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NH gets federal approval to fund syringe services programs

By SHAWNE K. WICKHAM
New Hampshire Sunday News

May 21. 2018 1:31AM
Used syringes are collected by volunteers for the Hand-Up syringe services program in Dover and Rochester. They'll also meet up with individuals who are afraid to come to a public site. (Shawne K. Wickham/Sunday News)
NH Syringe Service Programs in action
Data reported by Syringe Services Programs to the state health department from June 2017 through March 31, 2018:

• Syringes Distributed: 54,510

• Syringes Collected: 16,346

• HIV Tests Performed: 3

• Referrals for HIV Testing: 29

• HCV Tests Performed: 3

• Referrals for HCV Testing: 30

• Referrals for SUD Treatment: 47

• Naloxone Kits Distributed: 624



Facing a growing risk of an HIV outbreak from the opioid epidemic, New Hampshire has gotten approval to use federal funds to expand syringe services programs (SSPs) in the state.

On Friday, the state Department of Health and Human Services issued a Request for Proposals for "infrastructure development" of community-based programs that distribute free syringes, naloxone and other supplies to people who inject drugs, and collect used needles from them.

Beth Daly is chief of the Bureau of Infectious Disease Control at the state Department of Health and Human Services.

She said there’s a prohibition on using federal funds to purchase syringes for SSPs.

But a 2016 federal law, passed in response to the nation’s opioid epidemic, does allow for some funding to be used to support such programs, she said. States have to petition the Centers for Disease Control and Prevention for approval.

Daly did so last October. In a letter to the CDC, she pointed out some grim statistics: New Hampshire saw a 70 percent increase in opioid-related emergency room visits from 2011 to 2015; a nearly 200 percent increase in overdose deaths from 2012 to 2016; and a jump in drug samples testing positive for opioids at the state forensic lab, from 103 in 2014 to 1,721 in 2016.

Three weeks after Daly sent her letter, the CDC gave its approval.

That doesn’t mean New Hampshire is getting any new federal money to start SSPs, Daly said, "but it means any funding we are receiving or we might get in the future, we can use to support syringe service programs."

The state plans to use some existing HIV prevention funds to expand SSPs to other areas, hopefully Manchester, the North Country and the western part of the state, she said.

Volunteers for Hand-Up Health Services distribute free safety kits that include cotton, alcohol wipes and sterile "cookers." (Shawne K. Wickham/Sunday News)

Last year, New Hampshire passed a law allowing organizations to run SSPs. There’s no state funding, but programs have to register with the state and submit quarterly reports on their activities, including the number of syringes distributed and taken back; HIV and Hepatitis C (HCV) testing; and referrals for HIV, HCV and substance use disorder treatment.

There are currently SSPs operating in Nashua and on the Seacoast; a third program, started by Dartmouth medical students last year in Claremont, was suspended because it was located too close to a school, which is against the state law. Organizers hope to restart that program this fall.

The state is seeing increases in new Hepatitis C cases and in the percentage of HIV infections related to injection drug use, Daly said.

Between Jan. 1, 2017, and April 30, 2018, there were 46 new HIV infections reported; 24 percent of those individuals reported injection drug use as the only risk factor, which Daly called "really concerning."

"It only takes one of these individuals who has a big needle-sharing network to cause a large outbreak," she said.

That’s what happened in 2015 in Indiana, where more than 200 people tested positive for HIV after sharing needles and drug-preparation equipment.

In 2017, New Hampshire also had 305 cases of Hepatitis C reported; 30 were "acute," meaning new infections, Daly said. Of those diagnosed with HCV, 85 reported injecting drugs previously, and 65 percent were still doing so at the time of diagnosis, she said.

And there are other health risks from injection drug use, Daly said, including bloodstream and heart infections, that syringe programs can reduce.

Expanding SSPs is "a good public health measure," Daly said. "At the end of the day, this is saving lives."

State Sen. James Gray, R-Rochester, sponsored the SSP law last year. "If your intent is to hate the sin but love the sinner, you need a way to engage the people," he said.

"We want people there trying to convince the people to go and get clean and to take advantage of the opportunities that are around."

In addition, Gray said, "The conservative in me says that it’s cheaper to buy a few needles, and put them into rehab," than to pay for treatment of HIV, HCV or other infections.

Daly said she thinks some of the stigma around syringe programs has lessened as the state deals with the opioid crisis. "I think part of that is because so many people are personally impacted," she said. "When it gets personal like that, it makes people more open to providing these types of services."

Beyond the Stigma, sponsored by the New Hampshire Solutions Journalism Lab at the Nackey S. Loeb School of Communications, is funded by the New Hampshire Charitable Foundation, Dartmouth-Hitchcock Medical Center, NAMI New Hampshire, and private individuals.


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