CHARLESTON, W.Va. – City councilors in West Virginia's Democrat-controlled capital city voted against a proposal from the state's long-time abortion provider to start a syringe service program in one of the country's most opioid-devastated areas.
The 17 to 9 vote on Monday came two years after the council and the Republican-controlled state Legislature passed regulations restricting the programs, which are supported by the Centers for Disease Control as scientifically-proven methods to curb drug use and prevent the spread of infections like hepatitis c and HIV. The opposition said they feared the program would bring increased drug use and crime into Charleston's west side, a low-income area that has suffered from redlining and historic disinvestment.
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Supporters of the Women's Health Center of West Virginia said drug use is already prevalent and that a syringe service program would help more people get into recovery in the community, which has also historically seen the city’s highest percentage of emergency overdose calls.
The meeting was the latest development in a years-long, highly contentious battle for recognition of what is considered medical best practice for harm reduction in substance use disorder and its intersection with poverty, race, and economic equity in West Virginia’s capital city.
“Our city is dying — it's our responsibility to do something about it," said Republican Frank Annie, a sponsor of the proposal and a research scientist specializing in cardiovascular health at Charleston Area Medical Center Memorial Hospital.
Annie, who represents the more affluent South Hills and was working with a coalition of all-Democratic councilors, spoke about the high rates of hepatitis c, HIV and endocarditis from intravenous drug use that are “crippling” local healthcare systems.
Dr. Adina Elise Bowe, an addiction psychiatrist with Charleston Area Medical Center, asked councilors to put “emotions aside and look at the evidence" supported by three decades of medical research.
West Virginia is the U.S. state with the highest rate of opioid overdoses. In 2021, the Centers for Disease Control and Prevention declared Charleston the scene of the country’s “most concerning HIV outbreak” due to intravenous drug use.
Women’s Health Center of West Virginia providers said their proposal was part of an effort to expand services for marginalized communities now that a near-total ban on abortion is in effect in the state.
Syringe service programs operate by allowing people to exchange dirty syringes used to inject drugs for clean, sterile ones. They are CDC-recommended methods to curb the spread of infection and typically offer a range of services, including referrals to counseling and substance use disorder treatment.
Such programs exist nationwide, but they are not without critics, who say they don’t do enough to prevent drug use. The city has one syringe service program now, located in the more affluent east end. A program run out of the Charleston-Kanawha Health Department was shuttered by the city in 2018.
West Virginia Republican Gov. Jim Justice signed a law in 2021 requiring syringe providers to be licensed with the state and recipients to show proof of residency and return each needle after use.
The Charleston City Council followed with an ordinance requiring programs to collect at least 90% of the syringes distributed. Exchange programs violating the restrictions can be charged with a misdemeanor criminal offense, adding fines of $500 to $1,000 per offense. The programs also must be approved by the council and county commission.
Christy Day, a Black west side resident who spoke against the proposal, said she's tired of coming to city council to talk about programs like syringe service without an equity plan focused on bringing other needed resources, like new families and businesses like grocery stores.
Larry Moore, the city council member representing the west side, said people in his community feel like they haven't always had a voice in decisions that are made in the city.
Kenny Matthews, a Black man in recovery from opioid use who lives on west side, said syringe service programs save lives by building trust with a hard-to-access community and connecting people to treatment while offering resources like fentanyl test strips and overdose-reversal drugs.
“What we’re asking to be done is to allow people to be surrounded by people that say, ‘You’re worth living. You have something to contribute, and you can be better,’” he said. “If we say that we don’t want harm reduction, then you’re saying that you don’t want people to live."
After the meeting, Democratic Mayor Amy Goodwin — who voted against the proposal — said she sees the benefit of syringe service programs and voted in support of the existing program run by a clinic for underinsured residents on the east end. But, she said more medical expert testimony and more time was needed to ask questions before being pushed to vote on this latest proposal. Women's Health Center providers said they reached out to Goodwin to talk about the program in June.