In last week’s column, I talked about expanding Maine’s Good Samaritan law, which makes saving the lives of people who use drugs easier in the short, immediate term by making it safer to call 911 in case of an overdose emergency. This week, I’d like to talk about a controversial but important resource for saving lives in the medium to longer term: syringe service programs, aka needle exchanges.

Some people who use drugs get to a point where they need syringes to inject them. That’s a fact. Medical syringes are generally meant to be single-use. That’s another fact. However, needles and syringes are often hard to come by, as they tend to be regulated medical supplies, which means that a person using them for illegal purposes is more likely to reuse or share needles. Reusing syringes puts someone at more risk for injury (the metal can get duller or rusty). And sharing needles, of course, can lead to shared infections, like HIV and hepatitis B and C. Fun fact: The plural of “hepatitis” is “hepatitides”! Sad fact: It’s possible to be infected with both hepatitides B and C at the same time, and both strains of the virus can lead to liver damage.

At a needle exchange, people can properly dispose of their used needles and receive clean, safe ones. Needle exchange programs also offer other harm reduction resources to help people who use drugs do so as safely as possible. These might include naloxone (to reverse overdoses); fentanyl testing strips (as you can’t really rely on drug dealers for quality control); HIV and hepatitides testing, and, yes, referrals to rehab and treatment.

Some people don’t like needle exchanges because they think that illegal drug use should be as dangerous as possible, as some sort of deterrent. The rising rates of drug-related deaths in Maine prove that no such deterrent exists. If you’ve gotten to the point where you are self-injecting with heroin, you have bigger things to worry about than the tut-tutting disapproval of general citizenry. Mostly, you’re worried about getting through the day and staving off withdrawal. Needle exchanges meet people where they are, which I find to be a very Christlike thing to do. (Source: Thirteen years of Catholic school education and going to Episcopal Mass every Sunday.)

Right now, needle exchanges in Maine are governed by a rule that states they must operate on a one-for-one basis: You must turn in a dirty needle for every clean needle you receive. This is a problem in a rural state like ours. Maybe the closest exchange is an hour away and you can get there only once a week, and you want to be able to take enough needles to last you the full week, but the law currently prevents that. Also, syringes are small, delicate and easy to break and lose, which can make it harder to turn them back in.

For a while during the pandemic, an executive order from Gov. Mills actually lifted the one-for-one restriction, so that people could stock up without having to come in and risk passing COVID-19 around. (Increasing the spread of disease goes against the whole point of the exchange programs, as we have already discussed.) Most folks not directly involved in the drug or recovery community probably didn’t notice.


A proposal before the Maine Legislature, L.D. 1909, would remove the one-for-one restriction permanently. It’s sponsored by Rep. Genevieve McDonald, a Democrat from Stonington (which also happens to be where my dad came from).

The primary concern that legislators seem to have about this bill – and one of the main reasons people tend to be against needle exchanges operating in their towns – is worry about an increase in syringe litter. Fortunately, it is literally not true that a needs-based approach to syringe programs increases syringe litter. The federal Centers for Disease Control and Prevention has gathered several peer-reviewed studies that prove it, and they support needle exchanges supplying needles on an as-needed basis. And yeah, I know the CDC hasn’t been perfect lately, but do you really think they would take such a publicly unpopular position as “give drug addicts more supplies” if there weren’t exceedingly convincing scientific reasons to do it?

In public policy, feelings tend to win over facts. But I’ve got an idea to reduce syringe litter. First, distribute biohazard sharps containers – the same type you see in hospitals and doctors offices – in varying sizes to everyone who asks. And secondly, treat them like aluminum cans, and give people a quarter for every syringe they turn in. No cans litter the road within a one-mile circle of my house. Do you know why? Because when my mom and I walk the dogs, we take a bag along with us and pick them up, as that’s money in the bank.

Finally, even if you don’t care about the lives of people who use drugs, let your heart be moved by the plight of health care workers. Pretty much everyone in the medical field is burned out right now. Specialists are booking out weeks and months. The last thing an overbooked cardiologist needs is to be called in on their day off to treat an urgent case of infective endocarditis. Every hepatitis infection prevented might mean one less person who needs a liver transplant a few years down the line. Every overdose that doesn’t happen is one less bed in the hallway of an overcrowded emergency room. Please pass L.D. 1909.

Victoria Hugo-Vidal is a Maine millennial. She can be contacted at:
Twitter: @mainemillennial

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