Public Safety: Changing Points of View

By Alex HoeftSure, there's trash on the Truckee River.Whether from passersby casually tossing aside a soda from McDonald's; or old, tattered clothing left behind from the homeless encampments once there, the trash exists.Sometimes, though, the trash isn't as simple or safe as paper or cloth. Biohazard materials like syringes ("sharps") also find home on the river banks.Northern Nevada HOPES combats the presence of such hazardous waste through its Change Point Harm Reduction Center.Change Point is Nevada's first legal Syringe Services Program, and provides access, disposal and exchange for syringes.HOPES began in 1997 as HIV outpatient program education services. Through that experience, the organization saw that the most effective prevention when it came to targeting injection users and cutting down the spread of HIV was SSP."Because of the tremendous preventative effect that Syringe Services Programs had in reducing the course of the HIV epidemic, we started to work with other groups in town to do coalition work specifically targeted at legalizing Syringe Services Programs here in Nevada," said Abigail Polus, former Harm Reduction and Outreach Coordinator with HOPES. "Some of those groups were the Northern Nevada Outreach Team, as well as the Public Health Alliance for Safety Access."Thus, Change Point was born in January of 2014.The space stands on Ralston Street in Reno, complete with onsite testing, supply distribution and plenty of staff and volunteers to assist people getting into health care, recovery programs and detox services.In addition to onsite services, staff and volunteers participate in monthly sharps pickups. During the month of October, around 86 percent of the syringes that left Change Point were brought back."We really encourage our participants to make sure that they’re bringing their points (sharps) back," said Robert Harding, Polus's replacement as of Dec. 4, 2015. "We provide them with a sharps container; we will provide them with every asset that we can to help get the client, including going and meeting them somewhere, grab their points and bringing them in. We have incentive programs where we pay individuals for bringing in syringes for multiple people, or a lot of syringes because they’re collecting syringes as they travel around town."Eighty-six percent is really good, but that's still 14 percent of used sharps not being properly disposed of. Often times, those used syringes make their way to "troubleshooting spots," as Polus calls them, along the Truckee River.Change Point focuses mostly on the river for cleanups, according to Harding. Sure, there have been a couple of non-river locations, but the river is primary.That's because the Truckee River has multiple appeals for those using syringes. Aside from the general allure nature draws, those users are looking for places that are away from the general public. The foliage and lack of walkways on different banks of the river provide shelter from prying eyes."One of the spots was up behind Waste Management on Commercial, ... there’s not anything but a bank there," explained Harding. "There’s no walkways, there’s not a lot of flat land, it’s really just kind of a place where people who are homeless are camping. There tends to be a little bit more (sharps) there than other places."Another appeal: the water."Water is this basic human necessity, and if you don’t have regular access to it, be it through a faucet or a shower or a service provider that can give that to you, then you are going to go where it’s free," said Polus.Polus continued, saying yes, the high population of homeless people living on the river somewhat attributes to the biohazard waste left behind, but that's not the only reason.First, people who aren't homeless are probably also using the river as a sharps trashcan."There could be individuals that do have a home that are not able to use (syringes) at home either because the stigma or relations with the people that they live with," said Harding. "They would need some place that’s out of the way and is protected from being seen by the public, so there could be a good portion still of individuals that aren’t homeless that are contributing to the problem."Second, there's (again) the water -- or lack thereof."It’s also really because of drought, and because things don’t wash down the river," said Polus. "And instead of what was previously a problem and maybe a little bit more hidden before... now is really obvious. Nothing’s getting flushed down the river the way it used to. Things are clinging to the shores, and it’s frightening and an eye sore."Concerning the cleanup of such biohazards, Change Point keeps it simple and safe. For picking up the syringes, the staff and volunteers use "reachers," three-foot long tong-type mechanisms that allow the user to safely pick up items from a distance.With the non-syringe items used for injection (cookers, cotton, caps, alcohol wipes, etc.), the danger lessens dramatically."All the pieces that go along with the injection process -- the cookers, the ties, alcohol wipes -- all of that stuff may contain some blood on it, which would be the risk of infection and exposure," said Harding. "Outside of something to puncture somebody’s skin, there’s not really a concern there."For those who correctly dispose of their used sharps, there are a couple options in addition to Change Point that provide sharps disposal options in the Reno-Sparks area: Waste Management, Washoe County Health District, Record Street, and Join Together Northern Nevada.Polus is working with other local organizations (Catholic Charities of Northern Nevada is one example she gave) that are interested in also housing a sharps disposal bin."I think that ... increasing access to sharps disposal options ... brings that rate of improperly discarded syringes down," said Polus. "Because you’re giving people the tools to make a decision on if they want to dispose of it properly or not."However, the opposition to federally funded SSPs is large in stature. In 1988, U.S. Congress banned all federal funding towards SSP. Years later, in 2009, President Barack Obama's administration and Congress lifted the ban.It was short lived. In December of 2011, the ban was reinstated by Congress."There’s still a lot of fear that by allowing access to sterile syringes, as well as sharps containers, that we are encouraging drug use," Polus offered as explanation.Change Point is helping assuage some fears, particularly for the syringe users. The HOPES branch is now a source for disposal, access and information where there once wasn't any."We’re handing out syringes but we’re taking in almost everything that we hand out. That’s better than prior to us opening where individuals could get points from their pharmacy and then not have anything to do with them," explained Harding. "And it’s not just illicit drug users that are having issues. We get calls every day from people that don’t know what to do with the sharps that they use for medical purposes. Having us around and having the outreach that we do to clean up the points has really cut down on a lot."