Why aren’t needle exchanges legal in PA? Advocates, scholars and politicians are asking

Syringe programs have been shown to reduce HIV infection and combat harm.

Prevention Point's syringe exchange program in action

Prevention Point's syringe exchange program in action

Prevention Point
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In Pennsylvania, needle exchange programs like Prevention Point Philadelphia are technically illegal, but there’s a growing movement for legalization.

The exchange programs, which have been shown to reduce incidence of HIV, fall afoul of the state’s drug paraphernalia laws, which criminalize possession of syringes. A swell of support has grown for changing that classification, as a way to combat the harm associated with the opioid epidemic.

Philly and Pittsburgh have legal exceptions that allow exchanges to operate. In 1992, then-Mayor Ed Rendell signed an executive order legalizing them in Philadelphia. In April 2002, Pittsburgh followed suit and established its own county-authorized needle exchange.

But the statewide drug paraphernalia laws are still on the books. Efforts to revise them have come from multiple directions.

The advocacy community is one. Last month, the Pennsylvania Harm Reduction Coalition started a Syringe Services Campaign that aims to collect signatures in support of exchange legalization.

Academia is another. In what’s considered an unprecedented move, all six of the deans representing Pennsylvania’s public health college programs have signed a letter to Gov. Wolf supporting a statewide syringe exchange program.

Meanwhile, in the world of government, Pittsburgh state rep. Ed Gainey sponsored a bill to do the same.

Per Devin Reaves, the Harm Reduction Coalition’s executive director, the movement has been building for some time. “Needle exchanges have been shown to reduce the rate of HIV and hepatitis,” Reaves said, “and increase the distribution of naloxone.”

The data behind the movement

The University of Pennsylvania has been researching the effectiveness of programs like Prevention Point since 1991, a year before they were officially allowed in Philly.

According to Penn’s data, needle exchanges have been shown to reduce new HIV infections from 6.8 percent per year to 0.05 percent per year. From 1992 to the present, Philly’s public health department measured a 34 percent decrease in new HIV infections among the drug-injecting population.

The middle of the state, Reaves said, has been left out of the benefits of needle exchanges. In his work, he’s seen the need particularly in smaller cities like Allentown, Wilkes-Barre, Scranton and Upper Darby.

“These are relatively large cities that don’t have this service,” Reaves said. “It’s kind of a no-brainer.”

University advocacy

Having public health department heads of six Pa. universities come together to write a letter to the governor is remarkable, Dean David Nash of Thomas Jefferson University’s College of Population Health told Billy Penn.

The note, which asks Gov. Wolf to remove syringes from the definition of “drug paraphernalia” in Pa.’s Controlled Substance, Drug, Device and Cosmetic Act, marks the first time in Nash’s memory that all the departments have come together for one cause.

In the letter, the academics make the same case Reaves does.

“Pittsburgh and Philadelphia have operated successful Syringe Service Program models for over 20 years,” the letter reads.

“However, other communities, especially hard-hit rural communities, are being left out of the benefits of such programs.”

The letter sent to Gov. Wolf regarding statewide needle exchanges

The letter sent to Gov. Wolf regarding statewide needle exchanges

Courtesy Devin Reaves

The deans realize that “this letter is not going to reverse the whole opioid epidemic,” Nash said. But the evidence is clear. “Wherever there’s good scientific evidence that something could contribute to the health of the public, I’m going to support it.”

Changing the law

The deans’ letter and the advocates’ petition can’t actually effect change. That has to come from government, in some form.

Asked whether Gov. Wolf was supportive of the university health departments’ please, his spokesperson was noncommittal.

“The short answer,” said press secretary J.J. Abbott, “is that we can’t do what they ask.”

If it’s up to the legislative side to take action, it’s up to the bill sponsored by Pa. Rep. Gainey. He first introduced it as House Bill 196 in December 2016. It got mired in committee, so he reintroduced it in February 2017.

If passed, the new law would exempt syringes from the act when provided to a drug-dependent person by a legit public or private health care provider.

Philly rep. Brian Sims is a big supporter of the bill. It “makes obvious sense,” he said, indicating he intends to cosponsor it.

“We’ve got a 20-year history in this region to see how effective these are,” Sims said. “This is one of the most successful ways to combat the opioid epidemic. If it can be effective in Philadelphia, it can be effective statewide.”