House committee approves bill to legalize syringe exchange programs for IV drug abusers

A House Committee has endorsed continued operation of programs that offer clean needles to drug abusers.

Representative Holly Rehder (Photo: Tim Bommel, Missouri House Communications)

Those programs aim to get drug users into treatment by introducing them to medical professionals who can consult with them while providing them clean needles.  They also fight the spread of diseases like HIV and Hepatitis C, which are often transmitted through the use of dirty needles.

Representative Holly Rehder (R-Sikeston) is carrying the legislation for a third straight year.  She said such programs operate in Missouri now, including one in St. Louis County and one that has been operating for decades in Kansas City, but they are technically in violation of state laws against distributing drug paraphernalia.

“The cities look the other way.  It’s kind of a gray area because the cities want them there because they are helping so much with harm reduction,” said Rehder.

“We do not want to create a scenario of increasing drug use.  In fact, syringe access programs have been found to cause a 13-percent reduction in use.  They play a very large role in the referral for treatment.  They’ve also been found to decrease needle sharing by 20-percent,” Rehder told the House Committee on Health and Mental Health Policy.

“[Drug abusers] are already using needles for their addiction.  No one starts using the needle because they can get a free one,” said Rehder.

The top Democrat on the committee, Representative Doug Clemens (D-St. Ann), said he is enthusiastic about House Bill 1486, and the finding that users who take advantage of needle exchanges are five times more likely to enter a drug treatment program.

“I appreciate legislation like this which actually works to solve a problem instead of punishing people arbitrarily for a disease.  Addiction is a disease and it’s something that we in Missouri are struggling with every day,” said Clemens.

Chad Sabora has testified to House committees on this proposal for several years.  He runs a needle exchange program in Missouri.  He is also a former Chicago prosecuting attorney who has been clean from a heroin addiction since 2011.  He said the way society treats drug abusers now could be described as, “negligence and malpractice.”

“The message has been call me when you’re ready for help.  The message has been when they get arrested they’ll get help, when they show up at a church basement for an AA meeting they’ll get help, when they make that phone call to treatment they’ll get help.  One hundred thousand people died last year because that’s our philosophy.  Our philosophy needs to change,” said Soborra.

Bill Kraemer of St. Genevieve testified in favor of the bill.  He told of finding his daughter dead on a basement floor of an overdose.  He managed to revive her and she recovered, and today is 2.5 years clean and just had a baby girl.

He said he learned through his experience with her that drug users will resort to dirty needles if they must.

“A person who needs to inject, sometimes they are so in need that they let their inhibitions down.  They need to shoot up so they will use a dirty needle.  My daughter was always meticulous in not using a dirty needle, always, but she found herself a couple times in need to inject and she used somebody else’s needle, and out of the three times that she used a dirty needle she got Hep C,” said Kraemer.

Kraemer and representatives on the Committee said they hope needle exchanges will spread to rural parts of the state, because it is needed there at least as much as in Missouri’s urban centers.

Rehder and other proponents of the programs say their ability to combat the spread of diseases is particularly important now.  Missouri is on the verge of a crisis in the spread of HIV and Hepatitis-C, mostly among drug users who are sharing needles.

“Right now in Missouri we have 13 counties on the CDC’s top five percent watch list … across the U.S. of counties that are on the verge or at risk of Hep C and/or HIV outbreaks,” said Rehder.

The proposed change would cost Missouri nothing as these programs are privately funded.  Rehder said the legislation could actually save the state some of the cost it has expended to treat drug abusers.

In each of the last two sessions the House has passed needle exchange legislation by sizable, bipartisan votes, but it has stalled in the Senate.  HB 1486 has been approved by one House committee and is awaiting a hearing by a second.

House asked to back needle exchanges to stem potential disease outbreaks

Members of a House Committee have been told a bill to exempt needle exchange programs from drug paraphernalia laws could help combat a potential outbreak in intravenous diseases like HIV and Hepatitis C.

Representative Holly Rehder (photo; Tim Bommel, Missouri House Communications)

Representative Holly Rehder (R-Sikeston) told the Special Committee on Urban Issues that abusers who take advantage of needle exchange programs are five times more likely to enter treatment programs.

The committee also heard that the Centers for Disease Control have identified 10 counties in Missouri where conditions could lead to an outbreak like that in Scott County, Indiana.  In that county of more than 24,000 people, 227 became infected with HIV in 2015 and 2016 due largely to sharing needles used to abuse intravenous drugs.

“This bill is to, honestly, sanction existing programs that we have running in the state,” Rehder told the committee about her bill, House Bill 1620.  “Right now we have syringe access, or needle exchange which it is also called, running in the St. Louis area and the Kansas City area.  These have been ongoing for some time but the problem is that they’re running in a somewhat grey area because Missouri’s law has a paraphernalia charge that could be charged.  The local jurisdictions have not pressed that because they see the good in these programs.”

Chad Sabora is a former prosecutor who became a heroin user, and is now an activist in fighting heroin addiction.  He runs one of the needle exchange programs operating in Missouri, which he said won’t stop an outbreak but is a “crucial piece of the puzzle.”

“80-percent of the people that use my syringe access program I put into treatment within three months, because as Holly stated it’s early engagement,” said Sabora.  “They walk into my office seeking clean needles and nothing else, and what they get is something different. They get conversation, they get compassion, they get treatment resources that they did not know exist, and once they find out that all these options are available for them most of them reach out for help, and I never would have told them about those options if they didn’t walk into my office just to get that clean needle that day.”

The committee heard needle exchange programs could also save the state money.  Rehder told the committee the cost to treat HIV patients on Medicaid is expected to increase this year because of changes to the Medicaid program.

Sabora told the committee that a rule change by the Department of Social Services means that anyone with Medicaid can receive treatment for Hepatitis C.

“Before that passed, when it was only the very limited few that got Medicaid treatment, the state still spent upwards of $80-million in 2014.  We can reduce these infections, we can reduce future cost of treatment, and lower the cost to the state,” said Sabora.

Rehder has led legislative efforts in recent years to pass a statewide drug monitoring program to help fight opioid abuse, and has shared how opioid addiction struck her family; her daughter became addicted to opioid painkillers after being treated for a cut she suffered at work.  Rehder said she sees this as another tool to fight opioid addiction.

“We’ve got to be sure that we move emotion to the side and actually look at the numbers, look at the statistics – what’s working?” said Rehder.  “When people first hear about needle exchange one of the first things they say is that’s enabling a user, but you have to look past that.  You have to look beyond the stigma of addiction and you have to see, ok but what helps?  What works?  What gets better outcomes?”

Rehder said if her bill passes to remove the “gray area,” she believes needle exchange programs will spread to other parts of the state including the counties flagged by the CDC.

“There are some federal dollars that we’re passing up right now because we don’t have in statute that these are clear of any gray area, so once we get this passed these individual health departments or individual needle exchanges can reach out to get some of that help in some of these more underserved areas,” said Rehder.

The committee voted unanimously to pass HB 1620.  It next goes to the House Committee on Rules.