Needle exchange bills make way through Legislature

Monitor staff
Published: 2/15/2017 7:36:52 PM

Epidemiologist Robin Pollini researches infectious disease resulting from IV drug use, everywhere from California and Tijuana, Mexico, to Massachusetts, Maryland and New Hampshire’s Strafford County. In her 17 years on the job, she hasn’t seen a place suffering as badly as New Hampshire, except for Tijuana.

“The level of drug use combined with the complete lack of access to syringes is generating an epidemic that the state is going to be paying for for a very, very long time,” Pollini recently told lawmakers.

With New Hampshire in the grip of a heroin and fentanyl crisis, health officials are warning of another crisis looming on the horizon – a spike in the number of people with HIV, Hepatitis C and other serious infections that can come from sharing needles.

Hepatitis C is of particular concern – the blood-borne disease is more easily transmitted than HIV, and it’s starting to show up in New Hampshire.

At Catholic Medical Center in Manchester, three-quarters of IV drug users that come into the hospital test positive for Hepatitis C, according to Chief Medical Officer Dr. William Goodman.

Even though older drug users are more likely to get the disease, Goodman is starting to see more young people testing positive.

New Hampshire’s Department of Health and Human Services only started collecting data on the disease in November, and should be releasing a report in the coming months, according to spokesman Jake Leon.

Health advocates say the crisis has worsened because there’s no ready supply of clean needles in New Hampshire.

This year, there are two bills in the New Hampshire Legislature that would create a needle exchange, House Bill 610 and Senate Bill 234.

While it is legal for New Hampshire pharmacies to sell needles, few do – wary of addicts shooting up and overdosing in the bathroom or parking lot.

And in the state, possessing a dirty needle containing heroin or fentanyl is a felony, carrying up to a seven-year prison sentence.

Without a ready supply of clean syringes, drug users are getting desperate, health officials said. Some shoot up with used needles they find on the side of the road, while others have been caught fishing dirty needles out of disposal boxes in hospitals.

Goodman remembers one patient at Catholic Medical Center who had unwound a wire hanger in his hospital room and was using it to fish a dirty syringe out of a disposal box, desperate for what little opiates it contained.

“It’s an addiction,” he said. “It’s sort of like you’re thirsty in the desert (and) there’s a collection box in your room.”

Clean and used needles are being sold on the street at a going rate of between $1 and $20 per needle. Other drug addicts are using the same needle over and over again, until they develop abscesses and the metal tip breaks off in their arm.

New Hampshire is the only state in New England that has yet to implement a needle exchange, despite an endorsement from the Centers for Disease Control and Prevention and studies showing the programs ultimately help reduce harm.

“We wish people didn’t have to use needles at all,” Goodman said. “If they have to use needles to stay healthy until they get into recovery, it’s a cost-effective way to do that.”

There’s a key difference between the needle exchange bills now before the Legislature; in addition to legalizing needle exchanges, SB 234 would also decriminalize trace amounts of drugs left in dirty needles – allowing users to safely dispose of needles without fear of prosecution.

Advocates say this is the best way to make sure needles aren’t being discarded in public parks and on streets.

Without an exchange that allows users to dispose of dirty needles, the program is effectively going to be putting even more syringes on the street, Pollini told lawmakers Tuesday.

She said the biggest reason drug users in Strafford County throw away dirty needles in public places is because they’re afraid of being caught and arrested.

“They fear holding them so they throw them out the car window, or if they see the police, they’ll throw them in the park because they don’t want to be caught with that syringe, even if it’s empty and just has residual in it,” Pollini said.

While law enforcement officials say they are fully behind the idea of a needle exchange, they aren’t as enthusiastic about the idea of decriminalizing trace amounts of drugs left behind.

“It’s hard to define what a residual amount is,” said Tim Pifer, director of the forensic lab for New Hampshire State Police. That’s because some drugs are much more potent than others, he said.

For instance, fentanyl is much stronger than heroin. Just a trace amount could kill someone, Pifer told lawmakers.

Pifer added that when police make traffic stops, spotting syringes in a car can be a clue that someone is trafficking.

“These are absolutely being used in prosecutions,” he said. “This does take a tool away from law enforcement.”

However, advocates said the sheer cost of treating infectious disease that stems from IV drug use alone is a reason to start a needle exchange as soon as possible.

The disease is extraordinarily expensive to treat – the Hepatitis C cure drug Harvoni costs more than $100,000.

“It’s an epidemic that’s going to explode at some point unless we act,” said Dr. Joe Hannon, a former state representative from Lee and fierce advocate for an exchange. “These people are pushed underground. They’re afraid to get help.”

(Ella Nilsen can be reached at 369-3322, or on Twitter @ella_nilsen.)

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