County needle exchange program may expand

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Service may soon be offered five days a week

By Randy Patrick

Sandra started shooting up in her 40s when her then-boyfriend got her addicted, and they shared dirty needles.


Now she injects a dangerous mix of heroin and meth.

“One’s up and one’s down, but it kind of goes in between,” she said.

She said she uses about 15 times a day, which isn’t atypical.

“If anybody tells you they’re using two or three times a day, they’re lying,” she said.

Sandra has talked with someone about treatment, but her Medicaid won’t cover the care that’s available, and without insurance, she can’t pay for it. And if the state rolls back its Medicaid expansion, she’ll have no insurance at all, she added.

If there is one positive development in her dark situation, it is that she is no longer sharing dirty needles, so she’s less likely to contract a deadly disease and give it to someone else.

Sandra, who lives in Bardstown, gets clean needles once a week from the Nelson County Health Department, which operates the first needle exchange in the six-county Lincoln Trail District. She may soon be able to get them on other days, as the department is considering expanding the exchange to five days a week.

Currently, it operates only on Thursdays from 1 to 4:30 p.m. at the clinic at 325 S. Third St. in Bardstown.

The exchange, which began July 6, got off to a slow start. The first couple of weeks, no one showed up, and by mid-August, there were only five patients.

That isn’t unusual, according to Donny Gill, harm reduction manager for the regional health department based in Elizabethtown.

People are apprehensive at first, he explained.

“There’s a reluctance by people who are injecting drugs to come and put themselves out there like that,” he said. “Plus, there’s some paranoia involved. They know they’re doing something illegal.”

The program, however, is confidential. When clients come in for the first time, they’re given a patient ID number and have to fill out some paperwork, and then Gill gives them a brief orientation and asks them a few questions, such as what drugs are they using.

“I talk with them about safe injection — not shooting in the same spot every time — and wound care if they have wounds, and then I ask them how many times a day they’re injecting, and I try to give them a week’s worth of needles,” he said.

The needles can only be used once. They retract into the plastic syringe after use and are returned to the Health Department, where they’re exchanged for sterile needles. The used ones are disposed of properly.

The main purpose of the program is to reduce the spread of blood-borne pathogens such as hepatitis C, HIV and AIDS.

Kentucky’s legislature passed, and the governor signed, a bill in 2015 to allow health departments to have needle exchanges after a rising heroin epidemic resulted in huge increases in these diseases.

Nelson County became the first in this region, Gill said, because county, city and health officials were receptive to it.

“I think what really got us over the top here is that city council members were really open to it, and some had addiction problems in their families,” he said.

The regional department is eyeing Marion County as the next one, he said.

A secondary benefit of the program is that the addicts who use needle exchanges are more likely to seek treatment.

The Nelson County Health Department has a counselor from Communicare, Debbie Wall, who can help patients locate and get access to treatment programs, though a minority do.

Still, Gill said, “If they come here and they really want help,” the health professionals can help them get it.

Gill said Tuesday that word is getting out about the program. On Thursday, the local Health Department had seven patients come in to get clean needles. Most have been from the 40004 postal zip code area, meaning they’re locals like Sandra, not people who are coming here from outside the county because the needles are being offered.

Sandra said she thinks more people would come if they didn’t have to wait in the lobby where people might recognize them, but could use another entrance.

“Everybody’s scared that people are going to talk,” and some of the users have jobs they’re afraid they’ll lose.

About half of them are employed, Gill said.

Gill said the Health Department has proposed to the Lincoln Trail board that the exchange be expanded to Monday through Friday from 8 a.m. to 4:30 p.m., and the board is receptive to that idea.

“What we’re doing is reacting to the calls we’re getting, which seem to be on Mondays and Tuesdays, and we want to meet them where they are,” he explained.

Sandra, who would not allow her last name or other identifying information to be included, said she knows some will think the needle exchange just enables people’s addiction, but people like her are going to use whether they have clean needles or dirty ones.

Her advice to other addicts is to use the clean needles.

“Don’t be afraid to step forward,” she said. “You’re going to save your life and the next person’s life.”