Needle exchange: Boulder County approves first legal dirty-for-clean needle swap in the state

The Boulder County Board of Health formalized what had been a long-standing informal agreement between the syringe exchange program and law enforcement not to prosecute participants exchanging dirty needles for clean ones.

Denver could soon follow suit. In March, the city council amended a 1997 city ordinance allowing needle exchange programs to make it easier to operate them. At least one organization, The Harm Reduction Action Center, whose mission is to empower and advocate for injection drug users, has said it plans to apply to run a legal program.

In 2009, Westword profiled an underground syringe exchange in Denver called Underground Syringe Exchange Denver, or USED. That story included the history of syringe exchange in Colorado, including a recap of how the Boulder program came about.

For a while in the late 1980s and early '90s, it seemed that Colorado was on the cutting edge of harm reduction.

It started with Boulder County. In 1989, the county health department discovered that seven residents, all IV drug users, were HIV-positive. Six of the seven were married couples with children. At the time, Anne Guilfoile was in charge of AIDS prevention for the county. "It was a compelling story. We could diagram out these families and say, 'This is how many kids [are affected],'" she says now. "That was a different picture than what most people had in mind when they thought of drug users, and the consequences of doing nothing were really clear."

Guilfoile came up with three options: teach drug users to bleach their works, which wasn't 100 percent effective; push them into drug treatment, which was typically even less effective; or swap their dirty, potentially HIV-tainted needles for clean ones.

Guilfoile chose the third and suggested it to the public health director, Federico Cruz-Uribe, who, she says, took a deep breath and then started a campaign to get health workers, county commissioners, the Boulder Daily Camera and then-district attorney Alex Hunter on board. It worked, and after finding little public opposition, Boulder County started the state's first aboveground (though still illegal) needle exchange program, with Hunter agreeing not to prosecute its participants.

It started out small but grew steadily, thanks in part to a model that trains current and former drug users as volunteers who collect dirty needles and distribute clean ones. Today there are 82 volunteers, and program coordinator Kyla Holcomb estimates they exchanged 40,000 needles with 437 injection drug users last year.

Former public health director Chuck Stout, who replaced Cruz-Uribe in 1990 and retired last year, says that while the needle exchange used up 19 percent of the total spent on the county's drug-user disease-prevention program, "it probably accounted for 90 percent of the success. It was the clear, compelling statement to the injection drug user that I accept you where you are, and my sole intention is to keep you safe."

Now that important message is 100-percent legal.

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