Kim Botteicher, founder and govt director of FAVOR ~ Western PA, runs the nonprofit out of the basement of an outdated church constructing in Bolivar, Pa. Along with offering varied dependancy and restoration help providers, she want to hand out clear syringes to assist stop illness transmission. However doing that is not approved underneath state regulation.
Nate Smallwood
cover caption
toggle caption
Nate Smallwood
Kim Botteicher, founder and govt director of FAVOR ~ Western PA, runs the nonprofit out of the basement of an outdated church constructing in Bolivar, Pa. Along with offering varied dependancy and restoration help providers, she want to hand out clear syringes to assist stop illness transmission. However doing that is not approved underneath state regulation.
Nate Smallwood
Kim Botteicher hardly thinks of herself as a felony.
On the principle flooring of a former Catholic church in Bolivar, Pennsylvania, Botteicher runs a flower store and cafe.
Within the church’s basement, she additionally operates a nonprofit targeted on serving to individuals caught up within the ongoing drug epidemic get again on their ft.
Botteicher based the nonprofit, FAVOR ~ Western PA, on this rural pocket of the Allegheny Mountains, east of Pittsburgh.
For every of the previous a number of years, the nonprofit’s dwelling county of Westmoreland has seen greater than 100 drug overdose deaths, the bulk involving fentanyl.
1000’s extra within the area have been touched by the scourge of dependancy, which is the place Botteicher is available in.
She helps individuals discover housing, jobs, and well being care, and works with households by working help teams and explaining that substance use dysfunction is a illness, not an ethical failing.
However she has additionally talked publicly about how she has made sterile syringes obtainable to individuals who use medication.
“When that particular person comes within the door,” she stated, “if they’re lined with abscesses as a result of they’ve been utilizing needles which can be soiled, or they have been sharing needles, possibly they have Hep C, we see that as, ‘Okay, that is our first step.'”
The confirmed well being advantages of syringe exchanges
Many research have recognized public well being advantages related to syringe-exchange providers. The Facilities for Illness Management and Prevention says these applications scale back HIV and hepatitis C infections, and that new customers of the applications usually tend to enter drug therapy and extra prone to cease utilizing medication.
Provides for a clear syringe equipment are seen at FAVOR ~ Western PA, a nonprofit restoration heart in Bolivar, Pa., on Nov. 7, 2023.
Nate Smallwood
cover caption
toggle caption
Nate Smallwood
Provides for a clear syringe equipment are seen at FAVOR ~ Western PA, a nonprofit restoration heart in Bolivar, Pa., on Nov. 7, 2023.
Nate Smallwood
This harm-reduction technique is supported by main well being teams, such because the American Medical Affiliation, the World Well being Group, and the Worldwide AIDS Society.
However for Botteicher, offering clear syringes may put her in authorized hazard. Below Pennsylvania regulation, it is a misdemeanor crime to distribute drug paraphernalia. The state’s definition consists of hypodermic syringes, needles, and different objects used for injecting banned medication.
These engaged on the entrance traces of the epidemic, like Botteicher, say a re-examination of this regulation is lengthy overdue.
There’s an urgency to the difficulty as nicely: Billions of {dollars} have begun flowing into Pennsylvania and different states from authorized settlements with firms concerned within the opioid epidemic, and syringe providers are among the many eligible interventions that could possibly be supported by that cash.
Syringe providers in Pennsylvania: very important and unauthorized
Included within the opioid settlements reached between drug firms and distributors, and a coalition of state attorneys common, have been beneficial methods for spending the cash, together with applications described as evidence-based. Increasing syringe providers is listed as one of many core methods.
An indication greets drivers arriving in Bolivar, Pennsylvania, in rural Westmoreland county. For the previous a number of years, the county has skilled greater than 100 drug overdose deaths a yr, the bulk involving fentanyl.
Nate Smallwood
cover caption
toggle caption
Nate Smallwood
An indication greets drivers arriving in Bolivar, Pennsylvania, in rural Westmoreland county. For the previous a number of years, the county has skilled greater than 100 drug overdose deaths a yr, the bulk involving fentanyl.
Nate Smallwood
However in Pennsylvania, the place 5,158 individuals died from a drug overdose in 2022, the state’s drug paraphernalia regulation stands in the way in which.
Considerations over Botteicher’s work with syringe providers just lately led Westmoreland County officers to cancel $150,000 in opioid settlement funds that they had beforehand permitted for her nonprofit. County Commissioner Douglas Chew defended the choice by saying the county “may be very risk-averse.”
Botteicher had deliberate to make use of the cash to rent further restoration specialists, not on syringes, she says. Supporters of syringe providers level to this incident as proof of the necessity to change state regulation, particularly given the suggestions of settlement paperwork.
“It is simply an enormous inconsistency,” stated Zoe Soslow, who leads overdose prevention work in Pennsylvania for the general public well being group Very important Methods. “It is inflicting quite a lot of confusion.”
Pennsylvania is one in every of 12 states that don’t implicitly or explicitly authorize syringe providers applications by way of statute or regulation, in keeping with a current evaluation.
Although sterile syringes could be bought from pharmacies with no prescription, handing out free ones to make drug use safer is mostly thought of unlawful — or a minimum of in a grey space — in many of the state. (In Pennsylvania’s two largest cities, Philadelphia and Pittsburgh, officers have used native well being powers to offer authorized safety to individuals who function syringe providers applications.)
In Philadelphia, Mayor Cherelle L. Parker, who took workplace in January, has made it clear she opposes utilizing opioid settlement cash, or every other metropolis funds, to pay for the distribution of fresh needles, in keeping with reporting by The Philadelphia Inquirer. This transfer alerts a main shift in that metropolis’s strategy to the opioid epidemic.
