CommunityCommunity

Pioneering needle exchange program reduces health risks

Two NEED volunteers wait for participants at the Long Haul’s site on Shattuck.  Photo: Namoi Nishihara
Two NEED volunteers wait for participants at the Long Haul community center on Shattuck Avenue in Berkeley. Photo: Naomi Nishihara

By Noelia González

Every week, at three different sites in Berkeley, volunteers set up a table with a few boxes of intravenous needles, some cotton and some disposal containers, and wait for people to drop by. They are part of a pioneering needle-exchange program the type of which, until 2000, was illegal in California.

In fact, Needle Exchange Emergency Distribution (NEED), a nonprofit that seeks to reduce infectious disease risks for East Bay intravenous drug users, was born a decade before such programs were legalized, as an underground program run by HIV positive people, people in recovery, and health activists.

NEED is one of 37 programs in California that provide syringe exchanges to reduce harm among drug users in the state. All of them are based on the premise that using clean needles and syringes reduces the risk of HIV, AIDS, and hepatitis C infection.


NEED’s volunteers carry the materials for the needle exchange program in their van. Photo: Namoi Nishihara
NEED volunteers carry the materials for the needle exchange program in their van. Photo: Naomi Nishihara

The nonprofit operates in Berkeley with three giveaways a week – on Tuesdays, Thursdays and Sundays. The volunteers carry supplies in a recently painted black-and-white van and set up at sites including the Long Haul community center on Shattuck Ave. and across the street from the Berkeley Free Clinic on Durant. The agency also does on-foot outreach, distributing supplies at People’s Park and around Telegraph Avenue, for one hour a week.

Along with needles and syringes, the volunteers also have available cotton, disposal containers, socks, and naloxone, an opioid antagonist used to counter the effects of a drug overdose. NEED stores its supplies at the Berkeley Free Clinic, a collective that is also staffed completely by volunteers.

At least two volunteers run the weekly sites, where they distribute clean supplies without asking for dirty needles, as most programs do. However volunteers’ coordinator Olivia Horan said they do encourage participants to bring in used needles. The rate of syringe return from July to December 2013 was 52%, according to NEED data.

“Everything is done anonymously; we don’t ask for their names,” said Horan. Yet volunteers do try to keep records of background information, such as age, ethnicity, gender and zip code. If clients are homeless, they give the zip code of the Berkeley Free Clinic.

Participants come from Richmond, Oakland, Albany, Vallejo and other neighborhoods, especially if they do not have access to a needle exchange program where they live. People also travel from far away because they do not need to bring used needles and syringes. They later exchange those supplies in other programs, explained Ryan Wythe, volunteer and president of NEED.


The giveaways draw “all different types of people,” Horan said.

But the majority of the people who make use of the program are white (70%), male (74%) and come from around Berkeley, according to NEED’s latest report, using data gathered from July to December 2013.

“Society informs us of what a drug user should be, but there’s no such thing,” said Horan, who added that she learned that first-hand after running her first site last summer.

Volunteers help the participants to choose which needle and syringe is more adequate for them.  Photo: Namoi Nishihara
Volunteers help the participants to choose which needle and syringe is most appropriate for them. Photo: Naomi Nishihara

In fact, it’s not only drug users who participate. People who suffer from diabetes also make use of the program, as well as parents who exchange the needles for their sons or daughters, who may be uncomfortable with coming to the sites, said Wythe.

“I remember the first day working with [NEED’s volunteers],” said Scott Carroll, a member of Berkeley Free Clinic’s board of directors. “It was a Thanksgiving,” he recalled. Carroll was surprised when he saw a whole family arriving to the site to accompany the son, who was around 18. “It was nice to see there are services that support people who have that in their lives,” Carroll said.


Berkeley Free Clinic provides NEED with a storage place, as well as with containers for disposal. “You can’t imagine how many needles and how much material they need to do this exchange,” Carroll said.

About 450,000 syringes were distributed at the three sites in Berkeley, according to NEED’s report for the most recent fiscal year ended June 30, 2014.

Although NEED does not have HIV and hepatitis testing or vaccination services, it works closely with the Berkeley Free Clinic to ensure people get tested, especially on Sundays, when they install the site right across the street from the clinic on Durant Avenue.

Alameda County had 10,506 people living with HIV or AIDS as of June 2014, according to the most recent data from the California Department of Public Health. Berkeley accounted for about 8% of both HIV and AIDS cases in Alameda County.

For the entire state, intravenous drug use was the cause of 6% of total HIV cases, and 10% of the total of AIDS cases, according to the same report.

“We don’t have the capacity to track the HIV status of people who come and exchange with us,” said Wythe. He added that NEED uses data from the California Department of Public Health (CDPH) to justify the level of service that the nonprofit proposes.

But although CDPH’s Office of AIDS and the White House agree that needle exchange programs give “more opportunities to stop the spread of HIV and other infections among injecting drug users,” according to the government’s website, the use of federal funds to buy needles for exchange programs has been banned in the United Stated since the 80s.

The Obama Administration was able to get the ban reversed in 2009, but Congress reinstated it within about a year. During that window, Wythe said, there was “not enough time to have a plan of action to say how federal funds could be used.”

Apart from needles and syringes, the sites provide the participants with other materials.
Apart from needles and syringes, the sites provide the participants with other materials. Photo: Naomi Nishihara

As a way of supporting this kind of program indirectly, the Office of AIDS in the Alameda County Department of Public Health gets federal, state and local funding and then contracts with local agencies, according to director Keith Waltrip. The office has been helping to fund the Oakland-based nonprofit HIV Education and Prevention Project of Alameda County (HEPPAC), for example.

Meanwhile, NEED receives funding from the City of Berkeley and different donors. It also receives in-kind donations – from latex gloves to socks — and also applies for various grants.

This year, NEED was awarded a two-year grant by the Elton John AIDS Foundation, administered by AIDS United. That means the nonprofit will have $28,000 per year  — a total of $56,000.

Despite financial struggles in past years, site coordinator Skye (who asked that only her first name be used) said this year has been better in terms of funding, “so we were able to expand our program.”

But it hasn’t always been that way. Until 2009, NEED had paid staff, but funding cuts led to the elimination of paid positions and the nonprofit became an all-volunteer agency, said Skye.

Skye is a former client of a needle-exchange program and she eventually stopped using drugs. “I felt really grateful that that service had such a huge impact in my life,” she said. Skye is now an undergraduate student at UC Berkeley studying social welfare.

“I really wanted to be part of a group of people who really care about building healthier communities and practicing harm reduction,” Skye said.

Like the other volunteers at NEED, she divides her time between several responsibilities. Volunteers’ coordinator Horan also works as a counselor at a drop-in center for the homeless, and NEED’s president, Wythe, is also a consultant at Resource Development Associates, a consulting firm devoted to social and economic justice, where he focuses on the implementation of mental-health programs.

But all the volunteers agreed that goodwill is not enough. “Without federal funding for needle exchange, many programs do not have the kind of stability we need to make a broad, consistent impact in improving our communities’ public health,” said Skye.

Noelia González is a health reporter at UC Berkeley Graduate School of Journalism.

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