Bexar County is set to become the first in Texas with an official needle exchange program, made possible by $80,000 approved by Commissioners Court on Tuesday for the fiscal year 2019-20 budget.

For the next four months, the Joint Opioid Task Force, a City/County collaboration to reduce the number of drug overdose deaths in the greater San Antonio area, will develop program parameters. Funding becomes available Oct. 1. 

Bexar County Judge Nelson Wolff said lack of support from the district attorney’s office is what previously prevented the development of a needle exchange program, which the County has had the legal authority to implement since 2007 as part of Medicaid-related legislation passed that year by the Texas Legislature.

“When Susan Reed was district attorney, she would hold needle distributors criminally responsible, and with Nico LaHood, he said he supported it but there were too many revisions he needed us to make and it became too complicated to implement,” Wolff said. “Now with Joe Gonzales, we have full support in implementing this program, which will save taxpayers a lot of money.”

Providing sterile needles to intravenous drug users helps stop the spread of disease and cuts down on costs associated with treating people who have contracted HIV/AIDS or hepatitis C, which Wolff said can cost up to $300,000 to treat.

“One of the arguments against needle exchange programs is that it promotes drug use, but the fact of the matter is that they are going to do it anyway, and they may do it with a dirty needle that causes an infection and then the situation becomes much worse,” Wolff said.

Addiction specialists and others had quietly been exchanging needles with drug users while trying to avoid law enforcement until May 2018, when “underground” syringe exchange programs were encouraged to go public with their operations and promised by City and County officials that they would not be prosecuted.

T.J. Mayes, Opioid Task Force chair and junior partner at Phipps Deacon Purnell, which filed a lawsuit against pharmaceutical opioid manufacturers and distributors on behalf of the County in May 2018, said the needle exchange program “aligns with the broader health goals in the community.”

“San Antonio was recently found to have a dramatic spike in HIV diagnoses, and one of the primary risk factors for HIV is needle sharing,” Mayes said. “Not to mention the toll opioids have taken locally,” with almost a third of the state’s cases of neonatal abstinence syndrome, a disease in which babies are born with opioid withdrawal because of their mother’s opioid use during pregnancy, happening in Bexar County.

Bexar County also has the third-highest rate of opioid-related drug overdose deaths per capita in the state of Texas, Mayes said.

The majority of the $80,000 will go toward purchasing “harm reduction” kits –  syringes, saline solution, cotton balls, and alcohol swabs – to give to local nonprofits, health care providers, and helping organizations for distribution to drug users.

“They authorized $80,000, but we might not spend that much. It just depends on the protocol we develop over the next four months and what we determine is the best way to roll this out,” Mayes said.

Wolff said he and the Commissioners Court view the needle exchange program as a pathway to treatment for local drug users.

“This program will allow us to make contact with these users on a positive basis so we can then try to get them into a drug treatment program,” Wolff said. “We want to convince these people there is a better way, and a first step to that is providing clean needles so they have a chance.”

Roseanna Garza reports on health and bioscience for the San Antonio Report.