In Iowa City, Ben, a 26-year-old who has been using heroin for years, met the Iowa Harm Reduction Coalition while the group was conducting outreach. He was able to access key harm reduction tools like naloxone, the opioid overdose reversal medication. But he was disappointed that state laws kept another vital resource out of reach: sterile syringes.
That’s where a new piece of state legislation could help. Senate File 500 (SF 500) would establish a needle exchange pilot program. In Iowa, needles and syringes are not classified as drug paraphernalia as long as they are used for “lawful purpose[s].” SF 500 would make the delivery, possession, and sale of needles and syringes lawful only in the context of the pilot program.
Syringe exchanges, as defined in the bill, could be run by the state, cities or nonprofits; but the pilot will be run by the Department of Public Health in “cooperation with the department of public safety, the governor’s office of drug control policy, and cities, counties, and nongovernmental organizations.”
Stocked with injection supplies, the pilot program aims to reduce blood-borne infectious disease transmission amongst people who inject, as well as needle sticks experienced by law enforcement. It would also encourage participants to move towards treatment.
Randy Mayer, who spearheads the public health department’s HIV and hepatitis bureau, told Iowa newspaper The Gazette that syringe service programs (SSPs) allow providers to build “a rapport with people who you are hoping are at some point are going to utilize drug treatment services.”
Five pilot programs will be established in five different jurisdictions, though such areas have not yet been identified yet. Iowa Harm Reduction Coalition (IHRC) believes that SSPs will be implemented in some of the nine county and city health departments already receiving IDPH’s Integrated Testing Services grants, which include Iowa City, Des Moines, Cedar Rapids and Sioux City.
HIV infections have been on the rise in Iowa, hitting a record high in 2016. That same year, 67 percent of people under the age of 30 diagnosed with hepatitis C reported that they used injection drugs. SSPs have been shown to cut HIV prevalence amongst communities served.
Passing the bill would expand access to sterile needles statewide. But the IHRC is already—albeit discreetly, and from the back of a car—distributing safe injection kits.
SF 500 was approved by the Committee on Judiciary on March 6, but has yet to be scheduled for a general vote.
Photograph by Jared Krauss