This is not a case
The good deed in question is an effort by Louisa Chen and Nasim Azizgolshani, students at Dartmouth’s Geisel School of Medicine, to establish a needle-exchange program in Claremont. Their goal was to help limit the spread of infectious diseases such as hepatitis C, HIV and AIDS, prevent intravenous drug users from dying of an overdose and help them find treatment.
The pair set up shop over the summer in the Claremont Soup Kitchen, where they collected dirty needles from drug users, gave them clean needles in return, provided the overdose-reversal drug naloxone and distributed information about available treatment options, all as part of an effort known as the Dartmouth Harm Reduction Program (although it is not an official Dartmouth College or Dartmouth-Hitchcock function).
That such programs can help reduce harm is beyond question. Sharing used syringes can transmit blood-borne diseases — the Centers for Disease Control and Prevention says needle sharing is the most common way the hepatitis C virus is spread in the United States — and there’s evidence that people who inject drugs will use sterile syringes if they can get them. The state law that authorizes the operation of “syringe service programs,” signed in June by Gov. Chris Sununu, acknowledges as much, in addition to noting that such programs do not result in increased use of illicit drugs, encourage first-time drug use, expand drug networks or increase crime rates.
Importantly, the law notes that intravenous drug users who participate in needle-exchange programs are five times more likely to enter drug treatment than non-participants, and that police officers in communities with needle-exchange programs experience a dramatic reduction in needle-stick injuries.
In a country convulsed by an epidemic — 91 Americans die every day from an opioid overdose, according to the CDC — efforts like these are one component of what must be a multi-pronged approach to the problem of addiction.
In the brief time they were in operation, between July 1 and Sept. 30, Chen and Azizgolshani took 329 dirty needles out of circulation, provided 1,690 sterile ones, dispensed 26 naloxone kits and referred two people to treatment. They had planned to increase the number of days they operated at the soup kitchen, which is also a satellite site for White River Junction-based Good Neighbor Health Clinic, and to begin offering the service at Valley Regional Hospital.
But after a late October meeting with Claremont officials, they had to shut the operation down.
Here’s where the blunt instrument comes into play.
The same enlightened state law that authorizes syringe service programs effectively kills the Claremont effort, at least for now, by prohibiting any such program from locating in a “drug-free school zone,” defined as within 1,000 feet of any property used by any school for any school purpose.
As correspondent Patrick O’Grady reported, the Claremont Soup Kitchen is about a block from New England Classical Academy. Valley Regional Hospital, one possible alternate site, is within 1,000 feet of Disnard Elementary School. Another possible site, the Hope for New Hampshire Recovery’s Claremont Recovery Community Center on Main Street, offers school-sponsored activities, likely disqualifying it.
No one wants illegal drugs near schools, of course, and the dirty needles being turned in likely contain “residual amounts” of controlled substances. But the state law authorizing the program notes that those residual amounts are “unusable.” Further, the people exchanging those dirty needles aren’t there to buy or sell drugs. They’re trying to avoid getting — and spreading — a disease.
Another problem: A one-size-fits-all rule like a 1,000-foot drug-free school zone fails to take into account the character, needs or even the geography of a community. As Claremont Police Chief Mark Chase, a supporter of the needle-exchange program, told staff writer Nora Doyle-Burr, maybe lawmakers simply didn’t consider how many schools are located in Claremont when they wrote the legislation.
Fortunately, and to their credit, some Claremont officials recognize the value of the program and seem willing to try to save it. City Manager Ryan McNutt said the City Council “generally supported the merits of project” and suggested that amendments to the law could be written to allow the program to continue at the hospital, for example.
For his part, Peter Wright, chief executive of Valley Regional Healthcare, said he hopes to persuade lawmakers to carve out an exemption to the drug-free school zone law for health care providers — a logical place to host a needle exchange, he said — while at the same time allowing the top administrator of any nearby school to sign off on the operation.
Solving the thorny problem of drug abuse and addiction will require dedication, courage and creativity. Blunt instruments simply miss the point.