OPINION: The State Should Be Supporting Harm-Reduction Programs, Not Trying To Kill Them

If you were an injection drug user in Plaza Midwood before 2015 — before syringe service programs (SSPs) were legal in North Carolina —you probably knew me, and you probably knew my house. It was the place you went to get clean syringes. It was the place you got drug-user health information. It was the place where you were surrounded by other people with experiences like yours, and where you could ask the questions you wanted to ask without feeling stigmatized and ashamed. It was a house of harm reduction. 

In the midst of a continuing opioid-involved overdose crisis, the state of North Carolina was recently poised to obstruct the reach of community-provided SSPs with the proposed Senate Bill 607.

SB 607 threatened to change the safe community spaces that are currently operating legally — programs that are run by people like me, with lived experience of what it’s like to use criminalized drugs, and the felony and misdemeanor charges that come with that lifestyle. As the bill was introduced to the North Carolina Senate, harm reductionists in programs like the North Carolina Survivors Union, where I work, wondered what it would mean for us if it passed.   

On May 10, a group of SSP advocates gathered in Raleigh to speak out on behalf of these programs. One by one, members of different organizations across the state — including the NC Department of Health and Human Services — addressed the crowd and discussed ways the community has been served by the very same SSP that SB607 stood to shut down.

SSPs save lives. Before I began my work in harm reduction I was alone and disconnected, I had lost most of my friends because of the drug war, I barely had a relationship with my family. I was looking for a reason to live because I had hundreds of reasons not to.

Not only do these programs help prevent fatal overdoses, prevent people from contracting and transmitting hepatitis C and HIV, and provide referrals to compassionate drug treatment, they also provide people with employment. And for many, a sense of purpose and a reason to strive for positive change within their own lives through helping others. 

SB 607 boasted multiple harmful changes to the original safe syringe law, including requiring SSPs to purchase expensive liability insurance, requiring them to engrave or mark syringes and other supplies they hand out with the logo or name of the SSP (which risks contaminating sterile equipment since the packages of syringes would have to be opened in order to do this), and outlawing the operation of mobile services that are heavily relied on by people in rural areas or those who are unable to leave their homes. 

But one of the most dangerous provisions of the bill was that it forbid leadership or board member positions (basically any position in which there was an ability for decision making) by those who have been previously convicted of drug-related charges — essentially excluding people with lived experience, the ones who are the bedrock of harm reduction and the most valuable workers at any SSP.

We have a saying in the drug-user activism world: “Nothing about us without us.” Community-led SSPs have the effectiveness and the trust to actually reach people who use drugs because people with lived experience are meeting them face-to-face. 

I am one of these people. These people are us. We are the ones whose lives were saved by becoming involved in harm-reduction programs that rely heavily on a staff of dedicated, knowledgeable individuals who have forged relationships with the drug user community — the community we know from the inside. The ones who celebrated on May 12 as word traveled through our networks that the bill was dead, and would not move any closer to becoming law. 

Elated as we were, we know it’s only a matter of time until there’s another bill to fight, another law targeting people who use drugs and the programs that support them. We all feel the burden of the state’s continued misunderstanding of drug users and substance-use disorder as it pushes for punishment instead of public health services. 

Harm-reduction programs encourage personal responsibility among people who use drugs. Evidence shows that people who participate in SSPs are more likely to access treatment and ultimately stop using drugs. If these programs lose the people best suited to run them, they will in turn lose many of the people who desperately need their services. 

SSPs are our greatest tool when it comes to reducing overdose and blood-borne disease transmission. They save the lives of the people who access them as well as the lives of the people who run them. Our state should be supporting us — not trying to kill us.

Read Queen City Nerve’s 2020 reporting on syringe exchange programs in Charlotte, or listen to Angela Allen of the Center for Prevention Services discuss the importance of local harm-reduction programs on our Nooze Hounds podcast. 

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