Desperate times call for desperate measures. And if there’s anything more desperate about New Hampshire’s opioid addiction crisis than the lives surrendered to this epidemic through overdoses, it just might be those lost to diseases spread through infected needles.
Yes, the epidemic is terrible in itself, but it’s brought with it a rise in deaths due to HIV and hepatitis. In 2016, the Centers for Disease Control and Prevention urged states to start needle exchange programs to help prevent HIV outbreaks.
“Opioids are a major public health problem in the U.S., not only because there were tens of thousands of overdoses last year, but also because the crisis is increasing infections of hepatitis A, B, and C, HIV, and STDs,” said Dr. Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, STD and TB Prevention, at a March conference.
Among the most effective means of lessening this threat are needle exchange programs, in which new, clean needles are provided to addicts in exchange for used ones.
The first response to such an idea may be: “Wait. What? Helping people use opioids is a good health policy choice?” Understandable. Providing free, clean needles doesn’t, as far as we know, reduce drug use. But it likely doesn’t increase it, either — with this exception: those who would have died or become so sickened by dirty needles that they couldn’t shoot up anymore.
And that’s the point: Such exchanges aren’t meant to stop opioid use. There are other efforts aimed at that. They’re a harm-reduction measure aimed at lessening the spread of communicable diseases. By doing that, they actually save public resources and medical costs in the long run.
Take Keene’s new syringe-exchange program. Run by the Keene Serenity Center, a nonprofit addiction-recovery facility, it’s funded by a grant from AIDS United, a national program that promotes strategies to reduce the spread of HIV.
Needle exchanges have been around for several decades, thanks to the AIDS epidemic. But they’re new to New Hampshire. This would be the fifth in the state, all made possible by legislation two years ago.
In 2017, lawmakers changed the state statute dealing with drug paraphernalia to exempt those working within a needle exchange program. Possessing dirty needles with residue or trace amounts of drugs like heroin is otherwise a crime in New Hampshire. The revised law allows for possession of needles and syringes with trace amounts of drugs, but only by those involved in exchanges.
The Keene program, which begins this month, will include visits to local homeless encampments. The first reason for this approach is that, according to the National Coalition for the Homeless, more than a third of homeless people struggle with drug and alcohol misuse. They also have fewer resources, and so may be more likely to share or reuse syringes. So they’re a prime target for the exchange.
Also, we suspect, this approach is meant to assuage fears that addicts will be drawn to the center’s Mechanic Street headquarters. Of the four existing programs, three, like Keene’s, bring syringes to targeted populations. Only Claremont’s exchange, at Valley Regional Hospital, distributes them in-house.
Billions of dollars and other resources have been committed to dealing with the opioid crisis. But if the tide is turning, it’s doing so slowly. Many more will die before anything close to success is achieved. Like the ready distribution of Narcan, syringe exchanges will help prevent unnecessary deaths while the fight continues.