Conflicted, We Wobble — Jessie Dunleavy

There are several bills before the Maryland General Assembly that, if passed, will get us a step closer to humane and effective drug policy reform. I remain hopeful about the Overdose and Infectious Disease Prevention Services Program, now under consideration for the sixth year in a row, but want to draw attention to other important legislation.

The Paraphernalia Decriminalization bill would repeal the prohibition of possession of items associated with the use of illicit drugs. I am encouraged by any measure that minimizes punitive consequences for those who do not violate the rights of others. Not only do we arrest far too many people, but doing so only undermines their capacity to take care of themselves.

As it is, the possession of paraphernalia (without the presence of any drug) is a criminal offense, with first-time violations subject to a misdemeanor charge and a $500 fine, and subsequent violations incurring up to two years of imprisonment and a $2,000 fine. In looking at the impact of the current law on the lives of real people, and considering the nuances that may not readily meet the eye—such as those relating to Syringe Service Programs (SSPs)—this legislation represents an important step in reducing unnecessary arrests and the associated harms.

In 2016, Maryland passed legislation to expand SSPs statewide and did so in recognition of the ironclad scientific consensus that clean needle programs reduce by 50% the transmission of infectious diseases such as HIV and Hepatitis C, and that program participants are five times more likely than non-participants to seek treatment. With Maryland ranking nationally in the top four or five states in terms of the prevalence of HIV cases, this was clearly the right thing to do. In the same spirit, legislation simultaneously granted an exemption for syringe possession for documented participants in a Syringe Service Program.

Here's the rub:

Let's just say I live in Baltimore City where SSPs are fairly accessible and I am a participant. Walking in my neighborhood one evening, and not involved in any criminal activity, I am stopped and charged with possession of a syringe. I tell the officer that I am a registered SSP participant but, either because I cannot produce documentation on the spot, or because he is confused by the patchwork of paraphernalia exceptions, I am arrested. Subsequently, I attend a mandated court hearing where my citation is dismissed. But the resources I expended as a result of this unnecessary ordeal represent a hardship as does the mistreatment I endured. To avoid these injustices in the future, I may opt to share a used needle or, in some circumstances, I may resort to careless disposal of a needle in my possession. I do not trust the police to be fair in applying the law, especially in my neighborhood. While the people who run the SSP are respectful and supportive, I am scared of being arrested upon leaving the facility. Because my health takes a backseat to my fear of law enforcement, I decide not to risk participation in the SSP program.

In many jurisdictions within the state, where unfortunately SSPs are non-existent, there is no question about possession of a syringe. It is a crime. Even though the Code of Maryland Regulations (COMAR) says that syringes may be sold without a prescription, and the Maryland Board of Pharmacy unanimously agreed that syringes reduce the spread of disease, an individual who buys a syringe is not protected by the law and is subject to arrest and its long term impact on employment, schooling, and other services.

What we have is addiction experts throughout the land urging the bold expansion of syringe access and, at the same time, police arresting people for possession of a clean syringe. In sum, we have a law that says syringe exchange programs are legal in Maryland, and another law—politically not scientifically motivated—that says you can be arrested and fined for possession of a clean syringe.

Reducing infectious disease is reason enough to support the Paraphernalia Decriminalization bill, as is the shift away from law enforcement in favor of health care for those who use drugs. Furthermore, reducing the barriers to SSP services makes economic sense. A sterile needle costs 10 cents wholesale, and health care for one person with AIDS costs $620,000.

Logic and compassion aside, we continue to create obstacles to needed services. We do this because we see drug use as a sin that must be wiped out by criminalization, a belief that many cling to despite gigabytes of data that prove otherwise.

If you agree with me, and you live in Maryland, please consider contacting your legislators to advocate for the passage of Paraphernalia Decriminalization (HB372; SB420). It's the right thing for all of us.

[photo credit: Tingey Law]