Gov. Pat McCrory on Monday approved the law despite objections from some conservative representatives who say such exchange programs only facilitate addictions.
But McCrory, and the majority of the General Assembly, are grasping for new approaches to combat the rising rates of heroin use and its ripple effects on communities, which include increased costs to the state in Medicaid dollars and addicts cycling through the justice system.
"It's not the politically correct thing to do, at least on my side of the aisle, but it's the right thing to do," McCrory, a Republican, said at the signing.
Between 2010 and 2014, heroin overdose deaths in North Carolina have increased fivefold to 253 and cases of hepatitis C, often spread through shared needles, have nearly tripled, according to state health data.
The needle exchange provisions allow programs to provide drug users with replacement needles and hypodermic syringes, as long as no public funds are used to purchase them. Program volunteers, workers and participants would be immune from possible drug-related charges. The programs also will have to help participants with addiction treatment.
Tessie Castillo of the North Carolina Harm Reduction Coalition, which has lobbied for the legislation since 2009, said she knows of at least five needle exchange programs already in the state that serve more than 7,000 people a year. The new law does not provide funding, but will now allow health professionals to refer people to the programs and volunteers and donors to safely contribute.
"People are risking arrest and incarceration to do it, but couldn't really advertise what they were up to," said the Coalition's executive director Robert Childs. "This is helping out thousands of people who had no opportunity before."
Brunswick County Sheriff John Ingram said the programs increase public safety because they place value on safely disposing dirty needles, rather than discarding them in parks, streets and graveyards, all places where law enforcement and unsuspecting citizens have accidentally gotten stuck.
Ingram said as the state has toughened laws to access to prescription drugs in recent years, opioid addicts have turned to heroin and officers now come into daily contact with users. Officers in Brunswick County are now reporting people injecting the drug in grocery stores and while driving down highways with seatbelts cinched around one arm. Ingram said law enforcement is rethinking their approach to heroin addiction, ensuring officers carry overdose reversal drug naloxone and working with community recovery resources.
"Traditionally law enforcement approached it from 'Arrest everyone and let the system sort it out,' but that's really not getting us anywhere," Ingram said. "Locking up users repeatedly is doing nothing but bog down our justice systems."
Mike Page, a Wilmington social worker and former heroin addict, said a needle exchange program in Arizona was where he first built relationships with doctors and counselors who later guided him toward recovery. Page said the exchange programs are more sustainable way to encourage people to get clean than abstinence based programs, because they don't shame addicts who are still using or may have relapsed.
At least 20 other states have explicitly legalized needle exchange programs in state law, according to the Council of State Governments.