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Local officials weigh options of needle program

Martinsville Bulletin - 7/9/2017

MARTINSVILLE?Should Martinsville, Henry or Patrick counties apply to run a "harm reduction" program? And if they do, what impact will that have on how local laws are enforced? Those are the questions being weighed by local officials, in the wake of the new law that took effect in Virginia on July 1.

Earlier this year, the Virginia General Assembly passed a law authorizing the commissioner of health to establish and operate local or regional comprehensive harm reduction programs during a declared public health emergency. The law went into effect July 1. On Nov. 21, 2016, State Health Commissioner Dr. Marissa Levine declared the opioid addiction crisis addiction crisis in Virginia a public health emergency.

What is a "comprehensive harm reduction" program? As the Bulletin reported earlier this week, the program is designed to "reduce the negative impact of drug use including HIV, hepatitis C, other infections, overdose and death, among people who are unable or not ready to stop using drugs," according to a Virginia Department of Health website.

Comprehensive harm reduction programs are split into several parts. First, local health departments can allow drug addicts 18 years and older to come in and pick up sterile needles and syringes. Second, those addicts are allowed to bring in used needles and with no questions asked, the department can dispose of them. Third, addicts are offered information through an education program and referral to drug treatment, testing and other health services.

Specifically, they have to provide counseling to the addict that focuses on making behavioral changes that "reduce or eliminate [the] use of drugs." Also, the programs have to offer educational materials to the addicts that talk about ways to prevent drug abuse and include information about where and how the addicts can get treatment. Also included in the bill is a requirement for the local programs to provide condoms to the addicts as well as alcohol skin wipes that reduce other infections, bandages to reduce the potential for blood exposure after injecting the needle and supplies that help them carry the syringes, needles and other materials home from the health department.

There are some questions that come with the program. As it stands currently, a person caught with items labeled as "drug paraphernalia" can be charged with a crime. But if the state and city or county are the ones providing the needles and syringes, does it make sense to turn around and charge people for using those materials?

The Martinsville Bulletin asked Henry County Sheriff Lane Perry and Patrick County Sheriff Dan Smith what their departments will do now about drug paraphernalia cases.

Perry said his department possibly might file charges if drug users participating in the program used needles and syringes in a way that goes against the intent of the program ? for example, not properly disposing of them but rather continuing to reuse them. That would be looked at on a case-by-case basis, he said.

Perry said his department will continue to charge people for paraphernalia offenses involving smoking devices and scales.

"In terms of simple possession of paraphernalia charges go, we enforce the laws of the Commonwealth," Perry said. "That's what we have sworn to do. In some cases, a simple possession charge is what gets the addict on the path to recovery through a judge's mandate of drug treatment/education. So, there is benefit to criminally charging for such offenses."

According to the protocols and standards, comprehensive harm reduction programs: "are required to provide appropriate disposal of used hypodermic needles and syringes"; "must provide sterile needles and syringes and other injection supplies at no cost to participants"; "must ensure reasonable and adequate security of program sites, equipment and personnel"; and "must be able to verify that a hypodermic needle or syringe or other injection supplies were obtained from their program."

Smith also pointed out that in his area, he hasn't seen a lot of needle use among the opioid addicts.

"Most of what we are seeing is prescription pill abuse by taking the drug orally or by crushing and snorting the pills," Smith said. "At this point, I fully support anti-opioid education, but I do not support supplying needles or other drug paraphernalia to addicts. If giving out needles is a condition of participating in the program, then this office will not be participating."

Politicians weigh in

In recent months, Martinsville and Henry County (which are combined for the purposes of calculating the population rate per 100,000) have had among the highest rates of emergency department visits for unintentional overdose by opioid or unspecified substance among localities reporting in Virginia. For example, Martinsville and Henry County tied for the fourth highest rate in Virginia in December 2016, had the highest rate in Virginia in January, tied for the 11th highest rate in February and tied for the seventh highest rate in April, according to Virginia Department of Health data.

Martinsville Vice Mayor Chad Martin said he would support the idea of the city applying to operate the program.

Chad Martin said: "In reviewing the wonderful work of our amazing police while seeing the local and the national trend of opioid abuse, I would definitely be in favor of the (comprehensive harm reduction) program," Martin said. "The work that department of health, healthcare coalition, as well as the hospital on promoting good health in our locale it would lead me to believe they would be the best leads on a project like this. They are accessible to the public and with the new partnership of the Martinsville and Danville hospital, it becomes a regional conversation about public safety."

"A project of this nature would easily be able to be funded through a state or federal grant," Martin added, "with all stakeholders being able to benefit in a win-win outcome while bridging stronger ties with existing organizations who serve the community."

Martinsville Mayor Gene Teague and City Council member Sharon Brooks Hodge were more tentative when asked if they would support the idea of the city of Martinsville applying to operate a comprehensive harm reduction program.

"This [just became law] on July 1st, and it is a grant that is available if you meet certain standards and protocols," Teague said. "It will take some time for our locality to digest this information and determine if we need to/want to apply for this grant and if there are benefits or consequences to implementing a program like this. Before rushing to any judgment, I would want to hear from the experts on the benefits and any unintended consequences. We will be inviting Dr. Hershey to a future council meeting to provide a more public overview of what this is and (its) applicability to our region." Teague was referring to Dr. Jody Hershey, director of the West Piedmont Health District.

"Actually, I have not yet formed an opinion," Brooks Hodge said. "I don't believe I have enough information right now to either support or oppose it."

The other members of Martinsville City Council, Martinsville Police Chief Eddie Cassady and all the members of the Henry County Board of Supervisors did not respond to requests for comment by press time.

Henry, Patrick and Franklin counties and the city of Martinsville are among the 55 localities in Virginia eligible to submit applications to operate local or regional comprehensive harm reduction programs.

Dr. Hershey said the comprehensive harm reduction programs "can be established in areas of higher risk where the data shows risk for or increases in HIV, viral hepatitis, and/or other blood-borne infections resulting from injection drug use."