House Bill 1163 passed in the North Dakota Senate 35-12 on Thursday, April 15. The bill amends the Syringe Services Program (SSP), commonly referred to as a needle exchange program, in North Dakota.
The amendment to the needle exchange program would provide supplies such as sterile disposal preparation spoons, cotton, sterile filters, alcohol wipes, sterile water, saline, tourniquets, overdose-reversing drugs, testing strips and other items recognized as supporting safe drug use, according to the bill.
HB 1163 previously passed in the North Dakota House 55-38 on Wednesday, April 14.
“This whole needle exchange program is the harm reduction model. Obviously, we don’t want to encourage the use of IV (intravenous) drugs, but what we want to do is make sure that if people are using them, they have access to sanitary supplies so we’re not dealing with the spread of diseases,” said Rep. Shannon Roers Jones (R-46), the primary sponsor for HB 1163.
SSPs are primarily meant to prevent the spread of diseases such as HIV and viral hepatitis.
“Nearly 30 years of research shows that comprehensive SSPs are safe, effective, and cost-saving, do not increase illegal drug use or crime and play an important role in reducing the transmission of viral hepatitis, HIV and other infections,” according to the Centers for Disease Control and Prevention website.
They also serve as a contact point between IV drug users and health professionals. Health professionals can build a relationship with IV drug users and connect them with treatment resources.
“SSPs are shown to reduce drug use by increasing entry into substance use treatment programs. People who inject drugs are five times more likely to enter treatment for substance abuse disorder than people who do not utilize these programs,” according to North Dakota Department of Health reports on SSPs.
Needle exchange services were first permitted in North Dakota following the passage of Senate Bill 2320 during the 65th legislative session.
SSPs are overseen by the North Dakota Department of Health and target areas with a higher risk of disease transmission via needle sharing.
Alisa Mitskog (D-25) voted in favor of the HB 1163.
“The Syringe Exchange Program is certainly a controversial bill, but I supported the bill in order to reduce the spread of hepatitis, HIV and other bloodborne diseases that are commonly spread by IV drug use,” Mitskog said.
Mitskog believes the bill creates an opportunity for users to enter drug treatment programs.
Rep. Kathy Skroch (R-26) voted against HB 1163, saying the amendments go too far. She voted yes on SB 2320 during the 65th legislative session.
“We’ve expanded it and I think for me it has come closer to the point where we’re now enablers. I understand all the dynamics about it, how they hope to get people in and coax them into rehabilitation,” Skroch said.
The North Dakota Department of Health reported in the first half of 2019 that of the 84,413 syringes distributed through the program, 72,266, or 86 percent, were returned.
In the second half of 2019, 144,577 syringes were distributed and 84,787, or 59 percent, were collected.
Richland County Sheriff Larry Leshovky said removing needles from public places is beneficial from law enforcement’s perspective.
“We don’t want to see those syringes in places where people end up having access to them, especially with this fentanyl use now that is out there and it could cause an overdose, even unintentionally, just by having something that like accidentally stick them,” he said.
Richland County Health Department Health Services Director said the department is supportive of SSPs. The nearest is SSP is located in Fargo.
“Right now we have five Richland County’s that have enrolled in the Syringe Service Program,” Carlson said.
She said the number could be higher, as the service will provide additional supplies for other IV users if requested.
In 2018, the most recent year data is available, 6.6 percent of new HIV diagnoses, or 2,492 cases, were caused by drug injection.
A study released by the North Dakota Department of Health titled “2019 North Dakota HIV, STI, TB & Viral Hepatitis Epidemiological Profile” found “Nationally, HIV is most often reported among men who have sex with men (MSM). North Dakota risk data shows similar patterns between prevalent cases and incident cases among males from 2015 to 2019. Injection drug use alone has been a risk factor for the past four years.”
According to the CDC, SSPs save on health care costs. The average lifetime cost of treatment for HIV is approximately $400,000.
From 2017-2019, The North Dakota Department of Health ran the Hepatitis C Enhanced Surveillance Program with the goal “to identify acute and chronic cases and understand transmission in North Dakota,” the same 2019 report said.
The study found that “In 2018, 88 percent of cases interviewed reported injection drug use as a risk factor.”
The CDC reports that SSPs can prevent 320,000 deaths related to hepatitis C.
The bill is headed to Gov. Doug Burgum’s desk for signing.