The Behavioral Health Services division of the Frederick County Health Department has been awarded nearly $23,000 in grant funding from the Maryland Department of Health and Mental Hygiene (DHMH) to launch a feasibility study for a syringe service program — commonly called needle exchange, said Andrea Walker, the director of mental health services.
The Behavioral Health Services division is technically a unit of state government and considered a part of the Maryland DHMH, said Dr. Barbara Brookmyer, the health officer for Frederick County.
Syringe service programs had previously been restricted to Baltimore and Prince George’s County, but a 2016 bill passed by the Maryland General Assembly allowed counties across the state to establish them.
The programs are an example of what Walker called “harm reduction,” or attempting to prevent some of the negative side effects of drug addiction. Injecting heroin can lead to high rates of HIV and hepatitis, and the intent of the programs are to provide users with clean needles and remove used syringes from circulation.
“We know that addicted people will continue to use until they’re ready to get treatment, so this can at least reduce the risk of drug use and the potential for disease transmission,” Walker said. It’s also a way to link addicts with drug treatment services and other benefits, she added, including testing for HIV and other diseases linked to intravenous drug use.
Since the start of Baltimore’s needle exchange program, the percentage of new infections linked to syringes decreased from 62 percent in 1994 to 12 percent in 2011, according to information in the General Assembly bill.
“It’s another way to build relationships with addicted members of the community and reach out to them where they are,” Walker said.
The division is in the initial stage of the feasibility study, which involves reaching out to the community and stakeholder groups to find out if there would be support for a needle exchange program within the county, Brookmyer said.
In addition to reaching out to interested groups — including Frederick Memorial Hospital and law enforcement agencies — the division will consider whether to collect better data on local rates of infection. Brookmyer added.
Planners will also identify what referral resources would be available for needle exchange users, if the program was implemented.
"We still need to consider what would need to be in place for the program to be safe, for it to be successful, and for it to be supported by the community at large," Brookmyer said.
Less formalized but still under discussion are plans to introduce local physicians to screening tools that could help them identify patients addicted to opiates and refer them to treatment.
According to Walker, the Health Department launched a similar effort in 2012, when it sent screening tools for anxiety and depression to 77 percent of licensed physicians in Frederick County. Doctors were also provided with a list of resources, which they could use to refer patients to further treatment.
In the next two years, Walker hopes to send out similar resources for opioid addiction. Called Screening, Brief Intervention and Referral to Treatment (SBIRT), the tool kit provides doctors with a brief set of questions used to identify potential substance abuse. It also trains them to provide patients with brief feedback and advice before referring them to specialized treatment.
“You can’t force a medical practice to use these tools, but you can give them the guidelines and training,” Walker said. “It’s a way to possibly identify more people and reduce some of those negative health consequences.”