Leaders in Lewis and Clark County will start discussions later this year on the possibility of creating a needle exchange program. However, many of them say they still have reservations about the idea.
On Thursday morning, the Lewis and Clark County commission voted to accept a $5,000 Centers for Disease Control and Prevention grant, through the Montana Department of Public Health and Human Services. They will use the money to set up a community-wide evaluation of a possible “integrated syringe services program.”
“We’re going to conduct a collective impact project with local stakeholders and decisionmakers to evaluate the program – whether or not it makes sense in our community, to look at the facts, look at the data,” said Eric Merchant, Lewis and Clark Public Health’s disease control and prevention division administrator.
Public health leaders say they’re concerned that the use of injected drugs – including heroin, opioids and meth – may lead to the spread of infections like HIV and hepatitis C.
“We can have a situation, as we’ve seen in communities across this country, where there’s very low incidence of HIV infection, and then something happens like an outbreak associated with intravenous drug use, and you go from a very low incidence to all of a sudden a very high incidence pretty quickly,” Merchant said.
They say a syringe services program could help address that risk. It would allow drug users to turn in used needles in exchange for clean ones, reducing the chance of contamination. In addition, program staff would try to direct users to other services, like mental and behavioral health and addiction support.
“The theory behind an integrated syringe services program is that you’re providing something that those individuals that are addicted to drugs want – that is, clean materials to do drugs,” said Merchant. “When they are accessing those resources, they then have access to other resources.”
Merchant said Flathead County has already started a syringe services program, and a nonprofit in Missoula County offers one as well.
Needle exchange programs have become controversial around the U.S., with opponents arguing they enable drug abuse and the negative effects that go along with it.
During Thursday’s meeting, Helena Police Chief Steve Hagen and Lewis and Clark County Sheriff Leo Dutton both said they have serious concerns about the idea of a syringe services program, but that they are willing to be part of the discussion.
“I am going into it with a bias: that I’ve seen the criminality from drug use, and providing needles for the furtherance of that is not something that I’m in support of,” Dutton told MTN. “But I’ll keep an open mind, I’ll listen to what they say, and then make a decision after that.”
Dutton said drug abuse is a contributing factor in a large percentage of the crimes his office responds to – particularly violent crimes. He said his initial reaction to needle exchanges was that they were comparable to “giving condoms to people who commit sexual assaults.” He said he wants any new program to focus more on educating people and getting them help for their addiction, rather than simply on providing supplies for drug use.
Some county commissioners also expressed reluctance about moving forward, but they said they want to see the data and have a full conversation with the community.
“I’m not in favor of needle exchanges; just the title, I’m put off,” said Commissioner Jim McCormick. “But, as others have stated and from my conversations with Mr. Merchant, I’m willing to listen.”
“I look forward to participating in these conversations,” said Commissioner Susan Good Geise. “Know that I am a skeptic going in, but for 70 years, we’ve tried one approach. It’s not working very well. We need to own up to that. And so it’s time to examine the pros and cons of another approach.”
Merchant said they hope to begin holding these discussions soon. The grant will extend through mid-October.
Dutton said, if a syringe services program is to go forward in Lewis and Clark County, the community will have to be behind it.
“If there’s a substantial backlash, pushing back, saying ‘No, we don’t want this exchange,’ that’s something that we all should consider and heed to,” he said.
Commissioner Andy Hunthausen said it is worth taking this time to look closely into the possibility.
“We’ve got to study ways to try and make a difference,” said Commissioner Andy Hunthausen. “If it is something we can benefit from, then great. If not, then we’ll move on.”