Syringe Service Programs – an urgent need

In the early 1980s, an unknown disease was menacing the drug user communities in urban areas on both the East and West Coasts. Starting with coughing, strange pneumonias, skin cancers such as Kaposi Sarcoma and constant lymph node enlargement, this disease would be known as Acquired Immune Deficiency Syndrome, caused by the Human Immunodeficiency Virus. While HIV was primarily known, in its early years, for its effect on gay men and transgender people, it impacted the intravenous and intramuscular drug user communities as well.

Another virus that wasn’t discovered until it caused millions of deaths was the hepatitis C Virus. Both HIV and HCV would ravage the communities of intravenous and intramuscular drug users, destroying their immune systems and, in the case of HCV, their livers. While now HIV is treatable, with chronic conditions rather than invariably fatal ones, and HCV is curable, the drug user community has sought ways to avoid infection altogether. 

Other diseases, such as hepatitis A and B, also are a risk when using drugs intravenously or intramuscularly.

In the late 1980s, while the AIDS epidemic was still running rampant and intravenous drug users were discarded and left to die, drug users and their allies came up with a means of saving lives: the syringe service program (SSP), also called syringe exchanges. The idea of a syringe exchange is easy to grasp: A drug user uses their needles, then goes to the program to discard and replace them.

When other people, non-drug users, need to use needles to inject their medications, nobody bats an eye when they return the used needles to a certified location. But when drug users do it, it triggers a response out of the “War on Drugs.” The anti-drug warriors believe that if you help the addicts get clean needles, you enable their addiction. They don’t care that rates of HIV, HCV, HBV and other diseases decrease when SSPs are active.

Pennsylvania: care woefully inadequate

Credit: Pennsylvania Harm Reduction Network

In Pennsylvania, only Philadelphia and Pittsburgh have organizations that operate SSPs. The reason SSPs function there is that they operate in a legal gray area: The two cities’ mayors issued executive orders to permit the syringe programs within city borders. There’s an unspoken agreement that these programs run without interference from law enforcement, though with a new mayor in Philadelphia — Cherelle Parker — that might change.

Pennsylvania has one of the highest rates of overdose deaths in the United States, a whopping 5,168 in 2021 alone. The overdose crisis has ravaged the rural locales in Pennsylvania, which have a higher per capita death rate than in urban areas. People are coming down with HIV and AIDS, hepatitis C, endocarditis (inflammation of the lining of the heart) and other diseases that cost the users, their loved ones and medical assistance programs tens to hundreds of thousands of dollars. They can end up paying an exorbitant amount of money due to the reuse of needles when SSPs are inaccessible.

All of that can be prevented by this progressive, single innovation. Fortunately, on Feb. 14, a bill to legalize SSPs — HB1245 — came out of Pennsylvania’s House Judiciary Committee, advancing to the wider legislature. 

Although people cannot rely on a capitalist government to craft a progressive response to drugs in the way that is needed, this victory must be seen in its proper context.

Revolutionaries, people living with HIV and AIDS, people who use drugs and the loved ones of people who use drugs have been demanding this action since the first appearances of HIV and AIDS in the drug user community. 

We have to fight for any victories we can create. The lives of tens of thousands of people depend on it.

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