The discussion of syringe exchange programs in the Nov. 24 article on hepatitis C prevention in Maine omits a key element, which is the provision of safe-injection sites supplementing syringe exchange.

Such sites provide settings where those self-injecting street drugs can do so in a safe, monitored environment. More importantly, they provide a door to substance abuse treatment and other services for this high-risk population.

Safe-injection sites have proven their worth in Canada. A bill providing for them was introduced in the Maine Legislature in April but didn’t go anywhere. There is a federal prohibition on safe injection-sites that must be dealt with, but in Philadelphia this has been successfully challenged in court and the first such U.S. sites may soon be operational there.

Maine should not spend $1.5 million on the expansion of syringe exchange without considering provision of safe-injection sites as part of a hepatitis C prevention program.

James Berry, M.D.

Gorham


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