Harm Reduction Programs Face Regulations, Sheriff Approval

Programs that hand out clean syringes to IV drug users may soon be required to obtain a license.

Senate Bill 334 passed the West Virginia Senate Tuesday, and as written, it would hold harm reduction programs to some basic standards. But opponents say it could shut down critical services that curb the spread of HIV.

West Virginia has long struggled with opioid use, and many are connected to the crisis in some way.

Democratic Sen. Richard Lindsay of Kanawha County talked on the floor Tuesday about his younger cousin who has a drug use disorder, but is now in recovery.

“And I’m so proud of him, but I guarantee you he would not be alive, he would not have children, he would not have a family and job, if he contracted HIV or Hep C in the process,” Lindsay said.

IV drug users face a serious risk of becoming infected with HIV and other blood-borne illnesses. And West Virginia has two of the most concerning HIV outbreaks in the nation — in Cabell and Kanawha counties.

To combat the crisis, several harm reduction programs have started handing out clean syringes to prevent users from sharing potentially infected needles.

These programs are unlicensed and are run by non-profits, local health departments and grassroots volunteers.

Republican Sen. Eric Tarr of Putnam County wants needle exchange programs to be regulated like most other public health programs.

“I can go out in the parking lot and start distributing needles. There’s no regulation that says I can’t,” Tarr said.

Senate Bill 334, sponsored by Tarr, calls on programs to obtain licenses through the state.

That involves plenty of paperwork, quarterly reports, and licensed health staff on hand. These programs would have to ensure they’re also providing other services like STD testing, birth control, overdose reversal supplies and education. Participants would also need to show a West Virginia ID.

The bill also instructs programs to keep a close watch of the number of needles they distribute. Programs would need to follow a 1:1 exchange, as much as possible. That means giving one needle for every needle a participant returns.

Dr. Michael Kilkenny, CEO and chief health officer at the Cabell-Huntington Health Department, says a 1:1 exchange doesn’t work well. He said it’s too restrictive, and can lead participants to opt out.

“1:1 says if you don’t bring me any, you don’t get any. It doesn’t mean you don’t need them,” Kilkenny told West Virginia Public Broadcasting. “For public health, it won’t change the statistics.”

His department started a syringe exchange program in 2015. In the past it was more restrictive, limiting the number of needles and who it served. He’s pivoted.

“Some of the things in SB 334 are mistakes I’ve already made or observed. We don’t have the luxury of making the same mistake over and over again,” Kilkenny said.

The bill would also require programs to mark each individual needle to better track them.

Tarr said all of this is in the name of public safety. He worries that needles supplied from these programs are ending up on sidewalks and other public outdoor spaces.

He also added language in the bill that local sheriffs could shut down these programs at any time.

“Should that needle exchange be significantly increasing the crime in that area, placing his deputies at risk, police and other law enforcement at risk, placing the community at risk… he can rescind the letter of support. And it produces a closure of that needle exchange,” Tarr said.

That’s on top of approval needed by county commissions.

The bill passed the Senate 22-11. It now heads to the House of Delegates.