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Baltimore City Mayor & Health Commissioner Announce Passage Of Needs-Based Syringe Exchange Bill

BALTIMORE, MD (April 1, 2014)  – Baltimore leaders say passage Monday evening by the General Assembly of legislation permitting needs-based exchange of syringes will go a long way toward ensuring the continued success of the city’s highly successful syringe exchange program.  This bill was a top legislative priority for the Mayor and Health Department during the 2014 General Assembly session.

"The passage of this bill is another step toward a healthier Baltimore," said Mayor Rawlings-Blake. "We will see less exposure to dirty syringes and put Baltimore in a stronger position to prevent the spread of diseases through intravenous drug use.  Other cities have seen AIDS and other diseases reduced utilizing a similar approach and I'm optimistic Baltimore can achieve similar reductions with this legislation."

“This is a significant moment in the continued effort to reduce our HIV rates, which is one of the goals of the city’s Healthy Baltimore 2015 initiative, and will also help reduce Hepatitis C rates,” added Oxiris Barbot, M.D., Commissioner of Health.

While the current one-for-one model of syringe exchange has been a factor in the HIV rate decreasing among injection drug users in Baltimore from 53 percent in 1992 to 12 percent in 2011, health officials believe this rate is still too high and further improvements can be realized.  Needs-based models are in place in cities such as Boston, Chicago, New York, San Francisco and Vancouver.

Under the one-for-one model in Baltimore, surveys showed clients were often reusing or sharing syringes, both of which can have significant adverse health consequences. Sixty-nine percent of users reported reusing a syringe within the past 30 days, and 30 percent of clients reporting sharing a syringe in the same time period.  In addition, more than half (53 percent) reported not having enough syringes between visits.

“Our goal is for clients to use a new sterile syringe every time,” Dr. Barbot said.

Baltimore health officials did extensive research into successful needs-based programs in other cities in preparation for this legislation.

• When the city of Vancouver transitioned to their needs-based syringe exchange model, there was a reported 40 percent decrease in sharing of syringes and a decrease in HIV incidence.

“We found that needs-based syringe exchange doesn’t result in increased injection drug use, rates of return for used syringes are higher in those cities, and a so-called “black-market” for syringes doesn’t develop because people will not choose to buy syringes when they can obtain them for free,” Dr. Barbot said. “These are all myths about syringe exchange that are based more on fears and sterotypes than on facts.”

The needs-based syringe legislation now awaits the governor’s signature.

Baltimore’s syringe exchange program currently has more than 5,000 clients enrolled at 18 sites around the city.  Of those, approximately 2,500 are regular clients and 2,500 report occasional use.  The program operates in mobile units six days a week providing syringe exchange as well as additional health services such as testing for HIV and other sexually transmitted diseases, reproductive health services and wound care services.  The program also provides referrals to treatment and transitional housing services.

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