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COLUMN: Re-thinking needles in the community

Columnist Amber Streukens writes about needle exchange and needlestick injuries
Amber Streukens is the harm reduction peer navigator at ANKORS. Photo: Tyler Harper

by Amber Streukens

ANKORS harm reduction peer navigator

In the early days of harm reduction, needle exchange programs originally required participants to return used syringes to obtain new ones. This practice has been shown to increase harms to people who inject drugs, and accelerate blood-borne infection rates. This affects us all.

Supported by the BC Centre for Disease Control, Ministry of Health and the Best Practice Recommendations for Canadian Harm Reduction Programs, B.C. has had a province-wide needle distribution policy since 2002. Needle distribution is a best practice approach to reduce transmission of Hepatitis C (HCV) and HIV/AIDS in our communities. And it works — since 2005, the number of new HIV diagnoses among people who inject drugs has dropped 86 per cent. Reducing injection-related transmission of blood-borne infections benefits the population as a whole by reducing health care costs and limiting transmission.

“But what about the syringes that are not returned?!”

This concern continues to be echoed in communities everywhere. Though the risks associated with sharing injection supplies are quite high, the risk of infection through accidental community needlestick injury are incredibly low. No cases of HIV transmission, and very few cases of Hepatitis B or C transmission, have ever been reported from community needlestick injuries.

If a needlestick injury does occur, it is best to let the wound bleed freely and to wash with soap and water. Never squeeze or poke a needlestick injury, and do not use alcohol or bleach to clean it. Seek medical attention at the emergency department for baseline blood tests, assessment for prophylaxis, and to create a follow-up plan.

No single solution will eliminate improper syringe disposal, but there are clear ways to improve public safety without increasing stigma against people who use drugs. Improving access to community sharps disposal boxes reduces unsafe disposal. Educating children about needle safety and educating adults about safer syringe handling can reduce the risk of needlestick injury, as well as open up dialogue around community wellness. For more information on sharps disposal boxes or safer syringe handling, please call ANKORS at 250-505-5506, or visit the office at 101 Baker St.

With support from ANKORS, the Rural Empowered Drug Users Network (REDUN) conducts community clean-up of harm reduction supplies. REDUN is a group of people with lived and living experience of illicit substance use, including peer outreach workers trained in safe syringe disposal. For more information on REDUN Outreach, please email Requests for clean-up support can be texted to 250-505-9690.

Since ANKORS first began supporting people living with HIV/AIDS and/or HCV, testing and treatment has improved dramatically. Low-barrier, rapid-testing options are increasingly accessible. New HCV treatments are quite effective and come with drastically fewer side effects than older treatment options. Advances in HIV treatment have made it such that this diagnosis is now a manageable condition. Access to pre- and post-exposure prophylaxis (PrEP) reduced the risk of infection. Proper antiretroviral therapy for those living with HIV can help individuals maintain an undetectable viral load, making the virus untransmittable to sexual partners.

Despite great advances in HCV and HIV prevention, testing, and treatment, community wellness depends on consistent access and support for those at risk. COVID-19 restrictions severely impacted access to sexually transmitted and blood-borne infection (STBBI) testing in the early days of lockdown, creating a risky opportunity for unchecked transmission. Testing is recommended every three-to-12 months, depending on individual risk factors.

There are many ways to access STBBI testing in Nelson. Options for Sexual Health Clinic runs Wednesday afternoons at 333 Victoria St. (250-354-3094). Individuals can register independently at, submit samples at the lab and receive results without visiting a clinic.

ANKORS runs Prick! Clinics, offering private confidential STBBI testing and access to the PrEP registry. These clinics are for guys who like guys and the rainbow community, and the next one is scheduled for Monday, July 12. Please call 1-800-421-2437 for more information or to register.

People with lived and living experience of illicit substance use can also reach out for peer-testing support by contacting ANKORS. It takes a community response based on non-judgmental support, quality objective information, and best practice solutions to achieve community wellness.