Bipartisan health committee members reject limits on syringe service programs

A majority of legislators on the health committee on Wednesday rejected a bill to put stricter limits on the number of clean syringes certified programs can hand out, backing Maine’s more flexible policy, which medical providers and harm reduction experts have vouched for.

Penobscot County is currently experiencing an HIV outbreak, with 22 cases since last October (compared to one or two cases a year, in recent years). During the public hearing on the bill, health providers and operators of syringe service programs stressed the importance of access to clean needles in the light of this outbreak, citing research that supports the efficacy of these programs.

But some municipalities have blamed expanded syringe services for syringe litter on sidewalks, public parks and private property. 

LD 216, introduced by Rep. Anne-Marie Mastraccio (D-Sanford), would limit the number of clean syringes needle exchanges can hand out, reverting to a one-for-one ratio that Maine allowed until 2022, before adopting new rules that allow participants to bring in just one used syringe to receive 100 clean ones. Maine Department of Health and Human Services also allows participants to receive up to 100 syringes, even if they don’t bring any used ones in, at the discretion of the provider.

Maine DHHS, which oversees the Maine Center for Disease Control and Prevention, opposed the bill, arguing the “proposed language is not supported by evidenced based practice, would limit access, and increases infectious disease transmission risk including HIV and Hepatitis C,” according to testimony by Maine CDC Director Dr. Puthiery Va.

Needle exchanges face municipal pushback despite state, public health backing

Both Republicans and Democrats on the Legislature’s Health and Human Services Committee said Wednesday that municipalities should decide what policies are best suited for needle exchanges in their communities, but the statewide ratio does not need to change.

“To me, it just sounds like a disposal issue,” Sen. Marianne Moore (R-Washington) said during the work session on the bill. “However, it’s local control, so each of the cities can do their own ordinance. So I personally think that we should just leave it up at 100, because it’s been working other than the disposal part of it.”

With the exception of a few votes, the vast majority of the health committee voted against Mastraccio’s bill. That recommendation now heads to the full House and Senate to consider.

Municipalities blame providers for syringe litter

Last November, Sanford passed an emergency ordinance to revert back to the one-for-one syringe ratio, which Mastraccio said appears to have reduced syringe litter.

“We believe the ordinance has reduced the number of discards greatly, and I have not heard of corresponding outbreaks of HIV or Hepatitis among the needle exchange population,” she said in public testimony. 

Amanda Campbell of the Maine Municipal Association also said many towns and cities supported the tighter restrictions on needle exchanges because they are “concerned about the safety of their public works employees and their residents who are consistently exposed to used needle litter.”

But according to the Maine CDC’s syringe service report from 2023, released last May, most users bring in roughly the same amount of syringes they receive. Syringe services handed out 1.16 syringes for each one they collected last year, which means that despite some concern about the state’s 100 to 1 ratio, the effective rate of exchange has not dramatically changed. 

Syringe service programs also provide sharps disposal containers and help reduce discarded waste in communities, according to Dr. Kinna Thakarar, a physician at Maine Medical Center and an associate professor at the Tufts University School of Medicine.

Another solution lawmakers discussed is Portland’s needle buyback program, which the city’s public health director, Bridget Rauscher, said has helped reduce syringe litter by 76% and also resulted in a 58% increase in used syringe return. Participants can earn 10 cents per used needle they turn in, with a weekly cap of 200 syringes per person.