A proposal advancing in the Texas legislature would authorize syringe service program (SSP) pilots in a total of seven counties, but potentially charge participants a fee per syringe. HB 3174 had a public hearing before a House subcommittee on April 14 and has about one month left to cross over into the Senate.
Texas doesn’t authorize SSP state-wide, and for the past several years only Bexar County has permitted locally funded pilots to operate. That authorization became part of state law on April 1, but still applies only to Bexar County. The proposed bill would expand it to six others, effectively legalizing harm reduction services for those residents.
“While we will continue to advocate for the authorization of SSP in Texas, we do not anticipate that this legislation will necessarily pass during this session,” Maggie Luna, executive director of the Texas Harm Reduction Alliance (THRA), told Filter. “This has been a long struggle.”
The bill proposes a “one-to-one” restriction on any SSP opening in the protected counties, meaning participants wouldn’t be able to receive new syringes without bringing in an equal or greater number of used syringes. Public health experts including the Centers for Disease Control and Prevention have established that the most effective model for reducing blood-borne disease transmission is to give people however many syringes they need.
“Having a one-to-one basis is a great start, it’s something,” Luna said. “People will still end up re-using the same ones over and over.”
“Asking [people] to scrounge up some change to get one or two syringes, I don’t know if it would be worth it.”
The bill would also allow SSP to charge participants a fee for each syringe, capped at 150 percent of what the program paid for them. This would be highly unusual; SSP are designed for low-income communities, and traditionally everything they offer is free. The price cap would likely be under $1, which would be a lot cheaper than buying syringes elsewhere, but people who use syringes for intravenous drug injection very rarely access them that way.
“In what world does that help people who don’t have access?” Luna said. “The people we serve, we’re helping them find food, showers and clothes. Asking them to scrounge up some change to get one or two syringes, I don’t know if it would be worth it.”
Luna testified in support of the bill on April 14, but felt that many lawmakers were dismissive of the need for harm reduction services. She shared the story of training her teenage daughter to use Narcan, and how that allowed her daughter to reverse an overdose at her school.
“She had Narcan—nobody else did,” Luna said. “Since she was educated she knew how to spot an overdose and use it, now that child has another chance to live.”
Narcan isn’t criminalized in Texas. But syringes are, under drug paraphernalia statutes that also ban fentanyl test strips. THRA is therefore not authorized to distribute them, but that would change if the bill is enacted—one of the counties authorized for SSP would be Travis County, where THRA is based.
Luna said that if the bill did pass, THRA would consider becoming a licensed pilot program—but would proceed cautiously, while still supporting any other programs that chose authorization.”Our services are free, and it’s important to us that we always maintain free services,” she said. “While authorization is important, sometimes it does have it’s drawbacks, as I’m sure many programs can attest to.”
Image via Centers for Disease Control and Prevention