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Claremont Needle Exchange Program Searches for a New Home



Valley News Staff Writer
Saturday, November 11, 2017

Claremont — Medical students, who started a needle exchange program at a soup kitchen in Claremont earlier this year, are searching for a way to continue to distribute clean needles to intravenous drug users after city officials informed them that the soup kitchen is too close to a school.

Dartmouth College Geisel School of Medicine students Louisa Chen and Nasim Azizgolshani were forced to shutter their needle exchange program — which in addition to providing clean needles, collected dirty needles, provided users with the overdose reversal drug naloxone and information about treatment — following a late October meeting with city officials.

At that meeting, City Manager Ryan McNutt informed them that — under the law that Gov. Chris Sununu signed into law in June — needle exchanges cannot be located within a drug-free school zone, which is defined in state statute as being within 1,000 feet of a school or a property used by a school. Chen and Azizgolshani’s exchange, called Project 439, operated out of the Claremont Soup Kitchen on Central Street, which is about a block from New England Classical Academy.

“NH Law, according to our analysis, does not permit this activity in such a zone,” McNutt wrote in an Oct. 27 memo to the City Council. McNutt, in his memo, also said the needle exchange’s location in the soup kitchen does not comply with the city’s zoning ordinance.

Before the October meeting, Project 439 was planning to be at the soup kitchen two more days each month and to begin providing the service in the urgent care center at Valley Regional Hospital.

“Once we met with the city all of those plans basically stopped,” Chen said in a phone interview on Friday. “It’s been really, really ... devastating.”

The exchange at the soup kitchen is now closed and the most logical other locations — Valley Regional Hospital and Hope for New Hampshire Recovery’s Claremont Recovery Community Center — also are too close to school zones or to school-related programs. Though city officials have said they want to find another location for the exchange, some in the recovery community are concerned that the stigma of drug addiction will make it difficult to find any acceptable location to provide this service.

“Without having all of the information in front of me, I won’t speak specifically to the apparent zoning issues that are being heralded as the reason for the closure of the program,” said Wayne Miller, the manager of the Claremont Recovery Community Center. “What I will say, though, is that I  will not be surprised in the least if the team behind the project is able to find a new venue to provide these services, only to by faced with yet another obstructive challenge shortly thereafter. It all comes back to stigma and any given community’s willingness (or lack thereof) to address the issues that its citizens are faced with.”

Though the exchange had been operating for several months, city Councilor Bruce Temple raised the concern about the proximity of the needle exchange to a school in a City Council meeting in early October. Upon further investigation, city officials determined that the soup kitchen was not a legal place for the exchange.

Efforts to reach Temple on Friday by phone and email were not successful, but Mayor Charlene Lovett said she believes the desire to move the exchange stems from an “honest concern about kids.”

For her part, Chen said she couldn’t speak to the issue of the motivation for the city’s review of the needle exchange’s location.

“The members of the city are trying to work with us to really keep us in Claremont,” she said.

Even so, she said, broadly “there is definitely stigma that we face and that our clients face.”

Opposition in the early stages is to be expected with this type of program, said Dean LeMire, a member of the board of New Hampshire Harm Reduction Coalition and a volunteer with the state’s only other needle exchange program, which distributes needles and information to people in Strafford and Rockingham counties.

Sometimes people misunderstand needle exchanges as enabling drug use, rather than as preventing disease, LeMire said. In fact, according to the text of the state law, such programs have the effect of reducing the prevalence of diseases such as HIV and Hepatitis C. They also boost the likelihood that users will enter treatment.

“There’s always going to be people bitter about the disease of addiction (who) would honestly rather that those folks not be around,” he said.

To counter that resistance to needle exchanges, LeMire said, “You need your champions.”

Lovett said the council is expecting a presentation next month about the “breadth and the depth of the issue” of opioid abuse.

Once they understand the effect opioid abuse is having on their community, Lovett said, they can begin “the process of, well, how do we solve this problem? The needle exchange program is just one tool.”

Claremont Police Chief Mark Chase said he supports the needle exchange program. Though the police can’t be the ones to hand out clean needles, he appreciates that members of the medical profession have a different role to play.

“They want to help,” Chase said of the medical students. “If they can, I’m wiling to take the help. We’re dealing with this all the time.”

The timeframe for when the medical students and city officials might find a new location is unknown.

Peter Wright, the chief executive of Valley Regional Healthcare, said he hopes to convince lawmakers to approve an exemption of the drug-free school zone law for health care providers. Valley Regional Hospital sits within 1,000 feet of Disnard Elementary School on Hanover Street.

Wright said a health care facility is a logical place to host a needle exchange.

“We handle that stuff every day,” he said.

Wright’s proposal would require the superintendent of the nearby school to sign off on the operation of a needle exchange within the drug-free zone.

“That way if it’s a ‘no,’ it’s a ‘no’ because the local community says ‘no,’ not because the state says ‘no,’ ” he said.

Wright was unsure when such an exemption could be put into effect.

“It’s currently moving at the speed of politics,” he said.

Chase also spoke in favor of an exemption both for locating a needle exchange at the hospital and at the soup kitchen, which also serves as a satellite site for White River Junction-based Good Neighbor Health Clinic, which provides free services to the uninsured and underinsured.

Perhaps lawmakers didn’t consider the large number of schools in Claremont when they approved the legislation, Chase said.

“For the law to stop this from happening, it’s kind of baffling,” he said.

Though the needle exchange is not formally a program of either Dartmouth College or Dartmouth-Hitchcock, Chen said some of the college’s attorneys are looking at the issue and they may come up with a different interpretation of the law from that of the city officials.

“They’re going to call in experts in this field,” Chen said of the college’s attorneys. “The law is vague.”

The main goal is to continue to serve the people with whom Chen and her fellow students have built relationships. The group provided 1,690 clean needles and collected 329 dirty ones between July 1 and Sept. 30, according to a report they sent to the state. They also dispensed 26 naloxone kits and referred two people to treatment.

This month, when Chen and her colleagues aren’t there with needles, naloxone and information, she worries that people will come in looking for them, with dirty needles in hand.

“This is going to lead to I think overdose, people passing (on) blood-borne diseases ... people feeling isolated and alone,” Chen said. “It’s just been very devastating for our team. If we are not there, there’s really nobody else there for this community.”

There are two needle exchanges on the Vermont side of the Upper Valley operated by the Lebanon-based HIV/HCV Resource Center, in White River Junction and in Springfield. Laura Byrne, the center’s director, estimates about one-third of their clients are from New Hampshire.

More information about the Vermont exchanges is available online at h2rc.org/syring-exchange.

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.