exchange programs benefit neighborhoods and reduce drug use, HIV and hepatitis. I have people come to me not just for clean syringes, but for drug treatment referrals as well.”

Michael refers to studies such as a 2006 Institute of Medicine report that investigated whether SEPs encourage the use of drugs. The results showed that SEPs actually reduce community drug use, as well as lead to lower crime and lower incidences of HIV and hepatitis infections. Another Seattle study reported that SEP participants were 5 times as likely to enter drug treatment programs than nonparticipants.

Even many NC law enforcement officers support SEPs, despite their current illegality in NC, as SEPs are proven to reduce needlesticks to officers by 66%. “We’re honest with officers in Asheville about our program,” says Michael. “The officers appreciate the benefits of our effort to reduce crime, maintain cleaner streets and reduce potential needlesticks to them, so as long as we keep a low profile in the community and neighborhoods, they don’t interfere with this component of public health strategy.”

NEPA currently operates through mobile and secondary exchange. “I maintain the supplies,” says Michael. “People find out about the program through word of mouth. They call and leave a message and when I get home I call them back and ask what they need and where to meet up. The greatest challenge is consistency of service. Because the program has no staff or budget, it’s hard to get everyone the services they need.”

Sadly, Marty passed in 2001, but before he died, he requested that Michael continue the program after he was gone. Since then, between jobs as a prevention educator and street outreach worker for the Western NC AIDS Project and as a Spanish teacher, Michael makes time for syringe exchange not only to honor his great mentor and friend, but also because he sees the benefits of syringe exchange in his community.

“Syringe exchange is a vital part of health care that is missing,” says Michael. “People need to be educated on how to properly dispose of biohazardous material so we can curb the spread of HIV and hepatitis. Stigma against drug users is also part of the problem. If we address these issues we can raise the health index of our communities.”