A discarded needle in an alleyway off Cumberland Street in Portland on Thursday. Shawn Patrick Ouellette/Staff Photographer

Portland leaders are weighing how best to address increasing reports of discarded needles along city streets and parks, with the proposals ranging from reducing the number of clean needles given out to setting up a pilot program to pay people for returning used syringes.

“Once upon a time it used to be a few needles scattered about, but now it seems to be pervasive,” Mayor Mark Dion said. “It’s of our own making. We’re the ones distributing the needles, so I think the council has a responsibility to be assertive on the issue of needle waste.”

The city has run a needle exchange program since 1998, giving clean syringes to anyone who returns used ones for safe disposal. It’s a harm-reduction tactic that is proven to mitigate the spread of diseases like Hepatitis C and HIV because people are less likely to reuse or share needles.

For decades, Portland had a one-for-one exchange policy in accordance with state law. That meant someone could only get as many clean syringes as used ones they turned in. The governor temporarily loosened those restrictions during the pandemic, but Portland was one of the final cities to opt-in. The state law changed permanently in 2022, allowing needle exchange programs to give out as many as 100 clean needles at a time.

Dion wants to bring that exchange rate back down to one-to-one. But at the council’s Health and Human Services committee meeting on Tuesday night, city staff suggested less drastic measures, like a potential syringe buy-back program, increased cleanup efforts and education for addicts.

“It’s more effective to allow people to make the decision for themselves about how many needles they need to stay safe,” said Bridget Rauscher, the city’s interim director of public health.

According to data provided by the city, the program handed out 786,000 clean syringes to 2,329 people between Nov. 1, 2022, and Oct. 31, 2023, a rate of less than one needle per person per day. The city collected 537,000 discarded syringes in that time period.

In an op-ed published in the Portland Press Herald on Thursday, Dion insinuated that those approximately 200,000 uncollected needles ended up on the streets of Portland.

But Rauscher said that’s not necessarily the case.

“Needles in versus needles out doesn’t tell you how many people dispose of their needles in another place. People could dispose of their needles at the hospital, in jail, at the shelter, and we wouldn’t count those,” she said, emphasizing that the data only reflects needles collected by the city.

In 2024, the city is on track to give out – and collect – even more. By the end of August, the city had given out 611,000 syringes and collected 365,000.

Giving out clean needles at a higher ratio, Rauscher said, keeps people safe because it sometimes takes intravenous drug users several tries to properly inject themselves. Needles can also be lost or damaged and a shortage of clean needles leads to sharing or reusing dirty ones, she said.

A sharps container to dispose of used needles hangs on a fence along Elm Street on Thursday. Shawn Patrick Ouellette/Staff Photographer

DOES IT WORK 

While Rauscher acknowledged that the problem with discarded needles littering neighborhoods is inextricably linked to the exchange program, she said it’s a relatively small price to pay compared to an HIV or Hepatitis C outbreak. Hepatitis C rates are already very high in Portland, she said.

“There is always going to be syringe litter. There was syringe litter when we had a one-for-one as well. It’s just part of it. Not everybody is going to dispose of their syringes properly,” she said.

While she said her department is serious about tamping down on the problem, Rauscher emphasized that needle sticks are uncommon and developing a disease from them is rarer still.

“The likelihood is very small that you would develop Hepatitis C or HIV by an accidental needle stick, especially if you follow guidance around quickly washing the spot and tending to it,” Rauscher said.

Rauscher advocated at Tuesday’s meeting for increased education for intravenous drug users, installing more sharps containers and sending city staff out for an additional five to seven hours a week to clean up discarded needles. She also talked about researching a needle buy-back program, which would allow people to receive money in exchange for used syringes.

But Dion said he isn’t convinced these efforts will be enough.

Mayor Mark Dion. Ben McCanna/Staff Photographer

“I don’t think that (intravenous) drug abusers are able or willing to properly dispose of needles. If they were then I wouldn’t be responding to this volume of complaints from the public,” he said in a phone interview Wednesday.

He said he would be happy to see other suggestions implemented as well, but he is doubtful that the needle exchange program is an effective harm reduction tactic at all, and, in fact, might actually be enabling drug users.

“We are enabling a condition that has real life or death consequences. Any one injection can be fatal and if we’re giving them 100 needles, we’re giving them 100 chances to overdose,” he said.

The Centers for Disease Control and Prevention classify such programs as extremely effective.

“Nearly 30 years of research has shown that comprehensive (needle exchange programs) are safe, effective, and cost-saving, do not increase illegal drug use or crime, and play an important role in reducing the transmission of viral hepatitis, HIV and other infections,” the agency’s website reads.

MIXED REACTIONS 

When residents complained about the discarded needles at the West End Neighborhood Association’s meeting on Wednesday night, Community Prosecutor Rich Bianculli said he hoped the exchange rate would be reduced.

“It’s kind of a nightmare. I wish we could get back to the one-to-one needle exchange,” he said. “I just think it’s silly, we’re putting our kids at risk.”

But when Dion discussed his plans to limit the exchange ratio at Tuesday night’s committee meeting, he was met with several councilors who opposed the idea.

“The decisions that we make that inform our policy should not be based in stigma or fear,” said Councilor Anna Trevorrow.

A discarded needle found near Cumberland Street on Thursday. Shawn Patrick Ouellette/Staff Photographer

Councilor Kate Sykes said she doesn’t think needle litter poses any risk to Portlanders and that teaching people how to pick up needles themselves might help them feel safer.

“I think people are scared, so we need to educate people,” Sykes said.

Councilor Anna Bullett said she hoped councilors would consider the origin of the problem, addiction.

“A systemic, long-term crime was committed by the pharmaceutical industry and that’s why we have people who are in this situation. That’s why we are here.”