The Government Sector Findings

Goverment findings

State and local policies can interact to create barriers to recovery. Harm reduction programs, such as recovery housing, syringe exchange, and various group programs such as Alcoholics and Narcotics Anonymous, were identified by our interviewees as being vital to getting people in recovery, which leads to them seeking and maintaining work. 

When injection drug users share needles, they risk spreading infectious diseases such as hepatitis and HIV. A common worry is that syringe exchange programs increase and encourage drug use, however, studies show just the opposite. One study by Dr. Holly Hagan et al, showed that syringe exchange programs not only decrease viral infections such as hepatitis and HIV, but also decrease drug use and increase the rate of people going into recovery. Five out of eleven of our interviewees mentioned HIV or Hepatitis as a major health concern in the New River Valley as a result of injection drug use. 

Another barrier mentioned by our interviewees was transportation. Having a mobile syringe exchange would help give access to those without transportation the option to exchange syringes and get information regarding recovery. 

In response to these public health concerns, Virginia passed a code that allows health departments or affiliated organizations to establish syringe exchange programs. However, only three such programs have been established in Virginia – including one in Richmond and two in southwest Virginia. This is because syringe exchange programs still conflict with Virginia laws that make possessing drug paraphernalia a criminal offense.

We recommend that Virginia state paraphernalia code be revised such that immunity from prosecution for paraphernalia possession is granted upon the disclosure of syringe possession before search, mirroring similar existing laws in Tennessee and North Carolina. 

A major issue that the New River Health District faces in their effort to institute a syringe exchange program within their three eligible localities--Giles County, Pulaski County, and Radford City--involves local government and law enforcement’s reluctance to provide the explicit approval needed to implement a syringe exchange program. These apprehensions are due to both stigma and legitimate legal concerns around their resulting inability to enforce the current Virginia state paraphernalia code.

To promote support for this policy revision, we recommend targeting stigma within law enforcement through mandatory sensitivity training in interactive crisis intervention focused on substance use disorder. In a study by Dr. JD Livingston et al. this training was shown to have “significantly reduced officers' desire to maintain social distance from people with substance use disorders.” Currently approximately 25% of officers in the NRV receive this training, but we believe all officers should receive this important training.