PORTLAND — A City Council committee is set to review Portland’s needle exchange program Thursday, after the city’s approach was criticized as “antiquated” and unsafe during the pandemic in mid-February.

The topic is the only item on the agenda of the March 4 6 p.m. meeting of the Health and Human Services and Public Safety Committee.

The needle exchange program, established in 1998, is the only municipally operated program in the state.

“It is something that from a public health perspective is very important, particularly for harm-reduction efforts throughout the city,” City Manager Jon Jennings said at the City Council meeting Monday.

Typically a needle exchange operates on a 1-to-1 model, which provides a clean needle for every used needle clients hand over, but during the pandemic Gov. Janet Mills has asked for that requirement to be relaxed. The Portland program is the only exchange in the state that hasn’t followed Mills’ recommendation.

“It’s pretty rare for Portland to have the dishonorable distinction of having less progressive rules than other places, but we have the only exchange program in the state that has chosen to hang on to this policy. I have not heard a good rationale as to why,” Cait Vaughan said at the Feb. 22 council meeting during which several advocate urged the city to rethink the 1-to-1 policy.

“It is an antiquated policy. It was before the pandemic and certainly is now,” Vaughan said.

Elizabeth McCormack told councilors last month that suspending the 1-to-1 policy could “be a life-saving measure for some people.”

“More access to clean needles means decreased risk of HIV, Hepatitis C, endocarditis and other conditions common in IV drug use,” she said.

Vaughan said she is embarrassed by the city’s approach. Her loved ones are getting infections and are “dying at ridiculous rates,” she said, and the city “has the ability to help stop that.”

The city, Jennings said in a March 1 letter to councilors, is not required to relax its needle exchange rules in light of the pandemic.

“The Executive Order is not a mandate, rather an allowable exception during the State of Emergency, should exchange programs determine it would provide a benefit for clients,” he wrote. “Given the existing structure of the NEP’s operation, (7 days a week, two locations with more than 40 hours of operation, plus COVID safety protocols in place) Public Health staff determined they were still able to serve and meet our clients’ needs while, in most cases, adhering to the 1:1 rule. It’s important to remember, unless there is a permanent rule change, the 1:1 requirement will resume when the State of Emergency ends.”

The city offers exceptions to the 1-to-1 rule in some cases, such for new enrollees, those who are homeless or living in a shelter, those who have had their needles confiscated by law enforcement and for those recently released from prison, jail or the hospital. Those people are provided with safe injection supplies and 10 needles.

Although Jennings said the city is “no longer seeing the vast amounts of discarded needles in our parks and public places,” discarded needles increased from 598 in 2015 to 6,240 in 2020. The amount of money needed for the program has also increased, from $45,426 in fiscal year 2019 to $92,938 in fiscal year 2020.

A November audit of the program, Jennings wrote, found that “significant numbers of needles had been requested by and provided to individuals who sought them not for personal use but to facilitate the operation of unsanctioned needle exchange programs,” and the Portland Needle Exchange Program was inadvertently paying to dispose of needle waste from other programs.

Used needles are accepted by the city 40 hours a week Monday through Sunday, either at the India Street Public Health Center at 103 India St., which is open Monday through Friday, or at one of the outreach exchanges on Oxford and Elm streets. Jennings said that in January, the program distributed a little more than 30,000 needles while taking in 29,185 used needles over the course of 819 exchanges. In January 2020, the city gave out 27,250 needles and collected 18,240.

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