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Portland Press Herald, May 11, 2007
by Ann S. Kim, Staff Writer
AUGUSTA - A state panel is backing legislation that would relax limits on needle-exchange programs for drug users as a way to reduce the transmission of blood-borne infections such as human immunodeficiency virus and viral hepatitis.
A bill before the Legislature would allow participants to exchange an unlimited number of used syringes for sterile ones, eliminating the current limit of 10 per visit.
The measure also would protect participants from criminal charges that could stem from the possession of residual amounts of drugs in the used syringes.
Proponents of the measure hope that drug users who don't live near a program site will find it more worthwhile to make the trip if they can exchange more needles.
Injection drug use can carry a high risk of contracting HIV and hepatitis B and C.
The use of sterile syringes is an important strategy in fighting transmission of disease.
"Clearly, if you're in a rural area, this bill will help you, because you can drive fewer times and exchange more needles," said the bill's sponsor, Rep. Lisa Miller, D-Somerville.
Miller introduced the bill at the request of the state HIV Advisory Committee.
The proposal will go before the Health and Human Services Committee today for a public hearing.
A total of 555 people are enrolled in four state-certified needle-exchange programs in Maine. The programs are in Portland, Augusta, Bangor and Ellsworth.
On average, 10 syringes are the equivalent of a three-day supply, said Martin Sabol, the advisory committee chairman and manager of Portland's infectious-disease program.
It is legal to buy as many as 10 syringes without a prescription, but injection drug users may avoid pharmacies because they don't want to be seen making the purchases or because they want to avoid requirements such as providing an ID or signing a log.
It's also possible to sterilize syringes, but there's room for error, said Kate Perkins, an advisory committee member who is also director of health programs for Medical Care Development.
Maine would not be alone in having no cap on exchange programs.
Oregon, Hawaii, San Francisco and Baltimore already allow an unlimited number, she said.
Proponents acknowledged that some uneasiness remains around needle-exchange programs because of a sense that they condone drug use.
Maine passed a law allowing them 10 years ago.
"It makes people feel uncomfortable. I will not deny it's a difficult issue," Miller said.
Even one of her co-sponsors has reservations about the proposal.
Rep. Robert Walker, R-Lincolnville, said he likes the public heath benefit of such programs but he is not sold on the idea of lifting the cap altogether.
"I would have a lot of heartburn with that," said Walker, the ranking minority member of the Health and Human Services Committee. "I guess I would have to hear some very good arguments about why we should have the unlimited."
The pool of HIV-positive people using dirty needles is small, thanks to active outreach programs, but the likelihood of sharing a needle with someone infected with hepatitis C is much greater, Perkins said.
An estimated 20,000 people in Maine are infected with hepatitis C, with as many as half unaware of their infection, according to the Maine Center for Disease Control.
Hepatitis C is the most common blood-borne infection in the United States and the leading cause for liver transplants.
There is no vaccine for the disease, and treatment is expensive.
Proponents of the bill cite concerns about hepatitis C as one reason for the proposal.
According to Maine Center for Disease Control data, 1,025 to 1,381 cases were reported each year from 2000 to 2005.
The data does not indicate when the cases were contracted.
Nationally, the number of new infections has decreased from an average of 240,000 in the 1980s to roughly 26,000 in 2004.
The Boston Globe reported this week, however, that suspected and confirmed cases of hepatitis C among 15- to 25-year-old Massachusetts residents rose sharply from 254 in 2001 to at least 784 in 2005.