A bill in the North Carolina Senate that says it aims to make syringe service programs more accountable is so restrictive that it would effectively shut down such programs in the state, advocates say. That would eliminate an important tool in the fight against opioid use disorder.
Sponsored by Republican senators Chuck Edwards and Joyce Krawiec, Senate Bill 607 has been languishing in a senate committee since early April, a positive sign for many people in the substance abuse community including Colin Miller, who co-founded the Twin City Harm Reduction Collective in in 2016.
“In my reading of it, it would shut down or make it very difficult to operate pretty much all the syringe services program in the state, and at this point, we have 40 across North Carolina,” Miller said. “A lot of it doesn’t make sense. You can tell that this bill was not written by people who have any understanding of public health or harm reduction.”
Among other provisions, the bill requires syringe services programs to be offered in facilities that offer professional counseling or rehabilitation services; that all syringes and other supplies be engraved or marked with a logo that identifies the program; that people who use drugs illicitly to go to treatment; and background checks for staffers.
The bill would also ban mobile programs, which reach opioid users who lack transportation.
Many syringe service programs are small nonprofit organizations with small staffs and shoestring budgets. Folks in recovery are among the most effective staff members.
Often, because of their past misuse of opioids, they have criminal records, which would make them ineligible to work in these kinds of programs.
“This feels like it’s attacking people who use drugs and puts them in places where they’re going to have to be engaging in much more unsafe methods of drug use,” Miller said.
The bill comes at a time when the number of fatal overdoses has reached a record-high in the United States with more than 87,000 deaths from October 2019 to September 2020, according to provisional data released last month from the Centers for Disease Control and Prevention.
That represents a 29% increase from the previous 12-month period. In North Carolina, the CDC predicts that more than 2,700 died of fatal drug overdoses, an increase of 14% from the previous 12-month period.
The surge in cases is due in large part to the growing use of fentanyl, a powerful synthetic opioid that is 50 to 100 times more potent than morphine, according to the National Institute on Drug Abuse. The number of overdose cases involving fentanyl increased by 55% compared to previous 12-month periods.
Syringe services programs are a key component in a public health approach known as harm reduction, which tries to minimize health risks associated with opioids in a nonjudgmental way.
“We try to meet people where they are, regardless of what kind of behavior they’re engaging in,” Miller said. While getting people into treatment is one goal, harm reduction can also mean getting people to snort rather than inject drugs.
One component of harm reduction involves handing out sterile syringes to reduce the risks of contracting hepatitis C or HIV, developing soft tissue infections and endocarditis, a heart ailment.
The programs require people to exchange their used needles for sterile needles, Miller said.
Twin City Harm Reduction serves about 1,200 people. Last year, it distributed 400,000 sterile syringes and 2,700 naloxone kits. Those kits reversed 514 overdoses in 2020, Miller said.
“That’s a pretty big number,” he said. “Even if all of them wouldn’t have died, it’s safe to assume that some of them might have.”
Randy Abbott of Greensboro works with the SAFE Project, which stands for Stop the Addiction Fatality Epidemic. His daughter Vanessa died of a fatal opioid overdose in 2015.
One common knock against syringe service programs is that by providing syringes and other supplies, it enables drug users.
Abbott held that view until he had a talk with someone who worked with a syringe service program. He said he went into the conversation expecting to give the person a piece of his mind.
“Within 45 minutes I had a completely different line of thinking,” he said.
He quoted a CDC statistic that new users of syringe service programs are five times more likely to seek treatment for a drug disorder than those who don’t.
Abbott said some of the provisions in the bill, such as engraving supplies with logos, don’t make sense because that would render syringes and other supplies unsterile.
Syringe service programs, he said, are “actually good for the community. It reduces the spread of Hepatitis C, HIV, and it keeps needles off the street.”
Edwards’ district includes Asheville, where a neighborhood has been feuding with a syringe services program. Krawiec’s district covers Davie and Forsyth counties. She did not return requests for comment.