For the second time in less than three years, the Charleston City Council is readying to vote on restricting needle exchange programs.
A proposed ordinance amendment would change language to stop any group not certified by the state from running a syringe service program, a proven tool to lower the spread of infectious diseases, according to the Centers for Disease Control and Prevention.
The amendment is sponsored by council members Pat Jones, Shannon Snodgrass, Deanna McKinney, Bruce King, Chuck Overstreet, Adam Knauff, Jeanine Faegre, Sam Minardi and Jennifer Pharr.
Faegre, Minardi, Overstreet and Knauff did not respond to requests for comment.
Jones declined to comment. Snodgrass requested to receive questions by email but did not return answers.
Solutions Oriented Addiction Response, a grassroots community health organization specializing in harm reduction and assistance for those who use drugs, began operating a needle exchange program in 2019, a year after the Kanawha-Charleston Health Department’s program was shut down.
Rates of HIV and hepatitis increased among intravenous drug users the same year.
A months-long criminal investigation into SOAR by Charleston police yielded no criminal charges. Police cited “loose interpretations” of an existing ordinance.
The council drafted the amendment in response.
“It’s disappointing to have to fight this battle again, but we’re hopeful, a bit,” said Joe Solomon, co-founder of SOAR. “We hope the city government steps up and sees the potential here.”
The amendment is scheduled to be discussed at 5:30 p.m. Feb. 4 during the city’s Public Safety Commission meeting.
“We’ll have a number of people with medical backgrounds, people who work in addiction, who are going to share information with us,” committee Chairwoman Keeley Steele said. “Tensions [on council] are high right now, but I believe there’s still room to learn.”
Some council members, including Steele and Caitlin Cook, said they believe the amendment is being “rushed.”
“I want to get the voices of medical professionals in here,” Steele said. “I want to hear as many perspectives as possible.”
Pharr, a sponsor of the amendment, said that is not at all her intention and she hopes the other council members will agree to a longer process, focused on listening and learning.
“I want to see some data — how many are distributed, returned?” Pharr said. “I’m open to learning as much as we can, that’s how I want to do this.”
Some other backers of the measure feel a sense of urgency to do something, said Councilman Brady Campbell. They fear needle-stick injuries among the city’s first responders and the public.
Campbell, who manages property around Charleston, said he believes a syringe service program like SOAR’s would negatively affect business recruitment and retention.
“I’m talking to a business, someone looking at building a new medical facility, and they are not willing to come downtown,” Campbell said. “They’re afraid [a needle exchange program downtown] would hurt their business, attract the wrong kind of people to the area.”
Campbell, who is not a sponsor but is a supporter of the amendment, said he does not oppose needle exchange programs and he understands the research and expert opinions from the CDC, World Health Organization and others. He said he doesn’t think SOAR’s program is right for Charleston, even if it is best practice.
“Best practice” syringe service programs are no-barrier, no-cost and needs-based. While they encourage returning used syringes for clean ones, people do not have to return needles to receive more. This is SOAR’s model, which differs from the one used by Health Right, a free clinic on the East End.
Health Right limits the number of needles people receive. Those who don’t return needles can be suspended from the program, according to those who have used the program. Health Right requires identification, which many houseless people lack.
“I get it’s not 100% best practice, but if it’s not 100%, shouldn’t we take 97% best practice?” Campbell said.
Only best practice programs have proven to be beneficial; they’re three-times more likely to get people who suffer from substance use disorder into treatment, according to the National Institute for Drug Use Prevention and the CDC, among others. Being no-barrier means they’re more effective in slowing the spread of communicable diseases, like HIV and hepatitis.
In the past three years, HIV and hepatitis rates have soared in Kanawha County. In 2018 there were two HIV cases in the county tied to intravenous drug use. In 2019, there were 15, and last year there were at least 32, according to the state Department of Health and Human Resources.
Campbell said he’s not as concerned about those statistics as he is the economic prospects in Charleston.
“I agree it’s a problem, a growing problem and a huge problem, but for the 18 or so months, SOAR has continued to hand out needles and it’s only gotten worse,” Campbell said. “I understand the science, but as a city council person I have to look beyond science and data. I have to weigh bringing opportunity here, or helping people use drugs.”
McKinney, who represents the West Side of Charleston where SOAR runs its biweekly street outreach program, said she isn’t against SOAR but felt angry she had to learn through a police investigation about the program operating in her ward.
