On Tuesday evening, the city of Manchester became the first municipality in the state to pass an ordinance about syringe service programs, a public health initiative that provides clean needles, safe disposal options and resources for harm reduction to people who use injection drugs.
The measure was initially introduced by Mayor Jay Ruais to reduce the number of used needles in the city. It requires programs to register with the city, places limits on where mobile exchanges can operate and requires more data to be shared with city officials.
Manchester Public Health Director Anna Thomas supported the ordinance, saying that it would give her office more insight into how the programs operate in the city. She added that harm reduction initiatives have reduced overdoses by 25% and fatalities by 44% over the past two years. She said syringe service programs are particularly successful in helping people struggling with addiction who might not have been able to access other services.
“That trust that you build up over time and you start getting them to a healthier place, and making healthier choices. And giving them clean needles is the first step in that direction,” she said. “It is a relationship you build with that client over time. That's why they're so successful and it's founded on trust.”
Exchanges were authorized statewide in 2017 by the state legislature. They are required to register with the Department of Health and Human Services every year and report on program activities every quarter. There are currently two registered with the state that operate in Manchester: the Merrimack Valley Assistance Program and the Queen City Exchange, which is part of the New Hampshire Harm Reduction Coalition.
Lauren McGinley leads the New Hampshire Harm Reduction Coalition. She said the Queen City Exchange group can still operate with the new limits on where those types of exchanges can happen. As a mobile unit, they think about location as part of being a good neighbor.
“I think location absolutely should be a consideration for any program operating,” she said. “And within the ordinance that was passed last night [Tuesday], we can absolutely make those locations work for us and still be as effective as we need to serve the people that we care about in the city.”
One key difference in the approved ordinance is that it dropped the one-to-one exchange requirement included in the original proposal. That would have required programs to exchange one used needle for one new needle.
While there was a strong show of community support for syringe service programs during the public comment section of the meeting, some aldermen spoke against the revisions. Aldermen Crissy Kantor and Joseph Kelly Levasseur spoke in favor of one-to-one, citing concerns about the total number of needles present in the city.
Kerry Nolte,an associate professor of nursing and department chair at the University of New Hampshire, is one of the founders of the New Hampshire Harm Reduction Coalition. She said that syringe service programs actually decrease the amount of publicly discarded syringes.
Nolte added that one of the aims of harm reduction with these programs is to reduce the transmission of HIV and Hepatitis C by encouraging people who inject drugs to use one syringe for one injection. She said the standard model statewide is referred to as “one for one plus,” which exchanges used needles for new ones, with a few to spare.
“The idea of that is to get people so that they're only using one per injection, and also that they have some supplies to share with others,” she said. “And through sharing sterile syringes instead of sharing their used syringes to reduce hep C and HIV transmission.”
Ruais said the ordinance was part of what he called an “iterative process” on handling addiction and substance use in the city. He said it was possible to revise the ordinance in coming months based on the data gathered, including an upcoming study in Dover about the use of public biohazard containers for needles.
