Over 1,200 West Virginians died of overdose in 2020, new data show—a 45 percent increase from 2019. This coincides with an historic HIV outbreak that is rapidly spreading across the state. As these numbers grow, Governor Jim Justice on April 15 signed a bill that health experts argue will lead to further cases and deaths. Senate Bill 334 (SB 334) could practically end syringe service programs (SSP) in the state.
SB 334 requires all new and the existing SSP to apply for certification and offer multiple harm reduction services—including HIV testing, treatment referrals and overdose prevention education—not just syringe provision. Syringe provision will be limited to one-to-one exchange. Programs will now also have to show the written support of the city and county commissions—a severe challenge in a state where many politicians see harm reduction as a political issue, not a public health solution.
In total, the bill forces SSP to operate in a manner that over 300 West Virginia public health experts, medical professionals, nurses, educators and advocates argued in a letter to the governor is “in direct contravention of CDC guidance; guidance which is based on 30 years of peer-reviewed science.”
“SB 334 is incredibly restrictive legislation that seems clearly designed to outlaw as many syringe service programs as possible,” Loree Stark, legal director at the American Civil Liberties Union of West Virginia (ACLU-WV) told Filter. “The reasoning behind the bill has never made sense. All of this is not in the interest of public health.”
In spite of calls for the governor to veto the bill, he signed it mere hours after it hit his desk. Rule-making is still underway, so some terms and definitions are still in development. For now, the future of programs across the state is tenuous at best, with some saying they will close.
“It’s really devastating. Very few facilities have the funds to comply with the laundry list of requirements,” Stark said. “They will have to close down or risk getting fined by the licensing body.”
“We’re leaving health decisions in the hands of politicians.”
Requiring local officials to support harm reduction programs can be an especially challenging requirement in the highly conservative state. An recent HIV outbreak in Kanawha County, home of West Virginia’s capitol, Charleston, was called the most concerning in the country by the CDC. Response by local and federal representatives, including Senator Joe Manchin, was to call into question the CDC’s statement—not to address the issue of HIV increases.
To make matters worse, Charleston City Council passed on April 20 legislation that is even more restrictive for harm reduction programs operating in the city. The council added misdemeanor criminal charges to anyone distributing syringes, equating to fines, fees and potential incarceration for nurses and doctors supporting drug users.
The legislation passed with nearly unanimous support of the local council, in spite of the fact that 68 percent of residents in the county stated support for harm reduction programs.
“We’re leaving health decisions in the hands of politicians,” Stark said.
For opponents of SB 334, the fight is not over. Gaps in the legislation are problematic and potentially unconstitutional, they note, including requiring program participants to have West Virginia identification. This is additionally a practical challenge for unhoused communities and those who cannot get updated documents because of the pandemic.
The bill also lacks due process for commissions to respond to harm reduction programs seeking a letter of support per the requirements. With no mechanisms for accountability, there is a chance programs may never be responded to and could languish at the whim of local representatives.
Advocates and experts remain committed to ensuring drug users can get evidence-based support.
“We’re looking at how we can proceed to protect not only the harm reduction programs but also participants and public health. People are already sick, and more people will get sick,” Stark said.
“West Virginians are being failed by every level of government.”
Photograph by Carol M. Highsmith via Library of Congress/Wikipedia