What are syringe services programs?
Syringe services programs distribute unused sterile syringes and provide safe disposal methods for used syringes. They also provide health and resource information about treatment options and medical and social services to people who use drugs and their communities.
Are syringe services legal?
Syringe services programs became legal in North Carolina on July 11, 2016, when the legislature passed North Carolina General Statute 90-113.27. Find the full text of the law here.
Under the law, no syringe services employee, volunteer, or participant may be charged with possession of needles, syringes, or injection supplies, including paraphernalia containing residual amounts of controlled substances, if obtained from or returned to a syringe exchange. Syringe services provide cards (or other documentation) to identify participation in syringe services.
If a law enforcement officer in good faith arrests someone who is later determined to be immune under the law, he or she will not be subject to civil liability for the arrest or filing of charges.
What are the benefits of syringe services?
Beyond providing unused syringes and supplies that reduce the health harms and risks associated with injection drug use, syringe services connect people to the services they want and need, including medical care, counseling, and substance use disorder treatment. These services are often available to people affected by or involved with drug use in different ways, including friends, family members, and partners of people who use drugs.
Syringe services programs are financially practical ways to reduce costs associated with treating HIV and hepatitis C infections. About a fifth of HIV cases and over half of Hepatitis C cases are attributable to injection drug use. Lifetime HIV treatment can cost hundreds of thousands of dollars; Hepatitis C care costs tens of thousands of dollars and becomes significantly more expensive for people with longer life expectancy. When prevention, testing and early treatment are inaccessible, HIV and Hepatitis C can spread quickly. By investing in relationships with their communities, exchanges can alert public health agencies about observed changes in drug use, new health risks, and spread of infectious diseases. At approximately .04 cents per syringe, service programs are a pragmatic and cost-effective way to reduce the financial burden of HIV and Hepatitis C treatment in North Carolina.
Syringe services are important for public safety. Fear or hesitation to disclose syringe possession puts law enforcement officials and other emergency responders are at risk of needle stick injuries from used syringes. Since the law provides immunity of drug paraphernalia acquired at SSPs, people holding syringes may be more likely to disclose the possession of used syringes before being searched by law enforcement. Also, because syringe services provide unused syringes and injection supplies as well as a place to dispose of used syringes and supplies, people who inject drugs may be less likely to carry the used syringes that can pose a public safety risk.
What do syringe services in North Carolina provide?
Syringe services programs operating in North Carolina are required to provide the following:
- Safe disposal of used needles and hypodermic syringes
- New needles, hypodermic syringes and other injection supplies free of charge and in sufficient quantities to ensure that they are not reused or shared
- Reasonable and adequate security for program sites, equipment and personnel
- Educational materials on all of the following: overdose prevention; the prevention of HIV and viral hepatitis transmission; drug abuse prevention; treatment options for mental health issues, including treatment referrals; and treatment for substance use disorders, including referrals for medication-assisted treatment
- Access to naloxone kits or referrals to programs that provide access to naloxone
- For each individual requesting services, personal consultation from a program employee or volunteer concerning mental health or substance use disorder treatment as appropriate
Who can start a syringe services program in North Carolina?
According to the law authorizing syringe services in North Carolina, “any governmental or nongovernmental organization, including a local or district health department or an organization that promotes scientifically proven ways of mitigating health risks associated with drug use and other high-risk behaviors, may establish and operate a needle and hypodermic syringe services program.” This list includes, but is not limited to: harm reduction organizations, health departments, AIDS service organizations (ASOs), clinics, pharmacies and community-based organizations (CBOs).
How will my department know about syringe services in our jurisdiction?
The Division of Public Health encourages health departments and organizations interested in providing syringe services to contact law enforcement in their jurisdiction when discussing or planning services.
All syringe services in North Carolina are required to submit a security plan annually to any police or sheriff’s department with jurisdiction over the area(s) they serve. The Division of Public Health also suggests that syringe services share with law enforcement agencies the documents/identification distributed to participants by the program to demonstrate participation and entitlement to immunity for possession of syringes and other injection supplies obtained from a service under the law.
Please contact the Division of Public Health at SyringeExchangeNC@dhhs.nc.gov with any questions about local syringe services operations.
What do the required security plans include?
The law requires “reasonable and adequate security of program sites, equipment and personnel.” Organizational security plans are needed to ensure the safety of program staff, volunteers and participants. Should an emergency occur, responding law enforcement should be aware of internal security plans. Reasonable and adequate program security depends on the program’s size, location, resources and housed services. At minimum, services sites should be securely locked when not operating. Syringes and other supplies should be kept locked and the program must take reasonable steps to protect the health and safety of staff, volunteers and participants. Information about the program’s security plan must be sent to all police and/or sheriff’s offices with jurisdiction upon registration with the Division of Public Health and updated annually.
If you have any questions about syringe services programs, relevant laws, or operations requirements, please contact the Division of Public Health at SyringeExchangeNC@dhhs.nc.gov.
Relevant North Carolina Laws
Possession of Syringes/Tell Law Officer Law (G.S. 90-113.22)
The relevant immunity provision in this statute went into effect December 1, 2013. It states that if a person alerts an officer that s/he has a syringe or other sharp object on her or his person, premises or vehicle prior to a search, s/he cannot be charged or prosecuted with possession of drug paraphernalia for that object. The purpose of this law is to protect officers from punctures or wounds from sharp objects, including objects potentially contaminated with bloodborne diseases like HIV and Hepatitis C, and to encourage suspects to be honest with officers about paraphernalia they may have in possession.
Syringe Exchange Law (G.S. 90-113.27)
This statute legalized syringe exchange in North Carolina in July 2016. Syringe exchange programs collect used syringes, provide unused syringes and injection supplies and connect participants to social services, including treatment.
Included in the law is a provision that protects syringe exchange employees, volunteers and participants from being charged with possession of syringes or other injection supplies, including those with residual amounts of controlled substances present, if obtained or returned to a syringe exchange. Exchange employees, volunteers and participants must provide written verification (such as a participant card or other documentation) to be granted this limited immunity. A law enforcement officer acting on good faith who arrests or charges a person who is thereafter determined to be entitled to immunity from prosecution under this section shall not be subject to civil liability for the arrest or filing of charges.