One possible reason is the University of Miami’s syringe exchange program. Green-lit in December 2016, IDEA Exchange is the only legal exchange program operating in the state of Florida. “The fact that we’re here is effective,” says Emelina Martinez, who has worked as an outreach coordinator for IDEA Exchange since it started. “We’d be more effective if we could work outside of Dade County, but the law prohibits us from doing so... We have people who come in from the Keys, Tampa, Fort Myers, Naples, you name it. They’re coming in just to try to get needles.”
IDEA Exchange is a one-to-one needle exchange program, which means participants must bring in needles to get new ones. The program has received over 170,000 needles since opening. “They should’ve done it a long time ago,” says a 33-year-old woman who has participated in the program since its start and asked not to be named. “It would’ve saved a lot of lives. People close to me — it would have been that simple.”
The woman, who learned of IDEA through a New Times article, says several close friends who overdosed might have survived if help were offered earlier. And the woman might not have contracted hepatitis B. "Before, I would have to buy needles," she says. "Now I don’t have to. I don't reuse them, and it’s a lot safer."
The program has distributed more than 1,000 doses of naloxone, an overdose-reversing drug, and provides free hepatitis C and HIV testing. “I think that has, in a collateral kind of way, impacted and decreased the number of overdoses you see in Miami,” outreach coordinator Eddy Suarez says, adding that participants "take care of each other on the streets.”
In 2015, there were 228 needle exchanges operating across 35 states, but none in Florida. Though the federal government doesn't pay for needle exchanges, private sources funded those programs. Florida, however, has lagged behind. It took advocates at the University of Miami four years to convince the legislature to allow them to test-pilot IDEA Exchange in Miami-Dade.
Earlier this year, advocates tried to get the program statewide, but the measure failed, even after it was limited to Broward and Palm Beach counties. "Everybody was onboard until it got to the House," Martinez says. "It [failed] by one vote... Hopefully next session they’ll be onboard.”
The evidence of a drop in opioid deaths is firm. The first six months of 2017 saw 177 fewer deaths due to heroin, fentanyl, and morphine use than the last six months of 2016.
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According to IDEA Exchange, participants have brought in 11,000 more needles than the program has distributed. “They pick them up on the streets and bring them to us,” Martinez says. “It says something."
The center, located at 1636 NW Seventh Ave., is open Monday through Saturday. Four days of the week, the program operates out of a van that travels to communities across Miami-Dade, providing medical services, free condoms, meals, clothing, and backpacks to participants. The majority of participants have homes and are white.
“This is a safe haven for people,” says a 28-year-old man who has participated in the program for a year. “I’m from the suburbs. I’m surrounded by good people. Where I work, I make money. I’m not a typical junkie, but... I have not been back to the hospital because of these people.”