Despite efforts by Charleston, West Virginia, politicians to re-criminalize syringe distribution, harm reduction is popular among local residents, according to the newly released findings of a survey assessing community perceptions of much-embattled local syringe service programs (SSP).
More than half of Charleston’s Kanawha County residents surveyed in January 2021 by the West Virginia Drug Intervention Institute (WV DII) believe their community should have SSP. The survey, published on February 22, also revealed that 68 percent of respondents did not feel Kanawha County had “adequate resources for persons suffering from addiction and intravenous drug use.” The most common elaboration in the short-answer section was that “more programs, resources and facilities are needed.”
For WV DII President Dr. Susan Bissett, the results offer a new insight. “Given the amount of debate in the community, I was personally surprised the results were primarily positive in regard to the need for harm reduction and syringe exchange,” Bissett told Filter. “I expected there to be a bit more divide between those that responded ‘Yes’ and ‘No’ to the question asking if participants supported harm reduction in the community.”
Still, a significant proportion of Kanawha respondents raised concerns about SSP. The most common concern flagged of the short-answer responses to the question of SSP’s “dangers” was “Public Safety (including disregarded needles, waste and general public concerns).” Additionally, 18 percent say they believe that SSP are associated with increased crime and drug use. These long-held, debunked conservative talking points are the two most common “arguments” against SSP.
The WV DII’s two most substantive recommendations largely focused on quelling community members’ concerns and stigmatizing beliefs.
The city and county governments, according to WV DII, should launch a campaign to address “needle litter,” and another to tackle misinformation. The former would expand the availability of syringe disposal containers in public places, including public bathrooms; educate the public on safe syringe disposal; and implement syringe-collection activities.
The latter would be a public education campaign dispelling myths about people with substance use disorders; providing statistics on HIV, hepatitis C and overdose, as well as evidence-based information on harm reduction and SSP; sharing harm-reduction success stories, like “naloxone saves”; and disseminating information to advance the goals of the syringe litter campaign.
“A good community is a safe community. Safe for all—for those in active addition and those who are not.”
For Bissett, the results suggested that dedicating more money to harm reduction was not a priority for the community. “The community did not identify funding as a primary concern,” she said. “I suspect this will come with future conversations.”
Nonetheless, she values winning the support of people who had been on the fence or in opposition to harm reduction. “Perception about safety is a very strong component of community attitudes about harm reduction and syringe exchange. It is important to address concerns of public safety for all citizens,” she said. “I look at it this way, safety is part of Maslow’s Hierarchy of needs. A good community is a safe community. Safe for all—for those in active addition and those who are not.”
City Council Member Keeley Steele told Filter that, in contrast to the WV DII recommendations, health professionals should be in charge of the education campaign. “The City should support any public education effort. However, the education part, in my opinion, should be led by the public health and harm reduction community. These are the professionals.”
WV DII also called on Charleston Mayor Amy Goodwin to form a Harm Reduction Task Force. It would bring public entities, such as health departments and county elected officials, together with private stake-holders, such as service providers, like SOAR and health care facilities. Goodwin did not immediately respond to Filter‘s request for comment.
WV DII is recommending the City Council adopt the West Virginia Bureau for Public Health’s 2018 Harm Reduction Program (HRP) Guidelines and Certification Procedures. Steele told Filter that she would advocate for the adoption of the Guidelines and Procedures.
The broader City Council, however, does not appear interested in adopting them. On January 19, a bipartisan cohort of nine Council Members introduced a bill that effectively criminalizes SSP in the city. The proposed amendment to the Municipal Code would require syringe distributors to seek state certification—which the city’s most prominent SSP, SOAR, was denied on January 4 on the grounds that they had not sufficiently demonstrated community support. SOAR didn’t respond to Filter’s request for comment.
“You can’t just pick and focus on one component and force it on a whole community with many needs.”
Council Member Deanna McKinney, one of the introducers of the bid to criminalize groups like SOAR, told Filter “there is definitely a need for truth and transparency,” and said she was not even made aware of the WV DII survey. “I have NEVER received any type of survey regarding harm reduction programs in my community. I would like to know where and when the survey was done?”
McKinney, a Black politician, represents the historically Black Westside, which was subjected to decades of racist zoning laws and divestment. It’s also home to SOAR, the controversial SSP that, in McKinney’s opinion, is failing to meet the needs of her community.
“My community suffers from mental illness and trauma,” she wrote to Filter. “SOAR doesn’t offer anything to help the community they are in on the Westside. Everyone is talking about needles ONLY!!! Harm Reduction is bigger than that and EVERYONE should try to remember that. You can’t just pick and focus on one component and force it on a whole community with many needs.”
The bill’s introduction comes after a failed bid by the Charleston Police Department to persecute SOAR. On December 18, 2020, Charleston City Attorney Kevin Baker addressed a legal analysis to Police Chief James Hunt, writing that SOAR had not broken the law, as the Police Department had alleged in October 2020.
In the wake of the analysis, Chief Hunt announced on January 12 that no charges would be brought against SOAR, an organization that was unable to officially provide services for months amid an historic overdose crisis. The investigation into SOAR started just two-and-a-half years after the Charleston city health department ended its own SSP in March 2018.
The effort to undermine harm reduction work in the region is reaching its logical conclusion: an alarming new HIV cluster. For the year 2019, the county of 178,000 people was just one new HIV case shy of matching the the 35 new HIV cases in New York City, home to 8 million people—44 times the population of Kanawha. New cases in the county have spiked by 34 percent from 2019 to 2020, with 80 percent of them being attributable to injection drug use.
Photograph of Charleston, WV by Tim Kiser via Wikimedia Commons/Creative Commons 2.0