North Carolina Bill Poised to Drastically Restrict Syringe Service Programs

April 21, 2021

A bill filed in the North Carolina state Senate may threaten the existence of syringe service programs (SSP) statewide. Titled SB 607, it would alter existing laws authorizing SSP by imposing stringent new requirements for them to stay open.

“SB607, which seeks to heavily restrict syringe service program operations, would undo years of lifesaving work supported by bipartisan constituents and would increase the health risks associated with drug use in the community,” said the North Carolina AIDS Action Network in a statement

The North Carolina Harm Reduction Coalition put it more bluntly: “In short, if this bill were passed as written it would probably end all syringe exchange programs in the state.”

The North Carolina legislature and governor legalized SSP in the state in the summer of 2016 to combat the spread of blood-borne disease like HIV and hepatitis C. That victory came after five years of advocacy work, and after some members of the Republican party and the law enforcement community endorsed the reform. 

The legislation—actually an unconventional amendment that advocates managed to add to an unrelated bill requiring police departments to release dashboard and body cam footage to the public—mandated that SSP share information with participants about substance use disorder treatment services. No public funding was allocated, forcing providers to rely on donations. 

But SB 607, filed on April 6 by Republican Senators Joyce Krawiec and Chuck Edwards, now seeks to place new burdens on SSP providers who want to stay open.

The provisions include:

*Providers must not just “encourage” participants to seek substance use treatment—they must require them to do so.

*Providers cannot be located within a 3-mile radius of a school.

*No mobile services—i.e. vans—would be allowed.

*A new SSP in a residential area must seek a majority vote of support from a “meeting of the local residents.”

*No SSP owners or staff can have a criminal record for any felony, or for misdemeanor drug charges.

*All supplies distributed must be marked with a symbol or logo identifying the provider.

*Providers must maintain both general and professional liability insurance policies at $1 million each. A lapse in coverage will be grounds for immediate closure.


The bill’s text describes it as “An act making improvement and providing greater accountability” for SSP—even though many of its provisions would drastically curtail services, and in some cases ban them altogether. 

Banning services within a three-mile radius of schools would make it difficult to operate in most dense urban areas. It could push services further out into city outskirts, making them harder to access. 

The bill also proposes a ban on mobile services. Providers will often use vans to distribute syringes and other supplies. For North Carolinians in rural areas, mobile services can be the difference between life and death.

The bill ‘s provision to ban operators with certain criminal histories is simply punitive and unnecessary. It has nothing to do with public safety, and everything to do with discrimination. People with criminal histories are quite often the people most qualified to do the work of serving a population that is also highly vulnerable to policing and surveillance. 

“The collective impact of these provisions would lead to the majority of syringe service programs closing in North Carolina.”

The proposed requirement to make all SSP participants enroll in drug treatment is also arbitrary—and harmful. SSP are in the business of preventing blood-borne disease and keeping people alive—not preventing people from using drugs in the first place. As Filter has reported, mandating drug treatment is cruel, does not improve health outcomes, and is actually linked to higher rates of drug overdose and death.

Just as harmful is the requirement that providers brand all supplies distributed with an organization’s logo. Putting this burden on providers would be both cost- and labor-intensive. Providers, who source these syringes from medical supply companies, would most likely have to do the branding themselves. 

Advocates have even suggested that the bill as written would require the syringes themselves to be marked. The bill’s text is not exactly clear, but it’s possible that it would require providers—during a pandemic—to unwrap and individually mark thousands of syringes by hand before they can be distributed.

“The collective impact of these provisions would lead to the majority of syringe service programs closing in North Carolina,” Christina Adeleke of the NC AIDS Action Network told Filter

“Even if some of the most problematic provisions are removed, North Carolina doesn’t need any changes to the syringe service law. This program was passed with bipartisan support in 2016, and is a model of how to reduce HIV and HCV transmissions and meet people who use drugs where they are.”


Photograph of North Carolina Senate chamber by Government & Heritage Library via Flickr/Creative Commons 2.0

Alexander Lekhtman

Alexander is Filter's staff writer. He writes about the movement to end the War on Drugs. He grew up in New Jersey and swears it's actually alright. He's also a musician hoping to change the world through the power of ledger lines and legislation. Alexander was previously Filter's editorial fellow.

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