Needle exchanges don’t have to involve exchanges of needles, attorney general’s opinion says

Users of needles don’t have to trade in used ones to get new ones from needle-exchange programs authorized by this year’s anti-heroin law, Attorney General Jack Conway said in a formal opinion Dec. 18 and released Dec. 21.

The opinion was requested by state Senate President Robert Stivers of Manchester. He and other Republicans have said the intent of the law was a needle-for-needle exchange, and they are expected to move legislation requiring that in the legislative session that begins Jan. 5.

“Needle
exchanges surfaced as a contentious issue when Kentucky lawmakers
worked on sweeping legislation this year to combat the state’s heroin
scourge,” Bruce Schreiner notes for The Associated Press. “The goal of needle exchanges is to prevent the spread of HIV and hepatitis C and to steer drug users toward treatment. Kentucky has had the nation’s highest rate of acute hepatitis C.”

Dr. Sarah Moyer, Louisville’s interim public health and wellness director, told the AP that the city’s needle-exchange program is following a model that has proven effective across the country in reducing the spread of HIV and hepatitis C. AP reports, “The exchange ratio is down to two syringes handed out for every old needle turned in, she said. As expected, the ratio was much higher early on — about eight or nine syringes provided for every old needled turned in, health officials said.”

The opinion, written by Assistant Attorney General Matt James, focused on the Louisville program. He wrote, “As applied in this context, ‘exchange’ does not require a quid pro quo exchange of syringes; it only requires a benefit to the party promising, or a loss to the party to whom the promise is made.” Thus, a program “may exchange the loss of a needle for a promise to participate in the program, and that is sufficient for an exchange in the ordinary sense of the term.”

James wrote that if legislators had wanted to require needle-for-needle exchanges, they could have done so.

In a final compromise to pass the bill, the General Assembly required needle-exchange programs to get local-government approval.

Only three programs have been established, in Louisville, Lexington and Pendleton County. Local health officials have failed to persuade officials in several other jurisdictions, including Northern Kentucky and Frankfort. The Frankfort City Commission deadlocked 2-2 on the issue when Commissioner Lynn Bowers, who had seconded the motion to allow the program, abstained after hearing arguments from opponents on the commission. Health officials say they will try again, and The State Journal editorialized in favor of the program.

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