A rural Michigan county is getting its first syringe service program (SSP). It comes at a time when the state is reporting increasing diagnoses of HIV from injection drug use. SSPs give sterile syringes to people who inject drugs like heroin, to prevent disease transmission through sharing needles.
On November 24, the Board of Health for the Mid-Michigan District voted to approve an SSP. The district represents Montcalm, Clinton and Gratiot Counties. The SSP would open first in Montcalm County, then later expand to Clinton and Gratiot if county officials are satisfied it’s working well. Under Michigan law, syringes are considered illegal drug paraphernalia. But giving out sterile syringes as a public health intervention is legal, if authorized by a government agency.
Currently, the closest SSP Montcalm County residents can reach is in Ionia, which is over 22 miles from its largest city, Greenville. The county will partner with Red Project, a Grand Rapids nonprofit that already operates syringe services throughout the state.
“Best practice with regards to syringe access is to provide syringes based on needs,” Red Project Executive Director Steve Alsum told Filter. “So working with each individual client, talking with them about how often they’re injecting, when they can come down to the program, how many people are in their social network who inject … then using that opportunity when we see a participant to provide them with as many syringes as they’re going to need so that they can use a sterile syringe for each and every injection.”
The Michigan state health department recently reported that Montcalm County is experiencing an unusual increase in HIV diagnoses, linked to injection drug use.
Programs in some cities and states follow “one-to-one” guidelines, which they may be mandated to do. This means only one syringe is given to each participant for every used syringe they return. The practice contradicts scientific consensus—including from the CDC—on the best way to reduce blood-borne disease. Thankfully, Red Project gives clients as many as they need.
Red Project provides rapid HIV and hepatitis C testing in addition to syringe services. It won’t actually operate the SSP in Montcalm County, but will instead give training and other support to the health department as the department launches the program.
The Michigan state health department recently reported that Montcalm County is experiencing an unusual increase in HIV diagnoses, linked to injection drug use. At the same time, HIV diagnoses are declining for the whole state of Michigan.
There is no current data on HIV diagnoses in Montcalm County, but ts HIV prevalence has historically been relatively low. In 2019 the county had 54.7 HIV cases per 100,000 people. For comparison, Detroit, has 713.3 per 100,000 people.
According to data provided to the county board, Montcalm County paramedics are also administering far less naloxone than the state average—even though opioid-involved deaths there are 1.7 times higher than the state average. So far this year, 21 people in the county are suspected to have died of overdose. That would equate to 33 people per 100,000—significantly higher than the national death rate of 21.6 people per 100,000 in 2019.
It’s not clear yet what other services the SSP in Montcalm County will offer. A public information officer for the Mid-Michigan District Health Department declined Filter‘s request for comment, other than to state it’s too soon to share details.
Alsum also stressed that details on the new SSP aren’t yet finalized. But because the county agreed to partner with his organization to train them, he suspects the services will closely resemble those currently offered by Red Project. He estimated that if all goes well, the program should be open as soon as January 2022.
Photograph of Red Project in Grand Rapids harm reduction services, via Facebook.