NC City Values the Comfort of Home Owners Over the Lives of the Homeless

In 2010 I joined a team of North Carolinians committed to confronting the impacts of intravenous drug use with effective public health strategies. For years we urged the North Carolina General Assembly to authorize needle exchange programs so that local communities could meet the challenges of injection drug use with evidence-based programs proven to lower HIV and hepatitis C transmission and connect drug users to resources that can help them. North Carolina legalized needle exchange programs in 2016. I had never been more proud of our state.

Two years later, with 30 needle exchanges now established across the state, the City of Asheville in western North Carolina is threatening to shut down a needle exchange program in West Asheville. Though it is disheartening to see the picket lines drawn, I can’t say I am surprised. The battle for the life of the West Asheville needle exchange and its beneficiaries is eerily similar to the one fought in the halls of the state legislature.

The first year we tried to introduce a bill to the General Assembly, we marched in armed with decades of research proving the public health and safety benefits of needle exchange. We offered studies showing an 80% drop in HIV transmission among program participants; lower crime rates because people are connected to social services; a 66% drop in needle-stick injury to law enforcement; a decrease in overdose deaths; and evidence that participants of a needle exchange are five times more likely than non-participants to enter drug treatment programs. We thought these arguments would be enough to convince the legislators. We were foolish then.

It did not take long to learn that evidence, reasoning, and even the promise of saved tax dollars was all for naught in the face of one formidable foe: stigma. The greatest threat to a public health program to address the drug crisis is stigma and fear against the people it serves. It took years of work inside the halls of the legislature to break down that stigma enough for our policy makers to authorize action in the face of a looming public health crisis.

And now, with the City’s efforts to shut down West Asheville’s needle exchange program, it is clear that stigma is at the root of the fervor once again. Citizen complaints about activities such as loitering, camping, and witnessing intravenous drug use in public spurred the City to deliver a notice to the Steady Collective on August 17, 2018 notifying them of a zoning violation because “[o]perating a needle exchange program is most similar to the operation of a ‘Shelter’” and ‘shelter’ is not listed as a permitted use in that zone.

This is nonsense, of course. The needle exchange operates only one afternoon a week distributing medical supplies to prevent HIV infections and reduce death from opioid overdose. It is not a homeless shelter and to claim it as such is nothing more than clever political maneuvering.

I understand that some residents and business owners in West Asheville are concerned about the presence of the needle exchange program and the people it attracts. But I think it relevant to point out that not one person has been threatened or hurt by the existence of the program, while hundreds of the exchange’s participants have benefited from resources to prevent HIV or hepatitis C infections and overdose deaths.

Does a complaint about “loitering” hold more weight than the wellness a person who was successfully connected to drug treatment through the needle exchange? Is a complaint about “finding hypodermic needles littered on neighboring properties” worth more than the fact that the distribution of needles can reduce the spread of HIV by as much as 80% among program participants? Are any complaints worth more than the 47 lives that this program has saved from drug overdose?

It seems to me that the real issue here is that we value the comfort of people who own homes more than the lives of people who do not.