The town of Ipswich, Massachusetts is considering establishing a syringe service program (SSP). The effort to do so mirrors local campaigns in many smaller municipalities across the United States—and is facilitated by a state law that eased some severe restrictions on SSP in 2016.
As reported by the Salem News, the North Shore Health Project (NSHP) a nonprofit based in Gloucester, first approached Ipswich to propose an SSP, offering to be the town’s provider. The three members of the town’s Board of Health took up the idea at their May 9 meeting. On May 23, they announced they will continue exploring the idea at their next meeting, on June 6.
“We are interested in learning more about syringe service programs, and the information we receive will help guide us as we consider all options,” Board Chair Susan C. Hubbard said in a press release. The board has scheduled for Kevin Cranston, assistant commissioner for the Massachusetts Department of Public Health (MDPH) to attend the June 6 meeting and weigh in on how the state can be involved in setting up an SSP.
“No overdose death is insignificant, because they’re always accidental and preventable.”
SSP are proven to reduce transmission of blood-borne disease like HIV/AIDS and hepatitis C by providing sterile injecting equipment. They also offer the opioid-overdose reversal drug naloxone, together with many other services and referrals to people who use drugs.
Susan Gould-Coviello, executive director of NSHP, told Filter that her organization has been funded by the state to expand its operations to other towns in the North Shore area. They already work with and serve residents in Ipswich, a coastal town of around 14,000 people in Essex County, and are sure it would benefit from its own SSP.
“They generally have over the last five years an average of three or four overdose deaths a year,” she said, “which sounds small—but no overdose death is insignificant, because they’re always accidental and preventable. We do know there is drug use in Ipswich.”
Gould-Coviello added that hepatitis C diagnoses, primarily associated with injection drug use, have increased among residents.
Ipswich Police Chief Paul Nikas said during the May 9 meeting that he was “not adverse” to an SSP. But Gould-Coviello said he asked some pointed questions, including where the SSP would park its mobile outreach van, and he wondered if the SSP would attract more drug use to the town. As the Centers for Disease Control and Prevention note, research demonstrates that SSP do not increase drug use or crime. But Nikas’s support will be symbolically important, Gould-Coviello said, and could strongly influence the board’s final decision.
If that decision is positive, Ipswich’s SSP will also need to be approved by the state. The state would then find a provider to contract with. Very likely that would be NSHP, Gould-Coviello said, because it’s the only harm reduction provider in the North Shore region.
To date, 95 percent of NSHP’s funding comes from the MDPH. That money pays for staff and supplies, but not for other services the harm reduction workers offer. “We buy food carts [and groceries] for our clients, we buy sleeping bags and tents, we provide transportation to treatment centers,” Gould-Coviello said. “All of those are paid for with private funds.”
“We intend to keep this ball rolling, because the more syringes we can get in the hands of drug users, the more likely they are to live healthier lives.”
Massachusetts first began formally authorizing SSP in 1993. State law at the time was restrictive, allowing the MDPH to authorize just 10 programs statewide. And over 20 years later, only six SSP were in operation in the state. The law had a vague requirement that SSP get “local approval”—and for many programs, that’s proven a major obstacle. Tapestry Health, for example, which operates an SSP in Holyoke, ended up in a court battle a few years ago, after the city council tried to shut it down—despite the city’s health board, mayor and police chief all supporting the SSP. (Tapestry continues to operate in Holyoke today.)
In 2016, the legislature amended state law by lifting the cap on SSP, meaning more could open statewide. It also clarified that any SSP must be authorized by the MDPH, with additional approval needed from its local board of health—but not from elected officials. Within the first year after a new SSP opens, the MDPH must also report on its progress to the state legislature.
Since 2016, SSP have spread significantly in Massachusetts, with 41 cities and towns now hosting one.
“We intend to do this in other communities and keep this ball rolling, because the more syringes we can get in the hands of drug users, the more likely they are to live healthier lives,” Gould-Coviello said.
Photograph via US Department of Veterans Affairs