Katherine Hill is an epidemiologist, harm reduction researcher and PhD candidate at the Yale School of Public Health studying the drug supply in the Northeastern U.S. Both her grandmother and father live in Lewiston.

Harm reduction goes beyond simply distributing sterile syringes to people who use drugs.

For those deeply involved, harm reduction is a movement woven into a larger tapestry of social justice, aimed to ensure the health, rights and dignity of all people who use drugs.

This work is not just backed by decades of fierce advocacy, but by rigorous science at top academic institutions. Harm reduction practice has been shown, time and time again, to reduce overdose deaths, decrease HIV and HCV transmission, improve social connectivity and much more.

Despite its overwhelming success at saving lives, harm reduction practice has remained controversial for some. For instance, attacking science and public health, Trump’s recent executive order expressed a desire to avoid using discretionary federal grant dollars on programs “that fail to achieve adequate outcomes, including so-called ‘harm reduction.'”

This philosophical and fiscal assault on harm reduction at the federal level poses a significant challenge to the broader harm reduction movement. It not only disrupts daily operations, such as syringe exchange and condom provision, but also threatens a movement that asserts the right of people who use drugs to exist.

Nghi Vo, in her short story “Silk and Cotton and Linen and Blood,” writes “[t]here’s no
ownership like destruction.” Any attempt to erase harm reduction is a means to gain power and dictate values. It is crucial that we continue to strive toward justice and ensure that people who use drugs receive services that meet their needs, protect their health and uphold their dignity.

Lewiston is now at a crossroads. Lewiston City Council is proposing “An Ordinance Pertaining to Syringe Service Programs” that, if passed, will significantly reduce current syringe services and peer outreach support. The council intends to rezone syringe services to the outskirts of the city, impose expensive business licenses, limit the potential for life-saving overdose prevention centers and reinstate a 1:1 syringe exchange policy.

The measures proposed by the Lewiston City Council contradict federal best practices and
ignore decades of evidence. This path represents an anti-science, anti-public health approach aimed at dismantling harm reduction efforts.

Restricting syringe access increases a person’s risk for infectious diseases such as HIV and HCV, but also for other conditions such as endocarditis, a serious heart infection. Further, pushing out services to outskirts of cities can lead to increased stigma and decreased social support, both predictors of increased risk of fatal overdose.

A better path exists for Lewiston. By striking down this ordinance, Lewiston can allow syringe service programs to operate based on a needs-based standard. To reduce syringe litter, Lewiston can expand access to syringe disposal boxes and fund buy-back programs.

To better serve people who use drugs, Lewiston can use opioid settlement funds to launch a mobile syringe service program. Such programs not only deliver syringes and manage litter but also help get people into treatment for substance use disorders and increase testing for HIV and other infectious diseases. Moreover, these programs convey the message that Lewiston is committed to ensuring the health, rights and dignity of people who use drugs in the community.

This helps build social support and reduces stigma, potentially decreasing the fatal overdose rates among those most at risk.

This evening at Lewiston City Hall, community members will have the opportunity to voice their concern to their representatives for three minutes each.

It is imperative that the council moves Lewiston forward, following science and public health. What Lewiston needs most is not destruction and condemnation, but love and support for its most marginalized residents.