The Maine State Legislature is considering a bill that would remove restrictions on syringe service providers, often referred to as “needle exchange,” that harm reduction advocates say prevents them from adhering to best practices for public health.

The measure, LD 1909 , proposed by Rep. Genevieve McDonald (D-Stonington) would prohibit capping the number of syringes that providers can give out to people and rescind a policy known as one-for-one exchange, which requires such providers to get back a used syringe from a person in order to provide them a clean one.

“The medical community recommends that individuals use a new syringe at each injection, and the needs-based model allows individuals to identify the number of syringes they need in order to follow these recommendations,” McDonald said. “There is no reason that a person should not have safe, sterile supplies because of an arbitrary limit or cap.”

Supporters and directly affected people from around the state testified in support of McDonald’s bill Tuesday during a public hearing by the legislature’s Health and Human Services Committee. 

They explained to the committee that even when people don’t have a clean needle, they continue to use drugs. So rather than deter drug use, the policy just worsens the spread of infection and disease.

Maine’s one-for-one policy was suspended at the onset of the COVID-19 pandemic by Gov. Janet Mills by executive order because of the challenge clinics had at the time safely remaining open. But the governor’s order has now expired and harm reduction advocates say the reprieve should be continued. 

At the hearing, proponents said that trial period of a needs-based model has shown to help people who use drugs.

“LD 1909 and a needs-based model promotes public policy that is based on the dignity and respect of people who use drugs and means recognizing them as active participants in their health care,” said Hilary Eslinger of Maine Access Points, a harm reduction organization that provides syringe access services.

“We will continue to see our neighbors die from overdose, infection and other negative health implications associated with the one-for-one model until we pass public policy that ensures their safety,” Eslinger added.

Chasity Tuell, a person in long-term recovery and the program director of Maine Access Points in Washington County, echoed Eslinger’s remarks. 

“Going back to one-for-one after 15 months operating under a needs-based model has been devastating in rural Maine,” she said. “In Washington County, we have no public transportation — I think a single taxi service — and lots of miles in between anything and everything. It’s not feasible to expect people to get to their closest exchange multiple times a week to bring used syringes for new ones. Therefore they can’t make decisions based on safety.”

McDonald, a commercial fisherman on Deer Isle, is running for Maine Senate District 7 in a special election that was triggered by the resignation of Democratic Sen. Louis Luchini last month.

McDonald has promoted drug law reforms aimed at harm reduction since being elected to the Maine House in 2018, including a bill that was signed into law last year to decriminalize possession of hypodermic syringes. LD 1909 is among a slate of measures being heard this session to reform the state’s approach to drug policy.

During the public hearing on Tuesday, McDonald announced an amendment to her bill that would stop short of fully lifting the one-for-one cap by statute, instead allowing the Maine Department of Health and Human Services to make the final determination of possible limits if the bill becomes law. McDonald offered the amendment as a compromise with the governor, who has opposed several drug law reforms.

“While the needs-based model that eliminates the cap entirely is ideal, I recognize the necessity of compromise. While this amendment will not eliminate or establish a cap in statute, it will provide a pathway and the flexibility for the cap to be changed through rulemaking,” she said, referring to the law-making process where administrative agencies finalize regulations in statutes passed by the legislature.

Gordon Smith, the state’s director of opioid response, said that he did not support the needs-based model as originally drafted in McDonald’s bill, but said he “fully supported” the proposed amendment. 

Advocates also supported McDonald’s amendment, though voiced concern about caps being put in place by the administration.

“To be clear, we support the amendment but we do not support an arbitrary cap,” Eslinger said. “We do not recognize that as a needs-based model.”

Photo: Organizers with Portland Overdose Prevention Society demonstrate outside of Gov. Janet Mills’ 2019 Opioid Response Summit by being in possession of more syringes than is allowable under Maine law. | Beacon

Dan studied journalism at Colorado State University before beginning his career as a community newspaper reporter in Denver. He reported on the Global North's interventions in Africa, including documentaries on climate change, international asylum policy and U.S. militarization on the continent before returning to his home state of Illinois to teach community journalism on Chicago's West Side. He now lives in Portland. Dan can be reached at dan(at)mainebeacon.com.

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