Kim Botteicher organizes provides with coworker David Peightal within the church basement workplaces of FAVOR ~ Western PA in Bolivar, Pa. The nonprofit helps households fighting dependancy discover housing, jobs, and different restoration helps.
Nate Smallwood
cover caption
toggle caption
Nate Smallwood
Kim Botteicher organizes provides with coworker David Peightal within the church basement workplaces of FAVOR ~ Western PA in Bolivar, Pa. The nonprofit helps households fighting dependancy discover housing, jobs, and different restoration helps.
Nate Smallwood
However on the opposite facet of the state, opioid settlement funds have had a big effect for Prevention Level Pittsburgh, which final yr obtained $325,000 in settlement funds from Allegheny County to help its syringe providers work.
“It was completely unimaginable to not should fundraise each single greenback for the provides that exit,” stated Prevention Level’s govt director, Aaron Arnold. “It takes quite a lot of power. It pulls away from precise supply of providers whenever you’re consistently having to search out out, ‘Will we come up with the money for to even buy the provides that we wish to distribute?'”
In elements of Pennsylvania that lack these authorized protections, individuals typically function underground syringe applications.
A road in Bolivar in Pennsylvania’s Westmoreland County, on Nov. 7, 2023. Greater than 5,000 Pennsylvanians died from a drug overdose in 2022 — 118 of these deaths have been in Westmoreland County.
Nate Smallwood
cover caption
toggle caption
Nate Smallwood
A road in Bolivar in Pennsylvania’s Westmoreland County, on Nov. 7, 2023. Greater than 5,000 Pennsylvanians died from a drug overdose in 2022 — 118 of these deaths have been in Westmoreland County.
Nate Smallwood
The Pennsylvania regulation banning drug paraphernalia was by no means meant to use to syringe providers, argues Scott Burris, director of the Middle for Public Well being Regulation Analysis at Temple College. However there haven’t been courtroom circumstances in Pennsylvania to make clear the difficulty, and the failure of the legislature to behave creates a “chilling impact,” he stated.
Carla Sofronski, govt director of the Pennsylvania Hurt Discount Community, stated she’s not conscious of anybody ever dealing with felony fees for doing so within the state, however famous the menace hangs over them, and they’re taking a “nice danger.”
Widespread want exterior the largest cities
Three Pennsylvania counties — Cambria, Crawford, and Luzerne — have been flagged amongst 220 counties in a nationwide evaluation of communities probably susceptible to the speedy unfold of HIV and new or persevering with excessive charges of hepatitis C infections amongst individuals who inject medication. The evaluation from the CDC was revealed in 2016.
Luzerne County resident Kate Favata stated she began utilizing heroin in her late teenagers and would not be alive as we speak if it weren’t for the help and neighborhood she discovered at a syringe providers program in Philadelphia.
“It form of simply made me really feel like I used to be in a protected area. And I do not actually know if there was like a come-to-God second or come-to-Jesus second,” she stated. “However … I simply wished higher.”
Favata is now in long-term restoration and works for a medication-assisted therapy program.
Kim Botteicher based FAVOR ~ Western PA, a restoration heart in in Bolivar, Pa. FAVOR stands for Faces and Voices of Restoration.
Nate Smallwood
cover caption
toggle caption
Nate Smallwood
Kim Botteicher based FAVOR ~ Western PA, a restoration heart in in Bolivar, Pa. FAVOR stands for Faces and Voices of Restoration.
Nate Smallwood
At a clinic in Cambria County, Highlands Well being supplies free and charitable medical care. Regardless of the authorized danger, the group has operated a syringe program for a number of years, whereas additionally testing sufferers for infectious illnesses, distributing overdose-reversal remedy, and providing restoration choices.
Rosalie Danchanko, Highlands Well being’s govt director, stated she hopes opioid settlement cash can finally help her group.
“Why should not that wealth be unfold round for all organizations which can be working with individuals affected by the opioid downside?” she requested.
New efforts to alter state regulation
In February, laws to legalize syringe providers in Pennsylvania was permitted by a committee and has moved ahead. Democratic Gov. Josh Shapiro’s administration helps the laws. But it surely faces an unsure future within the full legislature, the place Democrats have a slender majority within the Home, and Republicans management the Senate.
The invoice’s lead sponsor, state Rep. Jim Struzzi, hasn’t at all times supported syringe providers. However the Republican from western Pennsylvania says that since his brother died from a drug overdose in 2014, he is come to raised perceive the character of dependancy.
In the course of the committee vote, most of Struzzi’s Republican colleagues opposed the invoice. State Rep. Paul Schemel stated authorizing the “very instrumentality of abuse” crossed a line for him and “can be enabling an evil.”
After the vote, Struzzi’s objective is to construct extra bipartisan help. He famous that a few of his personal skepticism in regards to the applications solely eased after he visited Prevention Level Pittsburgh, and noticed how staff do extra than simply hand out syringes. All these applications join individuals to assets — overdose reversal remedy, wound care, substance use therapy, and different providers— that may save lives and result in restoration.
“Numerous these individuals are … determined, they’re alone, they’re afraid. And these applications deliver them in to somebody who cares,” Struzzi stated. “And that to me is a step in the appropriate course.”
Botteicher is hoping lawmakers take motion.
“If it is one thing that is going to assist somebody, then why is it unlawful?” she stated. “It simply would not make any sense to me.”
This story was co-reported by WESA Public Radio and Highlight PA, an unbiased, nonpartisan, and nonprofit newsroom producing investigative and public-service journalism that holds energy to account and drives constructive change in Pennsylvania.
It was produced as a part of NPR’s well being reporting partnership with KFF Well being Information.
