Delaware's needle exchange program gives consistency amid turmoil

People walking through Wilmington's Hilltop neighborhood sought out the unmarked black van parked at Third and Delamore and the man seated inside. 

There, that man – Andre Rider – asked the same series of questions to everyone:

Has anything changed with your health? Have you had an overdose or witnessed one? Have you come into contact with police since we last saw you?

The one question he doesn't have to ask is whether or not they're still using drugs with a needle – it's the very reason so many people seek out him and his colleague, Tom Bell, every Tuesday.

The two are outreach workers for Brandywine Counseling and Community Services' Syringe Services Program, which allows those with addiction to exchange used needles for clean ones.

It's the only program in the state authorized to operate an exchange and it is a harm reduction tactic aimed at keeping HIV and hepatitis C rates lower in a state ravaged by the heroin and opioid epidemic.

"It's helping keep people alive until they're ready to seek the treatment that they need," said Brandywine's CEO, Dr. Lynn Fahey. "Not everyone is ready at the same time."

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Every person coming into contact with Bell and Rider are reminded of treatment options. They are told what time the clinic on Lancaster Avenue opens, handed pamphlets on local resources and encouraged to ask for help when they need it.

But still, the men typically see the same clients every week. 

One young woman said she comes every Tuesday, relying on the van to supply her with clean, safe needles. She recognizes the men and smiles at them, flashing a shy, toothy grin.

Already this year, Brandywine Counseling has collected more than 92,700 syringes statewide. It operates two sites in New Castle County every day, along with locations in Kent and Sussex counties on Monday.

The program expanded in March 2016 to serve downstate Delaware, which has long lacked services, especially in its most rural locations. Treatment providers have worked to expand services there, but the need remains high, especially after Brandywine Counseling saw a cut in state funding for the needle exchange program this year and no new dollars toward the downstate expansion.

The Syringe Services Program costs just over $200,000 a year – one-third of what it costs to treat just one HIV case for a lifetime, according to the organization.

In these southern locations, Brandywine Counseling uses an RV to offer mobile HIV and hepatitis testing, overdose education, syringe exchanges and pregnancy tests. Many women who use aren't aware they're even pregnant, Fahey said, largely because using opioids and heroin can throw their menstrual cycles out of whack.

Offering that service in New Castle County has been thwarted as of late since Brandywine Counseling no longer has a vehicle with a bathroom in it. Using an RV in Wilmington also isn't feasible due to street parking in the city, which has left the program "limping along."

Fahey is hopeful that fundraising for a new vehicle will soon allow them to again offer pregnancy testing when doing outreach in New Castle County, as well as more private spaces for rapid HIV testing.

It will save lives – and, in the long run, healthcare dollars spent on treating HIV and hepatitis patients, she said.

"Many people aren't necessarily ready for treatment but we're constantly saying 'Well, when you are, we're here. We can get you connected,'" Fahey said. "They've taken people straight to treatment from the streets when necessary."

So far this year, the state has lost at least 230 people to drug-related overdoses, and toxicology reports yet to be completed could increase that number after the calendar year ends, according to the state.

To help prevent more deaths, outreach workers are stocked with naloxone, the overdose-reversing drug that was used 2,334 times last year by emergency responders. The goal is to arm as many people as possible with the medication in hopes of saving lives, said Adam Smiley, supervisor of the syringe program.

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The exchanges sites – marked by little else than a sandwich board with the organization's name and number – are safe spaces for those using intravenous drugs. 

And they are also places to see familiar faces.

Bell remembers what it was like to struggle with his own addiction in Wilmington's West Center City neighborhood. It's a battle he's overcome, and an experience he now uses to help others.

"It's like a T-shirt I wore once that just don't fit no more," Bell said. 

Crouched in the back of Brandywine Counseling's van, he assembled packages of clean syringes, safe injection materials like bleach and alcohol wipes, and other necessities like condoms and lubricant. These packages keep people safer during their drug use, and it's clear from the way Bell speaks with people that he wants to see them get better.

One man got a hug and a thump on the back from Bell. Another got a big grin and a wave.

A woman, who the workers immediately recognize walking up the street, greeted the men with a smile. Her request for new syringes is filled quickly and she rattles off answers to Rider's questions while chatting with Bell. 

Before long, she tucked the clean syringes into a black, plastic bag, scooping them under her arm and hastily walking away.

She would be back, she told the men – same time, same place, next week.

And they will be there.

Contact Brittany Horn at (302) 324-2771 or bhorn@delawareonline.com. Follow her on Twitter at @brittanyhorn.

Where to exchange syringes

Monday

New Castle County: 10 a.m. to 12 p.m., BCCS Drop-In Center, 2713 Lancaster Avenue; 3 to 5 p.m., C & Townsend streets, Wilmington.

Kent County: 2 to 4 p.m., 211 W. Division St., Dover.

Sussex County: 10 a.m. to noon, 547 N. Bradford St., Seaford. 

Tuesday

10 a.m. to noon, Third and Delamore streets; 2 to 4 p.m., Sixth and Madison streets, Wilmington.

Wednesday

Noon to 2 p.m., Fifth and Harrison streets, Wilmington; 3 p.m. to 5 p.m. Brown-Burton Winchester Park, commonly known as Speakman Park, at 30th and Church streets, Wilmington.

Thursday

1 to 3 p.m., Christina Park, Third and Church streets; 6 to 8 p.m., Fifth and Harrison streets, Wilmington.

Friday

10 a.m. to noon, Eighth and Church streets; 1 to 3 p.m., 14th and Northeast Boulevard, Wilmington.