Staff Reports
In 1989, Portland’s Outside In, which provides varied services and health care to homeless youth and low-income communities, began a revolutionary needle exchange program. One of the first in the country to offer needle exchange, Outside In has battled through more than two decades of controversy and recessions to continue offering the service.
The program is currently at risk, failing to secure its annual funding in Mayor Charlie Hales’ proposed city budget.
Due to a federal ban on the program created in 2011, Outside In relies solely on local tax dollars to fund the program. Multnomah County and the city of Portland have worked together for 20 years to pay for the service. Last year the county contributed $126,000 and the city $65,000 toward the program.
Multnomah County funds the program primarily for public health reasons, a part of their public health response to HIV and hepatitis among drug injectors. The city funds the program for public safety reasons.
“We prevent half a million syringes annually from being tossed,” says Outside In Executive Director Kathy Oliver. “We’re keeping clients alive and safe. Giving them the means to protect themselves.”
“HIV is one disease that’s preventable,” says Oliver “We know exactly how to prevent it.”
“It’s also a benefit for the community — preventing accidental needle sticks; preventing the need for costly treatment for people with HIV/AIDS, helping people enter treatment when they’re ready to do so,” Oliver says. “We’re often the only point of contact our clients have with the world of health and social service. We serve as an important bridge to treatment and other services.”
“It’s a vital program and a high priority for me,” says city Commissioner Steve Novick. “I am confident that one way or another, it will be funded.”
In December 2009, President Barack Obama signed a law lifting a 21-year ban on federal funding for needle exchange programs. The Obama administration’s position was that needle exchange clinics are an evidence-based practice that lowers the transmission of HIV and other infections among injection drug users.
In 2011, Congress reversed the policy on federal funding for syringe exchange programs, leaving it up to local communities to fund the harm-reduction program.