Six counties in Maryland are planning, or considering needle exchange programs for drug users, as a way to reduce the spread of infectious diseases.
Anne Arundel, Baltimore, Frederick, Prince George’s and Washington counties “are continuing to move through the process of launching syringe services programs,” says Brittany Fowler, a spokesperson for the Maryland Department of Health. In addition, three other counties have expressed interest and are considering programs, Fowler told The Influence.
Baltimore City – once dubbed the nation’s “heroin capital” – currently has the state’s only operating program, launched in 1994. It relies largely on mobile units, which provide services in 16 locations around the city 26 times a week.
In 2016, the state legislature passed a measure allowing the programs to be established statewide in Maryland. Governor Larry Hogan signed the Opioid-Associated Disease Prevention and Outreach Act, after it passed the Maryland General Assembly with overwhelming bipartisan support.
As the opioid epidemic has developed, Maryland has experienced a rising rate of new HIV infections, recently ranking 2nd in the nation for the rate of new HIV infections per 100,000 residents, according to the Centers for Disease Control. In 2012, 20 to 29 year olds made up 31 percent of newly-diagnosed cases. In 2012, 22 percent of Maryland HIV cases in men and 26 percent in women were linked to injection drug use.
The new law authorizes local health departments and community-based organizations throughout Maryland to establish sterile syringe exchange programs. with approval from the state’s Department of Health & Mental Hygiene.
Needle exchange programs have proven effective in preventing the spread of infectious diseases such as HIV/AIDS and hepatitis C, along with serving a pathway into addiction treatment for illicit drug users. The only jurisdictions previously authorized authorized to create syringe exchange programs were Prince George’s County (which has not set up any programs yet) and Baltimore City.
With the new law, Maryland joined a growing number of states that have removed legal restrictions against syringe access programs over the last year, including Florida, Kentucky and Indiana
Syringe service programs are not only vital in reducing the harm of injection drug use, but they provide a humane and compassionate approach to addressing substance-use disorders, Mark Sine, Director of the Baltimore Student Harm Reduction Coalition, told Drug Policy.org. “Maryland has many active community-based organizations who will be able to significantly expand their positive impact with this new law.”
The change in state law was supported by a number of local organizations, such as the University of Maryland School of Law Drug Policy Clinic, Grief Recovery After a Substance Passing (GRASP), University of Maryland Medical Center, and many others.
Nationally, syringe access programs are supported by every major medical and public health organization, including the American Medical Association, National Academy of Sciences, American Academy of Pediatrics, American Bar Association, and U.S. Conference of Mayors.
In addition to significantly reducing the spread of infectious diseases by people who use drugs, syringe exchange programs can save the lives of police, firefighters and other first responders. Police officers are commonly stuck with syringes in the line of duty. Law enforcement leaders across the nation have become strong supporters of syringe exchanges.
Maryland state officials are encouraging the development of local exchanges, with technical assistance and some funding, says Onyeka Anaedozie, deputy director of the Maryland Department of Health’s Infectious Disease Prevention and Health Services Bureau. “We’ve talked to leadership in the jurisdictions about the importance of having a standing syringe services program,” she told the Baltimore Sun. “We want the efforts led by the local jurisdictions.”
Baltimore Health Commissioner Leana Wen, M.D. said she’s worked to inform area county officials on how the city program functions and provided more specific assistance when requested. The Baltimore city program costs about $800,000 annually, dispensing about a half million clean needles a year, and providing other services.
In an interview with the Sun, Wen said stigmatization remains a barrier, but she wants to help dispel myths about needle exchange programs. She said when the city program launched 23 years ago, 63 percent of those with HIV were IV drug users. By 2014, the only 7 percent were IV drug users, contributing to one of the nation’s largest drops in new HIV cases.
She considers needle exchange programs “a powerful tool” to prevent harm, in spite of some public resistance across.“It’s not about condoning or supporting drug use,” she said. “The first principal of public health is to protect the population from harm. We’ve seen this result. … That is why it’s important for us to share our experience.”
Acceptance of needle exchange programs has also been increasing at the national level. Last year, the Republican-controlled Congress passed a law allowing federal funds to be used for needle exchange.