Fewer needles are being exchanged through the Yakima Health District's harm reduction programs as more users smoke fentanyl and methamphetamine in pill form. Meanwhile demand for overdose-reversing Narcan has increased, officials said this week.
Council members had a work session Tuesday with Yakima Health District officials about the county's needle exchange program and listened to a presentation from the Yakima Police Department about illegal drugs in the city. The discussion came from a request from Council member Reedy Berg, who earlier suggested a discussion about banning the needle exchange.
Council members didn't take action or seem inclined to pursue major changes this week.
In an email after the meeting, Berg said he would keep discussing the program, but believed the needle exchange is broadly helpful.
"I do believe the exchange program offers benefits to the community, and I don't want to ban it /over regulate it. I do however want to iron out who would be deemed liable if an unfortunate circumstance arose," he said in an email. "I think if we, as a council, work in cooperation with the Health District to ensure another layer of safety, it would benefit all parties involved."
During a board of health meeting on Oct. 30, Mayor Patricia Byers said the council has had a lot of questions answered about harm reduction since the topic was first raised. The meeting Tuesday was a chance to hear more information, she said.
"The major question is do we have the ability or authority to direct another agency in terms of what they're doing. And I want to be cautious here: we likely don't," she said.
Needle exchange program
Yakima County has had a needle exchange program for more than 30 years, said Melissa Sixberry, the director of disease control at the Yakima Health District. It's a one-for-one needle exchange program that operates weekly in East Yakima and Toppenish to prevent the spread of HIV and hepatitis C among intravenous drug users.
Yakima City Council does not run the program and cannot ban it. The needle exchange program is overseen by the Yakima Health District and is funded by the state. City council members could add regulations for needle exchange programs in city limits but took no action Tuesday.
The needle exchange program is a form of harm reduction, Sixberry said. It's a program that is meant to reduce the negative effects of drug use. Originally, that meant preventing bloodborne contagious diseases that could be passed on through previously used needles.
Sixberry said the services offered with the syringe exchange program have expanded. Now, staff members offer Narcan, vaccines for diseases, free testing for sexually transmitted infections, wound care and connections to rehab and substance abuse treatment. Sixberry said a health district staff member on site encourages the users to seek treatment and gives them an important point of contact when they decide to do so.
At the council meeting, Sixberry said the program costs between $60,000 and $70,000 a year and is funded through state grants. Use of intravenous drugs has decreased in the last few years and so has the number of needles exchanged using the program. Several years ago, the program took in about 300,000 needles annually. It's dropped to about 60,000 this year with the emergence of drugs like fentanyl in pill form.
Health district officials shared results from the program this year. The program has interacted with more than 2,100 people in 2024. Narcan distributed by the program has resulted in more than 500 opioid overdose reversals. More than 50 people have been referred to further addiction treatment and one person has started treatment.
Andre Fresco, the health district's executive director, said the program accomplished its primary goal of stopping disease.
"Our goal is to reduce drug use in the community, but it's also to prevent outbreaks," he said.
Sixberry noted that there had been no outbreaks of HIV or Hepatitis C among injection drug users during the program's existence. Health officials also have been able to track and stop the spread of syphilis and Hepatitis A outbreaks to the larger Yakima community during the last few years.
Drug users can be anyone in the community, Fresco said, and can have jobs and roles that put them in contact with non-drug users.
The needle exchange program is a good opportunity to provide health care for and build trust with drug users, particularly those who might be homeless.
"They're not being managed through our traditional medical system," he said. "This is a way to reach them."
Preventing infectious diseases can also save taxpayers money in the long run, Sixberry said. The cost for curing Hepatitis C can be between $23,000 and $95,000 for a single patient. Health district officials estimate that the cost of treating HIV can be between $400,000 and $1.1 million, depending on the patient's situation.
Sixberry noted that if patients do not have insurance or are unable to pay for treatment, hospital beds and tax dollars will be used to treat them.
Council members voice opinions
Council members Berg and Rick Glenn were concerned about liability created by abandoned needles. Berg asked what would happen if a community member were to step on a used needle and contract a disease.
Dr. Neil Barg, Yakima Health District's health officer, said that the program was legal and liability fell on its user once it was distributed. It was like any pharmaceutical drug or tool that might be distributed legally, he said.
Fresco added that the health district runs a strict one-for-one exchange to prevent needles from being discarded improperly. Users only get clean needles if they come back with their dirty needles, he said. Health district officials said they do not track their needles, but they tend to see they same type of needles they distribute returned.
Used needles are carefully collected by staff and disposed of at local landfills.
"We are attempting to make sure people in the community are not harmed by those needles," Fresco said.
Berg brought up the possibility of tracking the needles through barcodes or radio frequency identification. Health district officials were concerned that tracking needles could violate patient privacy rights and discourage community members from using the program.
Several council members supported the program.
"I would feel less safe from a health perspective if you didn't have this program," said council member Janice Deccio.
Mayor Byers said there was no reason to change something that was helping.
"If we remove this program, it's not going to change the problem of drug addiction and homelessness," she said.
Drug use in Yakima
Yakima Police Department officials later presented on trends around drug use in Yakima. Detective Erik Horbatko noted that intravenous drug use had decreased greatly in Yakima.
That's primarily because fentanyl, methamphetamine and cocaine, drugs which are usually not injected, had become more common, he said.
Those drugs had gotten cheaper in the last few years, Horbatko said.
Fentanyl has outpaced heroin, Horbatko said, and is 60 to 100 times stronger. Much of it is imported from Mexico and is not made in a controlled fashion. Concentrations of fentanyl in individual pills can vary, increasing the risk of overdose.
"It's a synthetic, it makes people lethargic," he said. "Fentanyl has completely taken over."
After users become addicted, Horbatko said, they will continue to use the drug to avoid withdrawal symptoms and sickness. Police were trying to prosecute more controlled substance homicides, Horbatko said, going after dealers and distributors when someone dies of an overdose.
Methamphetamine is largely imported, Horbatko said, and has also grown cheaper. Cocaine, the third most common drug in the city, is trending the same way, he added.
Horbatko said the drug problem in Yakima has worsened in the last five to seven years. Council members asked for his opinion regarding solutions to those problems.
"My biggest complaint is chasing the same person over and over and over again," Horbotko said, advocating for stiffer consequences for repeat offenders.
In August, the council approved new "stay out of drug areas," two zones around North First Street and South Naches Avenue where municipal court judges can ban people facing drug charges from visiting as a condition around pre-trial release or after conviction.