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In South Florida, decades-old laws restrict access to clean needles
  Skyler Swisher and Brittany WallmanContact ReportersSun Sentinel
Dec 16 2016
In Palm Beach County, customers can buy syringes without a prescription.
But that's not the case for the rest of South Florida. A pair of 46-year-old ordinances in Broward and Miami-Dade counties require a prescription to purchase needles.
When adopted in 1970, supporters viewed the ordinances as a way to keep syringes away from drug users, but over the years, attitudes have changed. Broward County Mayor Barbara Sharief said she thinks it might be time to rethink those rules, and the head of the county's pharmacy association would also like to see the law repealed.
"It's a piece of antiquated law that needs to go," Sharief said, adding she plans to talk with county staff about changing the rules.
Miami-Dade spokesman Michael Hernandez said he's not aware of any efforts underway in his county to loosen restrictions on needle sales.
As a matter of policy, providing needles to addicts shouldn't be a crime, said Chris Beyrer, associate director of the Johns Hopkins University Center for AIDS Research. In Baltimore, Health Department vans canvass the city and pass out needles to drug users. Beyrer credits the program with preventing new cases of HIV and hepatitis C in Baltimore, along with helping to get dirty needles off the streets.
Instead of stopping drug use, laws restricting the sale of syringes force addicts to share needles, spreading HIV and hepatitis C, said Justin Kunzelman, who founded West Palm Beach-based Rebel Recovery, a group that supports harm reduction efforts. As the nation's heroin epidemic worsens, the problem will only get worse, he said.
"South Florida is still 20 years behind everybody else," Kunzelman said. "We are trying to allow for people to exchange needles. They are just using dirty needles. If one addict has that needle they are using that needle for everybody. It's pretty hard to find an ex-IV drug user who hasn't been exposed to hepatitis C."
A needle-exchange program started operating earlier this month in Miami. Yet, selling a syringe to someone without a prescription in Miami-Dade County is a criminal act punishable by a $500 fine or up to 60 days in the county jail.
The Centers for Disease Control and Prevention released a report last month touting the benefits of distributing clean needles to addicts. CDC Director Tom Frieden said studies have shown clean-needle programs, where addicts swap used needles for sterile ones, prevent disease and lower health care costs.
A lifetime of HIV treatment costs about $400,000, according to the CDC. [from Jules: likely a cost figure not including costs to care and treat comorbidities, only for ARTs& care for HIV.
About 9 percent of new HIV infections nationwide - more than 3,000 cases a year - involve people who inject drugs, according to the CDC. The latest surveillance report from the CDC shows that the Miami metropolitan area leads the nation in new HIV diagnoses per 100,000 people.
New HIV cases soar in Florida - july 2015 - The number of reported HIV cases in Florida has jumped 23 percent so far this year, the biggest increase in a continuing upward trend that began in 2012 after several years of decreases. And the proportion of Floridians infected with the disease is at its highest in seven years. Experts say the reasons include a decreased fear of dying from AIDS, subpar attempts at safe-sex education and disease prevention, and increased use of injected drugs such as heroin. Since hitting a low of 4,512 new HIV cases in 2012, the number of new cases in Florida rose 18 percent in 2013 and 11 percent in 2014. There are 3,555 new cases so far in 2015, a 23 percent increase from the first six months of 2014 to the first half of this year. According to the U.S. Centers for Disease Control, the annual cost for treating a single case of HIV is more than $25,000. With HIV-positive people now living longer lives, that means the cost over a lifetime can come close to $1 million. The most common way in which the disease is contracted is still through male-to-male sexual contact, according to the state health department. That accounted for 78 percent of all new cases in Florida in 2014, a percentage that has risen significantly since 2012, which keeps with national trends. On the other hand, the percentage who contracted HIV from intravenous drug use rose slightly from about 5 to 7 percent in Florida between 2012 and 2014.
Hepatitis C infections have jumped by 150 percent in recent years, driven in part by rising intravenous drug use, the CDC reports.
Pharmacists in Broward County also would like to see the ordinance repealed, said Dr. Aneesh Lakhani, head pharmacist of Garden Drug Pharmacy in Fort Lauderdale and director of the Broward County Pharmacy Association. Addicts just have to drive across the county line to buy what they want.
Meanwhile, Lakhani said, the ordinance prevents him from selling syringes to snowbirds and tourists with diabetes who are unaware of Broward County's rules.
"We are such a travel destination," he said. "I get someone about once a month. They have forgotten their syringes and can't buy them at the pharmacy."
That was the rationale of repealing Palm Beach County's restrictions on syringe sales. Hoping to crack down on drugs, commissioners passed an ordinance in 1982 requiring a prescription to buy needles.
Two years later, they voted to repeal the ordinance because of concerns that the restrictions were stopping legitimate patients from getting the medicine they need.

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