Clear to partly cloudy. Low around 60F. Winds light and variable..
Clear to partly cloudy. Low around 60F. Winds light and variable.
Among the CDC’s recommendations for Kanawha County to help address an outbreak of HIV is expanded access to sterile needles for those who inject drugs.
Among the CDC’s recommendations for Kanawha County to help address an outbreak of HIV is expanded access to sterile needles for those who inject drugs.
CHARLESTON — Harm reduction providers say they are uncertain about the future of these programs due to a new law regulating syringe service programs in the state.
Last week, a federal judge scrapped a temporary restraining order preventing Senate Bill 334, passed in the last legislative session and signed by Gov. Jim Justice in April to regulate syringe services programs, from going into effect.
Syringe services programs, also referred to as syringe exchange or needle exchange programs, provide sterile syringes to injection drug users and dispose of dirty needles. The programs are often part of broader harm reduction programs that aim to lessen the negative effects of illicit drug use.
In addition to sterile syringes, participants are often able to access naloxone for reversing an opioid overdose, testing for blood-borne illnesses like HIV and hepatitis C, vaccinations, medical care, referrals to substance use disorder treatment and other services.
Senate Bill 334 provisions include a licensure requirement for harm reduction programs operating syringe exchange programs, requiring a one-to-one syringe exchange, and necessitating a statement of support from city councils and county commissions to operate within a jurisdiction. It also requires participants of harm reduction programs in the state to have a West Virginia ID.
Syringes have to be “unique” to the program. Participants will not be able to pick up syringes for other intravenous drug users, and the law excludes minors from syringe exchange services.
The legislation also implements a licensing fee and penalties for non-compliance from $500 to $10,000 per violation.
To operate under the law, the program must receive a written statement of support from both city councils and county commissions of the jurisdictions in which the program will be located. These support letters can be rescinded by the body at any time.
Harm reduction programs offering syringe exchanges will be required to offer services from a qualified licensed health care provider at every visit, maintain a program for the public to report syringe litter and attempt to collect all syringe litter in the community.
Many public health officials have argued the restrictions are too onerous to follow and will result in the closure of syringe exchanges and harm reduction programs in the state.
The effect of closures will be “immediate and devastating” as the state experiences an unprecedented drug epidemic and an uptick in HIV cases, according to a friend-of-the-court brief filed by health and legal professionals supporting the ACLU of West Virginia’s request for a preliminary injunction blocking the law from going into effect.
Research has shown syringe exchange programs to be effective in reducing spread of blood-borne infections, decreasing syringe litter, connecting drug users to treatment and saving lives, according to the filing.
A lawsuit filed last month by the American Civil Liberties Union of West Virginia on behalf of syringe exchange service providers, including Milan Puskar Health Right in Morgantown, argues the law is unconstitutional at both the federal and the state levels.
Lead bill sponsor Sen. Eric Tarr, R-Putnam, has said the legislation was intended to reduce the amount of syringe litter and reduce crime in the state.
In Marion County, the harm reduction program has already shuttered due to the pending law.
“We felt it was just better to keep our program on hold pending final resolution of the injunction and what the state may do moving forward,” said Lloyd White, administrator of the Marion County Health Department.
Although White said he would prefer to keep the program open, the threat of a $10,000 fine was too great a risk.
Marion County’s harm reduction program was 100% grant funded with 98.7% of costs going to supplies, he said.
“I just couldn’t risk any kind of a fine, especially when it could have been upwards of $10,000. That program doesn’t generate revenue, so any potential fines would have come out of our General Fund revenue, which at a point in time when we’re in the middle of a pandemic, budgets always matter, but more so now, because I have no idea what I may have to spend moving forward. We just want to be really, really conservative with our budget and not really willing to accept the risk,” he said.
In Brooke County, the syringe exchange is ongoing, but the threat of financial penalties is daunting, according to Michael Bolen, administrator of the Brooke County Health Department.
“There are some good things about it (the law), don’t get me wrong, but there are some things that really hinder those type of programs, almost to the point where you’re kind of putting your neck out on the line and have the chance to be fined monetarily and things like that. We don’t have the money to absorb costs like that,” Bolen said.
Operators would like to keep the program, but the decision will be based on the ability to manage the program within the regulations.
“It’s worth it in my eyes, but if the state law is there, if they put it in place and keep it there, then it’s going to be a lot more difficult for us to manage,” Bolen said.
“The whole purpose of the program deep down is to help people,” Bolen said. “Unfortunately, a lot of people look at it as a negative type way, and I understand that, but people are going to have habits whether you’re there to help them or not, so if we can keep that disease spread down — and that’s our main goal through the needle exchange — that’s a huge effect not only on our public health locally, but in taxpayers pocketbooks and the state’s pocketbooks.”
In Taylor County, the harm reduction program and its syringe exchange remain operational. Health officials in the county plan to revisit the decision once the rules for the programs are released for review, according to public information officer and threat preparedness coordinator Shawn Thorn of the Grafton-Taylor County Health Department.
In Hancock and Ohio counties, administrators are hopeful they will be able to work within the guidelines.
Hancock County Health Department Administrator Jackie Huff said she believes the program has the support of the community, the county commission and the Board of Health to continue operations.
Huff said the goal of the syringe exchange is to reduce spread of communicable diseases and endocarditis, but the distribution of naloxone has been an important component of the program, as well, as the state again experiences an uptick in drug overdose deaths.
The Ohio County harm reduction program and syringe services program was one of the first three in the state to go into effect in response to an HIV crisis in Indiana, according to Howard Gamble, administrator of the Wheeling-Ohio County Health Department.
Gamble said he has received assurances from state officials that the state will provide his department staff with the training necessary to continue the program by Jan. 1.
Gamble did express concerns about the logistics of offering uniquely marked syringes, as ordering the syringes already labeled would likely increase the cost significantly. Adding a label after purchase would require breaking the seal of the package, thereby contaminating the previously sterile syringe, he said.
Another uptick in COVID-19 cases could also threaten the program, as it would be difficult for limited staff to make the necessary changes to the program while performing the contact tracing, testing, reporting, vaccinating and other work in responding to the ongoing pandemic, he said.
“Something will have to give,” he said.
Staff Writer JoAnn Snoderly can be reached at 304-626-1445, by email at jsnoderly@theet.com or on Twitter at @JoAnnSnoderly.
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