Some local officials reject needle exchanges and research showing that they don’t encourage and enable drug abuse

By Melissa Patrick
Kentucky Health News

Needle-exchange programs were approved this year as part of a landmark heroin bill, but they require local consent, and this caveat is proving to be a challenge because local officials think the exchanges encourage and enable drug abuse, which health officials say is not so.

Syringe Access Exchange Programs, the official name for needle-exchange programs, allow people to exchange dirty needles for clean ones to cut down on needle-sharing among drug users, which contributes to the spread of infectious diseases, particularly hepatitis C and HIV.

Three programs are operating in Kentucky: in Louisville, Lexington and Falmouth in Pendleton County.

Northern Kentucky, hurt most by heroin, isn’t ready for needle exchange

In late November, the Carrollton City Council voted 5-0 vote against allowing Three Rivers District Health Department to operate a needle exchange in the county, despite impassioned, fact-based arguments from local health officials, Kristin Beck reports for The News-Democrat in the Carroll County seat.

Jim Thaxton, coordinator of the Northern Kentucky Heroin Impact Response Task Force, made the presentation in favor of the needle exchange to the city council. He said, among other things, that Northern Kentucky has a high rate of intravenous drug use and that the hepatitis C rates in the region are among the highest in the nation.

“I know the gut, emotional feeling that many of you will have is this is enabling,” Thaxton said. “Syringe access exchange programs are not enabling. I thought they were; some people in this room still think they are, but they’re not. The research tells us they’re not. They do not encourage individuals to begin using drugs, they do not increase drug use among existing users and they do not increase crimes in neighborhoods in which the program operates.”

Thaxton argued, “The fear that you have is that you’re going to bring in people to this community that you don’t want here. Folks, they’re already here. They need your help and we’re here to help them.”

Carrollton Mayor Robb Adams said he couldn’t be persuaded, saying he believed the program will enable drug users and will increase crime in Carroll County, Beck reports.

Thaxton replied, “The people are going to continue to use and they’re going to still have the needles in their cars, in your parks and on the roads. This program, even though we’re giving them the needles, we’re keeping them from spreading the disease and we’re getting needles back.”

Adams also said that he believed people from surrounding counties would come to Carrollton to exchange their needles if they were the only area county on board, Beck reports. Thaxton said there are similar concerns in Pendleton County, but that program has seen only seen one person so far.

“Whenever we make a decision from fear, it’s probably a bad decision,” Thaxton said. “We have to make a decision based on the facts and the facts [of] over 30 years of research are these programs work” But it was to no avail.

Thaxton gave a similar presentation to the county Fiscal Court and was asked to come back in two months with an update on the status of needle exchanges in other counties, Beck reports.

Resistance to needle exchanges is consistent throughout the region. Similar sentiments were voiced at the Dec. 12 Kenton County mayors’ group meeting, Mark Hansel reported for the Northern Kentucky Tribune.

St. Elizabeth Healthcare‘s CEO Garren Colvin “made a strong argument in support of needle exchange” at this meeting, offering financial support for the program, but not hospital property to house it, Hansel reports. The hospital supports the health department to run these programs.

Colvin made a plea on behalf of the first responders who are “definitely at risk for receiving hepatitis C and ultimately HIV,” citing Northern Kentucky Health Department statistics that say there has been an increase of more than 80 percent in acute hepatitis C cases since 2010 due to increased heroin use in the region. He said the average cost of treatment for hepatitis C is about $86,000.

But still, there were no takers.

The Boone County Fiscal Court and the City of Florence “have no intention of approving needle exchange in their communities any time soon,” Hansel writes.

In addition, Covington Mayor Sherry Carran said her city decided against supporting needle exchange out of concerns that other cities might not follow with their own exchanges and make Covington a megnet for drug abusers.

There is little support among Northern Kentucky judge-executives, who are needed to muster support for approval from fiscal courts, Hansel writes: “The primary argument against a needle exchange program is that it provides addicts with the tool they need to continue abusing drugs.”

Some counties are talking about it

The process of educating law enforcement, other first responders, city officials and the public about needle exchange programs is underway in Daviess County, James Mayse reports for the Messenger-Inquirer in Owensboro.

“We have to educate the public that this is a containment strategy” to prevent the spread of disease, Gary Hall, temporary chairman of the Alliance for a Drug-Free Owensboro & Daviess County, said at a River Valley Behavioral Health meeting.

Hall said a needle exchange would best be established before local health officials see an increase in hepatitis C and HIV infections.

“One thing we need to educate our local officials on is, if we wait, it will be too late,” Hall said. “We know there are intravenous users in our community.”

Major Brock Peterson, field services supervisor for the Owensboro Police Department, said there will be a perception that a needle exchange “is going to encourage drug use,” and said that there was going to be a “huge backlash” against the idea.

The Barren River District Health Department, which serves eight counties in Southern Kentucky, has started educating its county boards of health about the benefits of needle-exchange programs, Alyssa Harvey reports for the Bowling Green Daily News.

“Just to start talking out loud about it is a step forward,” Dr. Brian Humble, a member of the Warren County and district boards of health. ” Drug use doesn’t go up when these programs are implemented. Anything we do is going to be an improvement on the lives of these people and the health of our community.”

Other counties have resolutions

Frankfort is considering a resolution that would establish a needle exchange program, which will be up for a vote “at a future commission meeting,” The State Journal reports, also noting that the Franklin County Fiscal Court approved a similar resolution last month.

Members of the Jessamine County Agency for Substance Abuse Policy committee signed a resolution in November to encourage the community and the local government to consider creating a needle-exchange program, Ben Kleppinger reports for The Jessamine Journal.

This proposal has the support of county Public Health Director Randy Gooch, but he noted several obstacles. including getting law enforcement on board and educating the community about the benefits of the program

“As the public health director for Jessamine County, this is certainly something that I think we need,” he said.

Programs in action

Louisville is adding a third needle-exchange location at the Redeemer Lutheran Church in western Louisville. The other ones are located at the downtown Public Health and Wellness headquarters and Lake Dreamland Fire Station in southwestern Louisville, Chris Kenning reports for The Courier-Journal.

As of Dec. 3, Louisville’s needle exchange has served 1,329 participants and referred 88 people for drug treatment, Dr. Sarah Moyer, interim director of the Metro Department of Public Health, told Kenning. They have also tested 156 people for HIV, so far all negative. Since September, 86 people have been tested for hepatitis C with 52 testing.

Looking to the future, health department officials said they were researching ways to create safe drop boxes for needles in some parts of town.

According to a Nov. 17 Lexington Health Department tweet, Lexington’s needle-exchange program has received 2,594 used needles and given out 3,724 clean ones since its opening in September.

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