Lawmakers are again exploring the concept of a needle exchange program in four of Texas' major counties—Harris, Travis, Bexar and Dallas. These programs, also called syringe exchange programs or SEPs, facilitate an exchange of used needles for never-used sterile ones. Programs are designed to prevent the spread of infectious diseases, such as HIV and hepatitis B and C. Texas' proposal by Rep. Toni Rose, D-Dallas, House Bill 3256, would call it a "disease control pilot program."

SEP history in Texas

Rose's legislation isn't the first SEP proposal that has been floated in Texas. For years, lawmakers tried unsuccessfully to implement such a program. They finally succeeded in 2007 when an amendment was tacked on to a major Medicaid reform bill allowing for a pilot program in Bexar County. However, before the program was scheduled to start, the county's district attorney said users of the program would not be shielded from criminal prosecution for possessing drug paraphernalia. The amendment's author, Rep. Ruth Jones McClendon, D-San Antonio, appealed to then-Attorney General Greg Abbott for guidance. He issued an opinion saying there was no immunity for possession of drug paraphernalia, effectively putting an end to what would have been Texas' first state-regulated needle exchange program. In the 10 years since, other states have implemented needle exchange programs. According to the North American Syringe Exchange Network, an organization that promotes such programs, California is currently operating 42, New Mexico is operating more than 30 and Louisiana is operating three.

National context

The most recent U.S. Syringe Exchange Survey results, conducted by NASEN in 2014, revealed there are 204 exchange programs in the United States among 33 states and 116 cities. Programs have facilitated the exchange of 45.9 million syringes and received 82 percent of financial support from public funding. If Rose's bill passes, Texas would allow programs in any of the four largest counties. The only one currently in operation, according to the NASEN, is the Texas Overdose Naloxone Initiative in Wichita Falls. Rose's bill stipulates that each exchange program would offer anonymity to its users, provide education and assist participants in accessing health care resources. Counties and hospital districts can contract with independent organizations to facilitate SEPs. Each year, the organizations must report back to the counties and districts on the effectiveness of the programs and effect on reducing communicable diseases. Notably, the bill was voted out of the House Public Health Committee with bipartisan support. Republicans who supported the bill include committee Chairman Rep. Four Price, R-Amarillo, and physician Rep. J.D. Sheffield, R-Gatesville. William Martin with the Rice University Baker Institute, which studies drug policy, said other Republicans throughout the country have implemented similar programs. Republican Vice President Mike Pence, as governor of Indiana, lifted a ban on these types of programs to try and solve the opioid epidemic in his state. "Some of the nation's most important and powerful Republican leaders have said yes, we should have syringe exchanges and if necessary we can use taxpayer money to pay for them," Martin said. The bill has been sent to the Calendars Committee and must be voted on by the full House before May 12 to progress to the Senate during this session.