In deciding not to fund syringe exchanges with opioid settlement dollars, Mayor Cherelle Parker is signaling a move away from her predecessors' wholehearted support for such measures.
Former Philadelphia Mayor Ed Rendell’s administration was willing to break state law three decades ago to provide sterile syringes to drug users in exchange for their used needles, seeking to reduce the risk of drug users sharing needles and spreading HIV and other illnesses. Insulin Needle Pen
Distributing syringes for drug use was prohibited in Pennsylvania — and still is not permitted statewide. But it’s been done in Philadelphia since 1992, when Rendell issued an executive order to allow exchanges to operate. The state remains one of eight nationally where exchanges operate only with the permission of local officials.
Rendell recalls using his announcement of the move to send a message to the state: “I said, ‘Listen, don’t go to the site in Kensington. Come to room 210 City Hall. That’s my office. And arrest me,’” he told The Inquirer last week. “Not surprisingly, that was the end of it.”
Now, amid a new health crisis of drug deaths, Mayor Cherelle L. Parker’s administration is taking a more conservative stance on funding syringe exchanges. Last week, the administration announced that it would not allow purchases of syringes or other items that enable drug use, like sterile pipes, from the $180 million coming to Philadelphia from state and local lawsuits against the drug companies who are blamed for fueling the opioid epidemic.
Public health researchers have sharply criticized the move, arguing that the amount of money at stake — about $38,000 in grants given last year specifically for syringe exchange — is so small that removing it is a signal of the administration’s political priorities.
Parker’s decision drew attention as the new mayor has promised to crack down on the open-air drug market in Kensington, the epicenter of an opioid crisis that in 2022 killed a record 1,413 people in Philadelphia.
Her administration has declined to say whether the mayor’s first budget proposal, expected this week, will end the city’s contributions of millions in funding to a nonprofit health organization, Prevention Point, that works out of Kensington to provide syringes to more than 30,000 people in addiction. Parker said her administration is focused on providing “long-term care, treatment, and housing” to people with addiction.
Syringe services should continue in Philadelphia, Parker said at a news conference last week, but she noted that charities can support such efforts.
Parker’s move to limit some funding to syringe exchanges puts her at odds with her predecessor in City Hall: The previous mayoral administration did allow opioid settlement funds to pay for syringe exchange. And Democratic state lawmakers have sought to expand access to syringe exchanges statewide.
Political conservatives have historically led the critics attempting to block such programs, saying they enable drug use, and laws in Pennsylvania define syringes that are used to inject drugs as illegal drug paraphernalia.
But Parker is not the only Democrat to balk at paying for such practices. In Atlantic City, some Democrats on the city council led efforts to close a local syringe exchange in 2021. Party divisions also surfaced in Washington when Sen. Joe Manchin (D., W. Va.) cosponsored a bill to block federal funding for needles and sterile pipes in 2022 after the Biden administration said some grant funds could cover those items.
Decades of research show syringe exchanges prevent the spread of bloodborne diseases like HIV and hepatitis. These services are central to the “harm reduction” approach to the opioid crisis, which aims to keep people alive until they are ready to seek treatment.
“I looked at it as very simple,” Rendell said of his decision to allow syringe exchanges to operate in Philadelphia. “We’re saving lives.”
Gov. Josh Shapiro, then the state’s attorney general, included syringe exchange services in the $54.1 billion national legal settlement that he helped to negotiate in 2022 between the drug companies that flooded America with prescription opioid painkillers and hundreds of municipalities now dealing with the consequences in Pennsylvania and beyond.
The settlement’s terms encourage communities to use the funds they receive to expand syringe exchange services.
Shapiro’s administration is deferring to local leaders to decide on how to spend their share of the roughly $2 billion coming to the state, said Manuel Bonder, a spokesperson for Shapiro.
Shapiro, a Democrat, supports legalizing and expanding syringe exchanges in Pennsylvania.
The concept has remained controversial in the state, even as dozens of other states, including New Jersey, legalized syringe exchanges and pledged to expand them.
Last month, officials in Westmoreland County, just east of Pittsburgh, pulled $150,000 in opioid settlement funds from an organization supporting recovery from drug addiction because the group had distributed syringes, Spotlight PA reported. County officials said they were concerned about potential lawsuits and the subsequent cost to taxpayers.
The Pennsylvania House of Representatives is slated to vote on a bill to legalize syringe services in the state — the first time in at least 10 years that the full body will consider doing so.
Support for the issue has so far skewed along party lines. Both Republicans and Democrats are listed as sponsors of the bill. Still, just one Republican in the House Judiciary Committee voted to send the bill to the full House, along with every Democrat on the committee.
Rep. Jim Struzzi (R., Indiana) is one of the cosponsors of the syringe-exchange bill. His brother died from an overdose in 2014.
“The tragic truth is, more and more people know someone that suffers from an addiction or died from an overdose,” he said. “I think it’s going to take time to educate everyone on what this can do to help people.”
Philadelphia’s mayors have encouraged syringe exchanges since the early 1990s, when HIV cases were rising among people who injected drugs. The HIV advocacy organization ACT UP was the first group to begin handing out syringes to drug users in North Philadelphia.
Coleman Terrell, an organizer with ACT UP, recalled a mid-1990s City Council hearing where some Council members tried to argue against funding syringe exchanges. The city health commissioner pushed back. “She was like, ‘No, we are doing this. It’s not up for debate,’” Terrell said.
Terrell went on to lead the Philadelphia health department’s HIV division. As syringe services became more established in the city, he said, HIV cases among injection drug users plummeted.
A study in 2019 from George Washington University estimated that Prevention Point had prevented more than 10,000 HIV diagnoses among people who injected drugs in the organization’s first 10 years.
“For years, I didn’t worry about HIV in that population,” Terrell said. “I worried about funding.”
Federal policy at the time prohibited funding for syringe services. Since 2016, the federal government has allowed its funding to support the operation of syringe service organizations, but not to pay for syringes themselves. That leaves many syringe exchanges to operate with local or private funding.
In Philadelphia, the city this fiscal year allocated more than $7 million to Prevention Point, which provides sterile needles to people with addiction, among other public health services.
Councilmember Quetcy Lozada, who represents parts of Kensington, last month said she might oppose city funding for Prevention Point, and urged a landlord to revoke the lease of Savage Sisters, another harm-reduction organization on Kensington Avenue.
She and other Democratic lawmakers who represent Kensington said they don’t oppose syringe exchanges as a concept but have criticized Prevention Point, which they say has not been “a good neighbor” to the community and attracts people who use drugs to the area.
A third of Prevention Point’s staffers live in the neighborhood, said Silvana Mazzella, Prevention Point’s executive director, and the organization cares “deeply” about the neighborhood and wants to continue providing care that can be lifesaving to some of the 30,000 people receiving services from the organization each year.
“Prevention Point believes that every person has value,” she said. “Limiting harm reduction organizations like Prevention Point would remove lifesaving services from our community.”
Injection Mold Staff writer Anna Orso contributed to this article.