State Senate passes ‘syringe-access bill’ for opioid treatment

The Senate has passed a bill that would allow organizations that are registered with the state to distribute clean needles and connect drug users with social services.

Senate Bill 690, which passed with bipartisan support, is sponsored by Sen. Holly Thompson Rehder, R-Sikeston.

Rehder said the bill would allow entities that are registered with the health department to distribute clean needles in places with an outbreak of bloodborne diseases, such as hepatitis B and HIV. She said such programs would help with the opioid epidemic as well.

According to The Foundation for AIDS Research, it was illegal to operate such programs in Missouri as of 2021. However, according to the North America Syringe Exchange Network, there are two syringe services programs operating in St. Louis. Rehder also mentioned another one in Kansas City. She said these programs were operating in what was regarded as a "gray area."

"The communities look the other way because these are so beneficial," Rehder said, adding a legal gray zone had prevented those programs from applying for available federal funds.

Under this bill, distributing clean needles in syringe- exchange programs would no longer be criminalized under drug paraphernalia laws. These programs would not be allowed within a quarter-mile of any school building.

The Centers for Disease Control and Prevention has listed 13 Missouri counties as "vulnerable" to HIV and hepatitis C outbreaks.

Rehder said the bill would help those with opioid addictions get help from "someone in their orbit" when they are ready to do so. A similar bill she sponsored passed both chambers last year but did not become law due to differences that were not resolved.

By narrowing the bill's title to dealing with those affected by the opioid epidemic, Rehder hopes it will not suffer the same fate.

The bill passed the Senate last week with 10 votes from Democrats and nine from Republicans. It now awaits a hearing by the House Emerging Issues Committee.

In a Senate committee hearing, the Missouri State Medical Association and Missouri Family Health Council testified for the bill. No residents spoke against it.

Suzanne Opperman, an advocate for the Missouri Nurses Association and a psychiatric nurse practitioner, said needle- exchange programs would decrease the chance of people getting bloodborne diseases.

"If you get them to come in to exchange needles, it's an opportunity to try to connect with those people to help them with their substance abuse," she said.

Opperman said many users of such programs are homeless and they "don't get health care." Because of that, she said needle-exchange programs would also examine the users' blood to check for diseases and connect them with social services.

"So instead of having the complication of potential infection from a fellow needle user, giving them a clean option is huge," she said.

Apart from allowing syringe-access programs, the bill would allow physicians to prescribe and pharmacists to sell naltrexone, a drug that prevents opiate relapses, without liability.

"It just allows our pharmacists to be able to write out a prescription for two days or 10 days of naltrexone for someone who's in recovery who knows that they're going into a rough patch," Rehder said.

Although this is a Republican-sponsored bill, 14 Republican senators voted against it, including the Conservative Caucus. Sen. Bob Onder, R-Lake Saint Louis, said he had "very mixed feelings on the issue."

"If you go back and look historically at needle-exchange programs, they have been controversial," Onder said, adding there was a line between "harm remediation" and "enabling."

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