Melissa Cross sat in the parking lot, her wares spread before her on a table and in a white van parked a few feet away.

Bundled against the chill, Cross and her partner Raul Morales waited for customers to appear. No money would change hands. Instead, they would collect dirty syringes from drug users and exchange them for clean ones. They’d hand out alcohol swabs, bandages, condoms, antibiotic ointment, miniature biohazard containers and other harm reduction supplies.

The point of Saturday’s needle exchange in front of Pendleton’s Eastern Oregon Center for Independent Living was to help reduce HIV and hepatitis C, a deadly liver disease linked to injection drugs and dirty syringes. Their organization — Blue Mountain Heart to Heart — runs similar exchanges in Walla Walla and Pasco.

As Cross sat at a table eating lunch, Morales leaned against the van, ready to fetch syringes from inside the vehicle. This was the first exchange and business was slow. Word had not yet spread. Eventually it will, they said, and more folks will show up at the bimonthly exchanges.

According to their boss, Executive Director Everett Maroon, such syringe exchanges bring financial and public health benefits to society.

“There’s been 1,500 studies about different aspects of syringe exchange programs,” Maroon said. “It’s one of the most studied public health strategies.”

He admits that the idea seems counterintuitive at first glance.

“We’re not asking anyone to love drug users. We’re not asking anyone to love drug use,” Maroon said. “But we know it really does cut the transmission of HIV and hepatitis C. Evidence shows the investment we make now really pays itself back in averted health care costs later.”

The Pendleton service started after the Oregon Washington Health Network was awarded a federal contract and $20,000 to launch the pilot project. OWHN is a coalition of nine partners — Lifeways, Umatilla and Walla Walla county health departments, Yellowhawk Tribal Health, St. Anthony, Good Shepherd and Providence St. Mary hospitals, Blue Mountain Community College and the Morrow County Health District — with a mission to improve health outcomes. The coalition subcontracted Heart to Heart to run the syringe exchange.

Advocates say the economics of preventing HIV or hepatitis C are compelling. According to the CDC, the estimated lifetime cost of treating one person living with HIV is more than $400,000. Hepatitis C treatment can run more than $60,000 for 12 weeks of treatment.

Cross said first-time visitors to needle exchanges often feel hesitant and ashamed.

“People are nervous,” said Cross, harm reduction coordinator for Blue Mountain Heart to Heart. “We tell them it’s a legal service to prevent blood-borne pathogens. It’s anonymous and confidential.”

Cross said the first time someone comes to a syringe exchange, they receive a pack of 10 syringes. After that, they trade dirty needles for clean. The Pasco service in a brick-and-mortar location has given out 98,000 syringes to 332 individuals since March. Maroon said 95 percent of the needles came back.

That’s contrary to critics who worry that such programs will cause improper disposal of needles in parks and other shared spaces, exposing the public to risk. Maroon disagrees.

“I don’t think data bears that out,” he said. “We’re getting the vast majority of syringes back. We are incentivizing people not to leave syringes in the street. Studies show it actually cleans up parks and public areas.”

In addition, he said people participate in needle exchanges are five times more likely to enter treatment.

Not everyone supports such a public health strategy.

Recently, Franklin County commissioners evicted Blue Mountain Heart to Heart from its county-owned space in Pasco. Commissioners fielded complaints from citizens who worried about enabling drug use and frightening people who work and shop in neighboring buildings, according to a report in the Tri-City Herald.

Cross said she isn’t there to judge, only to distribute sterile syringes and offer resources, such as referrals and testing for hepatitis C and HIV.

“We’re definitely helping a community that’s hidden, one that feels a lot of stigma,” she said. “They can come here and be treated with respect.”

It’s slow going. Only one person stopped by the parking lot at 322 S.W. Third St. on Saturday. That will change, Maroon said. It just takes time for word to spread.

They’ll return every first and third Saturday from noon to 4.

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