HB232 Would Legalize Syringe-Exchange Programs for Drug Users 

Sticking points: Proponents say program would reduce HIV and other diseases.

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The Utah House of Representatives voted unanimously in favor of a bill that aims to allow clean-needle-exchange programs aimed at reducing infectious diseases like HIV among injection-drug users. An amendment made to the bill, however, could create a flow of clean needles to users without any legal mechanism for collecting and disposing of the used ones.

This is mostly a victory for activist and fourth-year University of Utah pharmacy student Melissa Brewster, a single mom with two daughters. Brewster has family members who are intravenous-drug users, which sparked her interest in drug-control policy and lobbying for the bill throughout the past year. “I lost one of my brothers to heroin overdose shortly before I started pharmacy school,” she says.

Brewster spoke to City Weekly from Thailand, where she’s on a six-week tropical-medicine educational tour. She’s surprised the bill hasn’t been more controversial, but says the growing tally of drug-overdose deaths is persuading lawmakers to analyze drug-control policy in new and surprising ways.

“People are starting to realize that we have a growing drug problem in Utah. We have more accidental-overdose deaths from prescription medications than we do car-accident deaths. People are seeing kids younger and younger, even kids on the east side, getting into Oxycontin, and when they can no longer afford Oxycontin, they turn to injection drugs,” Brewster says.

About 19 percent of all U.S. cases of HIV—of which there are approximately 1 million—are attributed to injection-drug use, according to the U.S. Centers for Disease Control and Prevention. Approximately 40 percent of injection-drug users with HIV are diagnosed more than a year after they are infected, CDC data show, giving them ample time to infect others with whom they share needles.

House Bill 232 is sponsored by Rep. Evan Vickers, a Republican pharmacist from Cedar City, who credits Brewster with both conceiving the bill and gathering support for it. The House voted 68-0 in favor of the bill Feb. 17 after a unanimous recommendation by the House Judiciary Committee Feb. 9. Vickers says the hope of reducing Medicaid costs has persuaded lawmakers to support the bill.

“Right now, if someone wanted to conduct a syringe-exchange program, they have to do it below ground,” Vickers says. Brewster says an underground needle-exchange program existed in Utah but is now defunct. “[HB232] would allow them to do that above ground, but that’s not the main emphasis of the bill.”

The main emphasis, Vickers says, is to remove legal liability from distributors of unused syringes—like pharmacists. Currently in Utah, “It is unlawful for any person to deliver … any drug paraphernalia, knowing that the drug paraphernalia will be used to … inject … a controlled substance into the human body.” HB232 would make possession of unused, sealed syringes strictly legal and legalize distribution of syringes to known drug users for “the prevention of disease transmission.”

Needle-exchange programs have been widespread in Europe since the 1980s and highly controversial in the United States for just as long. Until recently, the United States prohibited the use of federal funding for syringe-exchange programs. Nevertheless, nearly 200 needle-exchange programs exist in 38 states, with funding from local governments or private sources, according to the Harm Reduction Coalition.

This month, says Harm Reduction Coalition’s western director Hilary McQuie, “The U.S. Surgeon General confirmed that needle-exchange programs did reduce the instances of HIV and did not increase drug use.” As a result, federal health-and-human-services funding can now be used for syringe-exchange programs.

“The loosening up of the federal purse strings has gotten a lot of states and health departments to clean up their paraphernalia laws … to be able to bid for the federal funding,” McQuie says.

The Utah Department of Health, Utah Law Enforcement Legislative Committee and the Utah Substance Abuse Advisory Council all support the bill.

Harm Reduction Coalition has not taken an official position, as McQuie has concerns that the bill does not go far enough to legalize syringes. Luciano Colonna, the former executive director of the now-defunct Salt Lake City-based Harm Reduction Project, also criticized the bill on his Facebook page. %uFFFD

A big problem with the bill, McQuie says, is an amendment that removed language that decriminalized possession of a syringe used for illicit drugs if the used syringe were contained in protective packaging. By removing that legal means of possessing and disposing of dirty needles, McQuie worries that syringe-exchange advocates would have no legal way of collecting used syringes and disposing of them properly.

“That [amendment] surprises me,” Brewster says. “That was one of the most valuable parts. I thought if we were having people properly disposing of [used] needles, that would be a great thing.” Even still, she’s excited to see the other aspects of the bill embraced by the Legislature.

Sen. Pat Jones, D-Salt Lake, will sponsor HB232 in the Senate, where it has yet to be assigned to a committee.

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