People closest to West Virginia harm reduction programs in West Virginia are urging a veto from Gov. Jim Justice, saying a newly-passed bill is too restrictive and will result in the spread of serious disease.
“We believe Governor Justice should veto the bill,” said Danny Scalise, executive director of the West Virginia State Medical Association, which represents doctors.
“Too many of the regulations put in place are going to prevent harm reduction programs from operating, which will increase HIV, Hepatitis C and Hepatitis B among other poor health outcomes.”
Senate Bill 334 has generated significant debate because of the high stakes for communities facing the health consequences of addiction. West Virginia has been among states with the highest rates of death from drug overdoses. West Virginia communities are also at risk for HIV and hepatitis C outbreaks.
The Legislature passed the bill on Saturday evening, the final night of the regular legislative session. The bill would establish a licensing requirement for syringe exchange programs and establish a goal of one-to-one exchange of needles. The bill includes immunity for providers and civil penalties for non-compliance, from $500 up to $10,000.
Governor Justice is deciding whether to sign the bill but has indicated he favors it.
“I’m really concerned about our West Virginia neighbors that are struggling from substance abuse disorders. This bill does not follow the science,” Laura Jones, executive director of Milan Puskar Health Right in Morgantown, said today on MetroNews’ “Talkline.”
She doesn’t disagree with some oversight of harm reduction programs, but believes that aspects of the bill — particularly an identification requirement for participants — are onerous and out-of-step with federally-recommended best practices.
“The goal here is harm reduction. It’s to prevent further illness from taking place. If we’re required to do what is proposed in this bill, we absolutely will see an increase in HIV,” Jones said, also referring to the likelihood of increased cases of hepatitis C, a liver infection, and endocarditis, a heart infection.
Jones said she doesn’t object to some regulation.
“This bill went steps beyond that,” she said. “Minimum requirements, absolutely. Even the issue of licensure. That’s not a problem. The issue is, the bill went beyond that and prevents us from operating anonymously initially with clients.”
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Late in the session, lawmakers amended the bill to include a requirement of local government support as well as the identification requirement.
Asked about the bill early this week, Governor Justice acknowledged not knowing many of its specifics but said his impression is that it strikes a balance.
“I am not an expert in this field at all,” Justice said. “But I really believe that everyone kind of came together on this thing and developed a real good, scientific balance that can aid and help the public in every way, but does so with good science and everything.
“It prevents the problems that we were having with needles all over the place that could cause all kinds of different problems in communities. But it still aids in helping those folks that we need to try to reach out and keep them safe too.”
Public Health Officer Ayne Amjad today said state officials are ready to follow the requirements of the legislation.
“That bill was a hot topic on the legislative floor. We support the governor’s decision. We have informed him about it, and it was discussed,” Amjad said at a briefing. “Our job right now is to follow whatever the Legislature has put into policy.”
ACLU-West Virginia sent a letter to the governor today, requesting a veto. The letter includes signatures by dozens of doctors, nurses, pharmacists, physician assistants, aides, psychologists, social workers, counselors, recovery coaches, advocates, and researchers.
“Governor, you have been misinformed,” they wrote. “SB 334 does not strike a balance. This legislation will all but eradicate syringe service programs in West Virginia. Senate Bill 334 would require syringe service programs to operate in a manner in direct contravention of CDC guidance, guidance which is based on 30 years of peer-reviewed science.”
Guidance from the Centers for Disease Control & Prevention concludes that syringe services programs help prevent people prevent transmitting bloodborne and other infections when they inject drugs. And, the CDC has concluded, when people who inject drugs use a syringe program they are more likely to enter treatment for substance use disorder.
The identification requirement is likely to discourage people with addiction problems, said Jones of Health Right in Morgantown.
“That’s very difficult for some of our folks. The idea of harm reduction is frightening for some people when they first come to the program,” she said. “If we ask them to bring ID, that really deters people from coming to the program in the first place.”
Rather than using names, she said, at first people are assigned a number. Names may be used if someone is referred to medical care or treatment. “For the purposes of getting them in the door, requiring an ID is not evidence-based,” Jones said.
Another change would require any existing provider not offering a full array of harm reduction services to cease offering a syringe exchange program.
That includes wellness checks, wound treatment from needle sticks, screening from communicable diseases, vaccination availability and counseling.
Jones said some organizations may be able to operate those programs and others may not.
“The most important part of harm reduction is the syringe. The syringe is the thing that prevents people from sharing needles,” she said. “The goal here is harm reduction. It’s to prevent further illness from taking place.”