We are making this post to provide additional, factual information regarding the Steady Collective’s weekly syringe access/naloxone distribution event hosted by our co-op on Tuesday afternoons. Although we have been providing a mobile distribution space to Steady since November of 2016, a surge in recent interest has brought with it rumors and misrepresentations that we’d like to correct.

Note that members of our co-operative are not experts on public health and are actively engaged in a process of self-education. We will continue to update this post as we learn more.

What Is Steady Collective?

Steady Collective (www.thesteadycollective.org) is an Asheville-based harm reduction organization that was started in 2015. The following year, when House Bill 972 made syringe access programs legal in North Carolina, Steady began an exchange.

• Steady’s syringe access event at Firestorm takes place for 2 hours/week.

• The location of this event was based on local data demonstrating high rates of injectable drug use in our neighborhood, namely the presence of syringe litter.

• Steady has operated with funding from the Buncombe County Health Department and is regulated by state law.

• Steady distributes clean syringes, naloxone (used to reverse fatal opioid overdose), fentanyl test kits, educational materials, and referrals to treatment upon request.

• In 2017, Steady received 258 overdose reversal reports from folks using their naloxone kits (66% of all street reversal reports in Buncombe County). These reports are increasing dramatically in 2018.

• Steady’s work has garnered the respect and support of organizations such as Human Rights Watch (source), AIDS United (source), and the local medical community (source).

While we recognize the need for safe injection sites in our community, Firestorm is a sober space and we actively discourage substance use at or around 610 Haywood Road. Additionally, our co-operative hosts weekly recovery meetings.

Why Needle Exchange / Syringe Access?

As the New York Times put it, “Politics Are Tricky but Science Is Clear: Needle Exchanges Work” (source). Organizations like Steady Collective use an evidence-based approach to public health that is endorsed by the World Health Organization and the American Medical Association.

• Syringe access programs, and harm reduction approaches overall, protect substance users and the public from the spread of HIV, and Hepatitis B and C.

• Exchanges DO NOT cause any increase in substance use according to the World Health Organization (source) and the Center for Disease Control (source).

• Exchange participants are 5 times more likely to enter treatment than non-participants (source).

• Crime has been shown to decrease near exchanges because participants are connected to drug treatment, housing, food pantries, and other social services (source).

• Exchanges collect used syringes and dispose of them safely, thereby reducing the number of syringes in public areas.

But Does the Exchange Endanger Neighbors?

As noted above, the presence of an exchange program has been demonstrated to reduce the risk of overdose, reduce the spread of infectious disease, reduce substance use, reduce crime, and reduce syringe litter.

On Haywood Road, much has been made about the proximity of Steady’s weekly event to schools. While we can all agree that discarded syringes are never acceptable on playgrounds, evidence shows that infections from needlestick injuries are extremely rare. So rare in fact, that a 2013 survey in the Journal of Public Health concluded “there have been only three reported cases each of [Hepatitis B] and [Hepatitis C] and no documented case of HIV transmission from non-healthcare-associated needlestick injuries” worldwide (source).

As with adults, teaching children how to stay safe around syringes is important both because it reduces the risk of injury and because it can alleviate fear. Luckily there are resources available for parents and teachers wanting to talk to children about what to do if they find a used syringe. We recommend starting with www.SeeANeedle.com.

Steady provides training in safe syringe pick-up and has coordinated regular volunteer cleanup days. They also make sharps containers available to community members for safe disposal of found syringes. For more information, please contact Steady directly.

What Is Going On In Asheville?

Southern Appalachia has been the region hardest hit by the national “opioid crisis,” a biomedically produced, policy-driven phenomenon of opioid overprescribing followed by irresponsible stoppage of pain medication prescriptions, leading to an increase in heroin use. More people in Appalachia suffer and die from opioid-related substance use disorders, with less access to treatment options, than anywhere else in the country.

According to the Center for Disease Control, overdose deaths in NC are expected to increase by 22.5% in 2018 (source). Buncombe County is experiencing increasing rates of Hepatitis B and C, related to injecting practices and lack of access to safe injecting supplies.

As prescription opioids have become harder to obtain, more substance users are turning to injecting heroin. And with the supply of heroin under threat, drug dealers have begun to cut their supply with a cheaper, more deadly opioid: fentanyl. In July 2018, the NC Office of the Chief Medical Examiner reported that deaths involving fentanyl and/or analogues had increased by 943.2% from 2010 to 2017. In Buncombe County, fentanyl-related deaths rose from 17 to 97 between 2016 and 2017 – more than fivefold (source).

So... Why Are There Syringes on the Ground?

As noted above, preexisting syringe litter was one of the reasons Steady chose to operate an exchange event on Haywood Road, so this problem is not new.

Asheville has one of the lowest return rates for used syringes in NC due to the Asheville Police Department’s practice of disregarding the limited immunity of exchange participants, in violation of state statute. Without being able to transport used syringes free of law enforcement harassment and possible arrest, individuals who are experiencing homelessness often lack proper disposal options and may discard, bury, or hide syringes.

Our co-operative now offers 24-hour syringe disposal with sharps containers located both inside our bathrooms and in our garden, thanks to a secure drop manufactured and installed by Asheville Greenworks. But one publicly available biohazard container for syringe disposal in West Asheville is inadequate. If we want to get serious about reducing syringe litter, we need safe disposal options throughout the Haywood Road Corridor and an end to the APD harassment of people who use drugs.