Leslee KulbaLocal OpinionOpinion

County board discusses Syringe Exchange Program (SEP)

Highway expansions are delayed in the name of protecting habitat for rare salamanders or bats, traffic calming is installed, roads take diets with sharrows and sidewalks, drivers pay to park to subsidize transit, etc. The result is, in some cities, people choosing to drive must idle their cars a couple hours both ways in their daily commutes.

So, Buncombe County government is exploring ways to expand needle exchanges, those places that give away the orange-capped syringes that cluster around bridge footers like a state flower. The logic is the same as that used to explain why government must provide free abortions and birth control: People are powerless to refrain from taboo that, by definition, jeopardizes their own health and casts a burden for care on society.

Compassion, we are told, dictates not that we struggle with the afflicted to break the chains of addiction, so they may move on to a meaningful life connected with the community; it effectively dictates we all must embrace and celebrate the wasting of precious human life. “Papa don’t preach,” counseled pop-star Madonna.

There are some, but not many in Asheville, who believe taking recreational street drugs known to be addictive and lethal is good for neither individuals nor society. As death rates climb and lives are ruined by the chains of addiction, the science is not settled. If this were an evil like driving, politicians would be putting the squeeze on narcotics trade routes and making up excuses like needing to save a rare bat or confiscate illicit gain for rehab. Unfortunately, the people who do that are law-enforcement agents, and there is a swift and hefty movement afoot to destroy their credibility by labeling them all racist.

In a presentation before the Buncombe County Commissioners, DHHS Medical Director Jennifer Mullendore conceded there were problems with needles littered along the roadside, clogging toilets in public housing, and pricking unsuspecting sanitation workers. Contaminated needles were exposing everybody to acute hepatitis B and C, AIDS, and even flesh-eating bacteria. She said the county is “continuing to explore … tools and training” to increase awareness and expand options for safe disposal.

Mullendore was presenting the commissioners with pros and cons for establishing a public needle exchange. There are already two private needle exchanges in Buncombe County. One, the WNC AIDS Project’s Needle Exchange Program of Asheville, distributed over 500,000 needles last year; and the other, the Steady Collective, handed out 73,000. But even at that volume, there remained tremendous unmet demand in the community.

In 2016, the state granted local governments authority to establish Syringe Exchange Programs (SEPs). SEPs do more than hand out needles, and the county already provides many other services they would cover, like providing testing and connecting people with counseling, treatment, and “protection.” Mullendore expected the DHHS could launch a full-service SEP once it moved back into the 40 Coxe Avenue building.

Cons associated with government SEPs stemmed from hegemony. A major problem is that persons using drugs illegally are typically afraid to go to county buildings where law-enforcement officers are stationed. Mullendore indicated a successful SEP would, “recognize that poverty, class, racism, gender-based discrimination, and other social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm.” During public comment, Dr. Bayla Ostrach, a research scientist with MAHEC, said not only do police officers deter people from using SEPs, their presence at SEPs is correlated with riskier needle use. What’s more, she said response medications and injection supplies at SEPs are often confiscated by law-enforcement officers, in Asheville and elsewhere.

Commissioner Joe Belcher explained when somebody is in serious need of help, nobody asks how they got themselves in that condition, they only want to get them out. He understood the compassion angle, but disagreed that abstinence was not an option. It would likely be a long, rough journey; but self-mastery, rather than drug-dependency, he believed, should be the ultimate goal as well as a part of the county’s programming. Mullendore repeated that abstinence was out-of-sight/out-of-mind to those she sees. Belcher said he understood. “I didn’t mean to talk so much, but I had a couple things on the heart, and I figured I’d get them off. If I don’t get rid of them, I explode, and they have to deal with me in the back,” he said.

Chair Brownie Newman spoke in favor of the county expanding SEPs. He acknowledged they can be seen as, “enabling destructive behavior,” but said evidence indicated doing nothing would lead to worse problems.

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