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For years, most of Arizona's needle exchange programs have operated underground. Under state law, hypodermic syringes are considered to be a form of drug paraphernalia, meaning that anyone found to be distributing syringes or needles can be charged with a Class 6 felony.
In Tucson, law enforcement officers won't arrest people who distribute clean needles as part of a county-sanctioned public health program. But in the rest of the state, similar programs exist in a legal gray area.
House Bill 2389 would change that by explicitly allowing local health departments and nongovernmental organizations to operate programs that hand out clean needles to drug users for free, and safely dispose of used (and potentially contaminated) needles.
"There’s a desperate need for it, even before the opioid epidemic," said Haley Coles, the director of Sonoran Prevention Works, which is helping to push the legislation. "The fact we know there are lots of people injecting drugs — more and more every day — means that we need to be proactive about making sure there’s not an outbreak of HIV and Hepatitis C."
Though it's legal for pharmacists to sell syringes without a prescription, very few opt to do so, Coles said.
Needle exchanges are often controversial, and some opponents, like Maricopa County Attorney Bill Montgomery, feel that the approach sends the wrong message. In an interview with KJZZ, Montgomery likened syringe-access programs to "a free-case-of-beer-a-month program for alcoholics."
But, as Coles points out, "Withholding [clean syringes] doesn’t prevent them from using drugs. It just puts them at risk of contracting hepatitis and HIV, in addition to other preventable illnesses."
Also, she notes, needle exchange often become a trusted resource from drug users, and can ultimately help guide them towards drug treatment programs and other social services. One study frequently cited by the Centers for Disease Control found that drug users who participate in syringe access programs are five times more likely to enter rehab.
"Truly, it’s a way to get people into treatment, refer people into services like housing, and really take people off the streets," she said.
The bill doesn't ask for any public funding for needle exchange programs, Coles noted. Advocates simply want to make sure that methadone clinics, community health clinics, hospitals, and other agencies that are already treating drug users can give out clean syringes without running the risk of prosecution.
It would also provide legal immunity for groups like A Shot In The Dark, an unsanctioned syringe access program which currently operates in Maricopa County.
Though syringe access programs are often thought of as a liberal issue, the bill was introduced by state representative Tony Rivero, a Republican who represents Sun City, Surprise, and Peoria.
That's by design.
"None of this would have a chance if it wasn’t bipartisan," Coles said. "It’s not a secret who has been the most impacted by opioid overdose deaths, and that’s white people. We’re seeing that trickle into upper-class and middle-class households, and we’re seeing a lot of elected officials who have family members affected by the crisis. It’s become real to to them, when previously they weren’t connected to the issue."