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Giving St. Louis Drug Users Syringes Could Help Curb HIV, Other Diseases

Syringe exchange programs have been used to reduce rates of HIV and other infectious diseases among drug users who share needles. The St. Louis Board of Aldermen next week could consider allowing addiction treatment providers to run such a program.11/8/19
File photo | Zachariah Hughes | Alaska Public Media
Syringe exchange programs have been used to reduce rates of HIV and other infectious diseases among drug users who share needles. The St. Louis Board of Aldermen next week could consider allowing addiction treatment providers to run such a program.

Addiction treatment providers in St. Louis could soon begin distributing clean syringes to intravenous drug users under a program overseen by the city’s health department. 

Alderwoman Cara Spencer, D-20th Ward, introduced a bill supporting the proposal on Friday. The board sent the bill to the Health and Human Services Committee, which could consider it next week. 

Syringe services programs, often described as needle exchanges, have proven track records of reducing the rates of infectious diseases such as HIV among drug users who share needles.

The programs also allow health workers to educate drug users about treatment options and distribute naloxone, said Fred Echols, director of the St. Louis Department of Health.

“For such a long time, actions towards individuals that inject drugs have been punitive,” Echols said. “This will be one of the first times I think in the history of St. Louis we’re actually reaching out to them provide some of the support they need.”

The health department would approve the providers that participate and track the program’s success. The providers would buy the syringes and cover the cost of distributing them, Spencer said.

The program would allow the city health department and recognized addiction treatment providers to distribute the syringes, despite current city and state lawsthat categorize them as illegal drug paraphernalia, Spencer said.

“Creating a syringe services program … encourages folks to come in, to get those syringes, and creates that point of intervention where those service providers can introduce those folks to other services available to them that could address their addiction,” she said. 

While some syringe programs require people to exchange used syringes to receive sterile ones, the proposed program will not operate on an exchange basis, Spencer said. 

There were more than 80 new cases of HIV in the city of St. Louis last year, Spencer said. Hepatitis C cases increased 24% statewide between 2013 and 2015, the last year in which data is available. Tens of thousands of new hepatitis C cases each year are attributed to injection drug use, according to the Centers for Disease Control and Prevention. 

Drug users often don’t have new needles to use every time they use drugs such as heroin, and reuse and sometimes share contaminated needles.

While syringe services programs provide sterile needles and other equipment, they also create a point of contact between providers and active users. Treatment professionals can check in on addicted people’s health and build trust, a crucial part of getting people in need to accept treatment, Echols said. 

“It would give us more insight as far as the burden of disease among individuals injecting drugs,” he said. 

Addiction treatment advocates have run a handful of programs in St. Louis without approval from city officials, Spencer said. She’s encouraged by positive experiences between the unauthorized distributors and the city’s law enforcement.

The ordinance also directs the St. Louis police to recognize the public health benefits of the program and not consider the syringes distributed through it as drug paraphernalia. 

Build-A-Bear rollback

Earlier this year, the Board of Aldermen approved nearly $4 million in incentives for Build-A-Bear Workshop, which plans to lease office space near Union Station for its headquarters. Legislation introduced Friday by Alderwoman Christine Ingrassia, D-6th Ward, would cancel the incentives over allegations the owner of the building at 415 S. 18th St. and the developer they're working with aren’t following the terms of the redevelopment deal. 

Requirements included hiring union workers, or paying prevailing wages if nonunion workers are used, she said, as well as participation thresholds for minority- or women-owned businesses.

“It doesn’t seem like they’ve adhered to that so far, so I want to pause on things to make sure that what we all agreed to is what’s happening on the ground,” Ingrassia said.

Build-A-Bear said in a statement that, to the company’s knowledge, the landlord of the building is “in compliance with the agreement with the City of St. Louis. We welcome the opportunity to help resolve any misunderstandings.” 

The city’s development agency and the landlord, a Texas-based investment company, did not immediately return calls for comment. 

More Freeholder delays

Also on Friday, Board President Lewis Reed shut down an effort to force Mayor Lyda Krewson’s nominees to the Board of Freeholders out of committee for a vote by the full board.

The move means Tuesday’s meeting of the board, which will consider regional consolidation, is expected to happen without any members from the city. The Black Caucus has held up committee action, objecting to the racial and geographic makeup of the nominees.

Reed said he believes a deal on the nominees is close. The mayor said in a letter sent to Reed on Friday that she “is very interested in working with the Committee to confirm City nominees.” She has said in the past that she stands behind her original nominees.

Rachel Lippmann contributed to this article

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Sarah Fentem is the health reporter at St. Louis Public Radio.