A used syringe slides into a bio-hazard receptacle as part of a needle exchange program. (NC Harm Reduction Coalition)

Law enforcement across North Carolina has battled for years to crack down on narcotics and related paraphernalia, including needles. But some police agencies have voiced strong support for a new state law that will legalize programs to distribute needles to drug users.

Addicts who inject drugs have already made choices that wreck their health. Many, perhaps most, would like to get clean. But with heroin and similar narcotics, it’s a little more difficult than quitting smoking, which is hard enough for many people.

So addicts remain enslaved to the next fix and dependent on needles to inject themselves. And those needles pose additional risks to themselves and others.

People do recover from addictions, especially with help. But diseases like HIV and Hepatitis C, spread through shared needles, currently remain incurable or incurable in a substantial percentage of cases. Those who contract these diseases risk passing them on to intimate partners or other users.

Advocates battled for years to get syringe exchange programs legalized in North Carolina. Some gave needles to drug users clandestinely, facing arrest in many communities. Instances of HIV and Hepatitis C increased, along with the use of heroin and other injection drugs.

Some law enforcement officers and politicians saw syringe exchanges as enabling drug users to continue their habits. But those attitudes have slowly changed over time. The new state law allowing needle exchanges represents some of that changed thinking.

Legal but unfunded

Lawmakers didn’t put any state funding toward paying for those programs. Even though the law enforcement community generally favors syringe exchanges, no county health departments Carolina Public Press spoke with have plans to open one in the immediate future.

Robert Childs, executive director of the North Carolina Harm Reduction Coalition, said the stipulation that public funds can’t go toward the purchase of syringes was necessary to get the legislation passed through the Republican-led General Assembly.

“That’s a universal Republican component of being OK with syringe exchanges,” Childs said. “It’s the exact same thing at the federal level. Public money can’t be spent on supplies, but you can spend it on staff … We and the police chiefs association worked on the final language of the bill. It has very strong public health and public safety language.”

Using clean needles can dramatically reduce the occurrence of HIV, Hepatitis C and other blood-borne diseases in injection drug users. Research has shown, in communities where syringe exchanges operate, drug users dispose fewer needles inappropriately. Needle exchanges coincide with less sharing of needles and increase the chances drug users enroll in treatment programs by five. Syringe exchanges alleviate the dangers that dirty or tainted syringes pose to both drug users and law enforcement.

House Bill 972 primarily focuses on police body cameras and standards for public access to those videos. But legislators added language about needle exchanges to the bill shortly before its passage, causing at least one state lawmaker to vote against the legislation. Needle exchange legislation was also introduced in the Senate by Sen. Stan Bingham, R-Davidson, a longtime proponent of the programs. Western North Carolina Sens. Jim Davis, R-Macon, and Terry Van Duyn, D-Buncombe, signed on as co-sponsors to that bill. Rep. John Faircloth, R-Guilford, sponsored mirror legislation in the House.

Advocates said several private organizations are in the planning stages of building a program in WNC, though when those programs will actually begin wasn’t clear.

Davis told Carolina Public Press he was initially skeptical of needle exchanges but that evidence of those programs leading to a decrease in drug use and fewer needle-related injuries to law enforcement in the areas where they’re implemented led him to attach himself to the Senate bill.

Proponents North Carolina syringe exchanges also say the programs help lower instances of HIV and Hepatitis C and can lead drug users to treatment because of a requirement in the bill that medical options be presented to anyone seeking clean needles.

Changes in attitudes

The North Carolina Harm Reduction Coalition, an organization that “engages in grassroots advocacy, resource development, coalition building and direct services for people impacted by drug use, sex work, overdose, immigration status, gender, STIs, HIV and hepatitis,” was instrumental in crafting the syringe exchange legislation. The new law “takes away a lot of the burden of setting up programs that other states have,” Childs said.

“In other states you have to get county board’s permission before considering operating,” he said. “This bill doesn’t have that kind of government overreach. If you’re a nonprofit or community-based organization, you can start a program.”

Waynesville Police Department Chief Bill Hollingsed, a vocal proponent of syringe exchanges, said people in his community have talked about starting an exchange.

“I’ve not always been a supporter of needle exchanges, as a law enforcement officer,” he said. “A lot of us looked at needle exchanges as giving needles to someone and empowering them to continue with a drug habit. After looking at the facts, needle exchanges don’t start new drug users. All it does is empower them to have clean needles to prevent the spread of disease. The current criminal justice system does not provide treatment and rehab, in its current form. … This may be the only opportunity for addicts to get the necessary treatment they need to get away from drugs.”

The Harm Reduction Coalition notes that syringe exchanges in North Carolina legally must provide “educational materials on all of the following: overdose prevention; the prevention of HIV, AIDS, and viral hepatitis transmission; drug abuse prevention; treatment for mental illness, including treatment referrals; treatment for substance abuse, including referrals for medication assisted treatment.”

“We see the same people over and over again through criminal justice system who are committing low-level crimes to support a drug habit,” Hollingsed said. “If we can break that cycle and get them into treatment and hopefully end the need to commit crimes to support a drug habit, we’re going to support that. We will never arrest our way out of the addiction issue.”

State Department of Health and Human Services statistics through 2014 show the rate of Hepatitis C infection has skyrocketed since 2009. New diagnoses for HIV have dropped since 2007, but nearly 30,000 infected people live in North Carolina. DHHS estimated in 2014 that 110,000 people in North Carolina were infected with Hepatitis C.

The Harm Reduction Coalition says syringe exchanges reduce drug users’ transmission rates of HIV by 80 percent and Hepatitis C by 50 percent.

Needle Exchange Program of Asheville

Asheville already has one of the largest and longest-running needle exchanges in the state. Marty Prarie created the Needle Exchange Program of Asheville in 1994, while working with the Western North Carolina AIDS Project. Michael Harney, the needle exchange’s director, said the exchange began as a separate initiative because such programs remained illegal. Local officials tolerated and supported the program.

Harney criticized the new law because it lacks state funding. This could make the work that he and other volunteers do in Western North Carolina more difficult, he said.

“I don’t know how it’s going to help us,” he said. “To me, it’s going to be more of a burden as bureaucratic forces are implemented and guidance comes from the state. We’ve been in operation for years without all that mess and we’ve been just fine.”

The Asheville program has given out nearly 300,000 needles so far this year, compared to 250,000 during all of 2015. Harney said the program has given needles to people from as far away as northern Georgia, Tennessee and upstate South Carolina.

When Carolina Public Press spoke to Harney in early August, he said the program had already distributed more than 20,000 syringes in a week’s time. The program had already exceeded its budget for the month.

“We can’t do it without some assistance,” he said. “We get private funding and money from a grant here or there, but it’s not enough for the overwhelming and potentially never ending demand.”

Harney said the people who receive syringes from his program come from all walks of life.

“It’s not what we see in the movies,” he said. “People come in and they’re gracious. They’re kind, they’re thoughtful, they’re grateful. They’re nice, they’re willing to help. It’s shocking to see who comes through the doors.”

Editor’s note: The article has been revised slightly to address treatment options for Hepatitis C. While treatable, that varies with the strain of the infection with many patients not responding to treatment. The discrepancy was pointed out by several alert readers.

Michael Gebelein

Michael Gebelein was an investigative reporter with Carolina Public Press. To contact Carolina Public Press, email info@carolinapublicpress.org or call 828-774-5290.

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