Portland's India Street Public Health Center is the home of the city's needle exchange program. (Portland Phoenix/Colin Ellis)
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Portland is standing by a decision to remain an outlier among the state’s needle exchange programs.

City councilors and other city officials, who have used executive sessions to keep the substance of their conversations behind closed doors, also continue to reject calls for their discussions about the program to be held in public.

The city’s Needle Exchange Program, which provides users with clean hypodermic needles and support services, is one of 10 such programs across the state. It is the only one that has ignored an executive order from Gov. Janet Mills to ease policy restrictions during the coronavirus pandemic.

The order allows the state-certified programs to provide clients with more clean syringes during the pandemic. Portland, however, is maintaing its one-to-one exchange policy – even after learning the policy hasn’t been enforced for several years.

Councilors held a two-hour executive session Jan. 20 to discuss the needle exchange program, despite calls from several members of the public for the discussion to be held in public.

The council’s right to conduct private discussions typically is invoked for personnel matters, pending litigation, or discussion of private proprietary information. The council cannot make a decision in executive session and must always vote in public.

Two days after the Jan. 20 closed-door session, the city issued a 1,200-word press release affirming its commitment to the needle-exchange program and stating its policies “had not had any negative impact on the quality or scope of the services provided.”

According to the city, Portland had actually not been following its own one-to-one rule for several years. The city commissioned an audit last November after individuals in city homeless shelters were discovered with large numbers of needles, in some cases as many as 100.

The audit disclosed the one-to-one rule had not actually been enforced since as far back as 2016. The city also said the audit revealed other concerns, including “significant numbers of needles” had been requested and provided to people who weren’t using them personally. Instead, these individuals were operating “unsanctioned needle exchange programs,” the press release said.

The city reinstated the one-to-one exchange limit in December, claims the program has not seen a dramatic shift in the number of clients and continues to enroll new clients on a weekly basis.

Kristen Dow, the city’s Health and Human Services director, called the audit findings “deeply disappointing.”

“As we move forward,” Dow said, “the city is committed to more thoroughly reviewing its needle exchange program data to ensure that our essential harm-reduction services continue to meet the needs of our clients as our staff work to provide life-saving resources for those living with substance use disorders.”

Meanwhile, Portland is in the midst of an ongoing homelessness crisis, made worse by a statewide opioid epidemic. Last summer, the city temporarily stopped maintaining Deering Oaks Park because of safety concerns that included finding hundreds of used needles in the park while it was used as a homeless encampment.

The India Street Public Health Center, which also operates an STD clinic and administers Naloxone distribution services, is the site of the exchange program. The city said it believes public health staff was confident the pandemic would not limit their ability to continue to safely provide needles. They said the program’s mobile location provided flexibility in addition to the physical location at India Street.

“The state’s temporary suspension of the one-to-one exchange limit has most likely proven to be beneficial to those operating in rural communities with limited access to syringe exchange programs,” Dow said.

Gordon Smith, director of opioid response for the Mills administration, acknowledged an interview request and said he would provide additional information via email, but did not follow up.

Maine drug deaths continue to climb 

Nearly 400 Mainers died from drug overdoses in the first nine months of 2020.

A report compiled by the University of Maine’s Margaret Chase Smith Policy Center and distributed by the office of the state attorney general said 122 people died from drug overdoses in the third quarter, which put 2020 on pace to significantly exceed the number of fatalities in 2019.

The report said there was a 7 percent decrease from the second quarter. But the 380 deaths through the first three quarters represented a 24 percent increase over the same period in 2019, which had just over 300 deaths.

Eighty-three percent of the recent deaths were caused by at least one opioid, usually fentanyl. Eighty-one percent of the deaths were caused by two or more drugs.

The report said the increase in deaths in Maine is comparable to national numbers and is likely due at least in part to the isolation people are experiencing during the coronavirus pandemic.

— Colin Ellis

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