“There was no communication, none, and that’s my people, that’s my community,” McKinney said. “With all the problems already on the West Side, you bring needles into here and don’t ask us what you can do for our community.”
King, who sponsored the amendment along with McKinney, agreed that trust had been lost since the organization chose to distribute needles without meeting with council members.
“It felt secret, and that left a bad taste. That’s not the way it should have been approached,” King said.
King is in long-term recovery from addiction himself. That experience is part of why he doesn’t support SOAR — he won’t support anything he believes enables drug abuse, he said.
King said he believes the science on harm reduction programs and believes they are effective.
“I do believe, I’m sure, they [syringe programs] save lives,” King said. “I believe it is enabling, though, and anyone who says otherwise is full of s**t.
“I understand the reason people advocate for it, I understand the public health aspect, but that’s only one aspect,” King continued, “there’s also the aspects of public safety and the economy.”
King said he didn’t know needle-stick injuries were not tracked among the public, and that he would support legislation to implement such a system in Charleston.
“It would be nice to have that information, yeah,” King said.
The issue is also personal for McKinney. She said she remembers growing up in the crack epidemic of the 1980s, watching many become addicted and, later, incarcerated. She said she still knows people serving time, and it’s hard for her to balance that with watching a group distribute syringes and “promote drug use” to a majority-white clientele in a majority-Black section of the city.
“It just doesn’t sit right, and I know it’s different, but people in my neighborhood, people on this side, our problem isn’t needles,” McKinney said. “I’m not saying no Black people inject drugs, but it’s a lot less I know. What are you doing for them? What do they get from you?”
McKinney said she knows increased HIV rates are a problem but she wants to know specifically how it affects the West Side. She previously said she hadn’t seen a study tying increased HIV rates to IV drug use.
The state is responsible for maintaining and monitoring HIV case numbers, and they’re recorded on a county-wide basis. Christine Teague, director of the Ryan White Program at Charleston Area Medical Center, previously has lamented a lack of testing on the West Side for HIV, especially among minorities.
HIV testing last year was down exponentially as health agencies battled the coronavirus pandemic. Yet HIV rates increased.
McKinney said she is not convinced. She said she remembers the HIV/AIDS epidemic of the 1980s, when millions of people died each year.
“It used to be hundreds of cases, thousands. I don’t think, 32 or 35 HIV cases are enough for me to justify giving out needles,” McKinney said.
McKinney, Campbell and others on the council also have cited concerns about needle litter and needle stick injuries.
There were less than 130 calls made to Metro 911 last year for needle litter. Twenty needle-stick injuries were recorded among Charleston City employees over the last three years, eight in 2018, two in 2019 and 10 last year, according to incident reports filed with the federal Occupational Safety and Health Administration. Five cases involved people being stuck while searching belongings. Most cases were punctures from uncapped needles in trash or people pricked while disposing of or bagging needles.
Solomon said a simple way to combat the problem would be to install more sharps containers around the city. In the past, he said, the group has tried to get support for that from the city but was blocked by red tape. There is such a container at the health department.
Campbell said he could spend an hour walking around downtown near his office and find 100 needles. He said he would not support legislation to add sharps containers in the city.
“We need to consider how we look to other people who come here. If we start putting sharps containers on the sidewalk, walking trails, around town, people are going to visit and wonder what’s the deal with having all those,” Campbell said.
King, who is also concerned about needle litter, said he does not support more sharps containers either.
Campbell said he knows needles, more than other drug paraphernalia, are stigmatized, but he also knows how scary it can be to find a needle.
Syringe programs can reduce needle litter, according to the CDC and a study published in Drug and Alcohol Dependence.
After the city halted the needle exchange program in 2018, the Logan County Commission passed a resolution banning an exchange program from starting there. In Cabell County, local politicians organized to reel in the Cabell-Huntington Health Department’s program.
“That is a real threat, and away from needle exchanges, too, not listening to science here, to research and evidence and data, could do irreparable harm to our efforts to end the opioid epidemic,” Cook said. “If we continue stigmatizing people instead of helping them, we will be worse off. There’s no getting around that.”
For Solomon, this battle isn’t just for Charleston. It’s for West Virginia and Appalachia.
“West Virginia is the heart of Appalachia, and Charleston is the heart of West Virginia. Other states, cities in the region look to us for progress,” Solomon said. “If we draw the line here against what we know works, against science, against helping our people, I think others could follow, and that’s scary. This isn’t just a city council vote; it’s a vote for the state, for the region and I hope council will see that.”
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