The Arizona Republic

A needle-exchange bill is still alive.

- Jason Pohl Arizona Republic USA TODAY NETWORK

The effort to bring needle-exchange programs out of Arizona’s shadows has inched forward, but only after a hard compromise that would water down the bill’s effects.

Sponsored by Rep. Tony Rivero, R-Peoria, House Bill 2389 called for the legalizati­on of syringe-access programs, which currently operate under the radar and afoul of Arizona drug parapherna­lia laws.

According to the proposed legislatio­n, which passed unanimousl­y out of the state House last month, programs could legally exist if the goal is to reduce the spread of disease, minimize needle pricks to law-enforcemen­t officers and encourage people to enroll in treatment programs. Efforts like Phoenix-area Shot in the Dark would also offer needle disposal and provide education on overdose prevention, naloxone access and mentalilln­ess treatment.

But an amendment approved last week by the Arizona Senate Committee on Government significan­tly alters the bill’s original intent and leaves continuous­ly running programs on the legal fringes. The lawmaker who proposed it represents a district in Mohave County that is a hot spot for drug overdoses and has been deemed by health experts to be at elevated risk of HIV spread.

Rather than allow for the ongoing operation of syringe-access programs, Sen. Sonny Borrelli, R-Lake Havasu City, wants state health officials to first declare a public health emergency to address “a possible outbreak of an infectious disease that is being spread by the sharing of needles.”

Borrelli didn’t return multiple requests from The Arizona Republic seeking comment.

Only after a needle-driven disease outbreak would syringe-access programs be authorized in the county or municipali­ty where the emergency is unfolding, according to the amendment.

“We need a way to reach people who are currently stuck in their addictions,” Rivero said during a March 14 hearing, adding he supported the amendment only because it continues the conversati­on. “We have to start building relationsh­ips with these people.”

An assistant to Rivero said he would not provide any interviews about the bill or amendments.

Despite the significan­t course change, discussion and debate was almost nonexisten­t in committee. Without the amendment, supporters feared it would have died altogether.

The amended bill passed 6-0. Shot in the Dark, an undergroun­d needle-exchange program, provides resources to drug users in the Valley and gives people dealing with addiction clean syringes and a place to dispose of used needles. The group also tries to connect them with treatment options before they disappear into the darkness.

In 2017, volunteers tallied more than 51,000 participan­t contacts among the nine weekly outreach efforts in the Phoenix metro area, their records show. They distribute­d almost 1.5 million syringes along with 14,700 doses of the overdosere­versal drug naloxone — free to participan­ts through a network of private donations.

Supporters laud such programs as cost-effective, evidence-based solutions that meet drug users on their terms and link those seeking treatment to options while stamping out high-risk, diseasespr­eading behavior.

Not having it operating steadily means needle-exchange groups will continue to be illegal, though there have not been any known enforcemen­t operations or prosecutio­ns of volunteers or participan­ts.

It also means any public health initiative will be reactive, left to address an outbreak rather than prevent it.

That’s what happened in Indiana when, in February 2015, state health officials declared an HIV outbreak after the first 30 cases were reported in one county. The cases were tied to intravenou­s use of a prescripti­on painkiller, and the number doubled by March,The Indianapol­is

Star reported.

After declaring the HIV epidemic in southeaste­rn Indiana a public health emergency, then-Indiana Gov. Mike Pence reversed his opposition to needleexch­ange programs and permitted a short-term program to help combat the growing crisis.

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