Fiscal Court to consider needle exchange support

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By Randy Patrick

When the southern Indiana town of Austin experienced an outbreak of HIV last year as a result of epidemic intravenous drug use, Gov. Mike Pence declared a public health emergency, allowing addicts to exchange their dirty needles for clean ones.

Alarmed by what happened across the Ohio River, Kentucky’s legislature last year enacted a bill to allow health departments here to follow suit.

On Nov. 5, the Lincoln Trail District Health Department’s board voted to begin needle exchanges in its counties, but it first needs the consent of Nelson County and Bardstown officials. On Tuesday, Nelson County Judge-Executive Dean Watts will ask the Fiscal Court to approve a resolution authorizing it.

Watts, a member of the health board, said he thinks it has the votes to pass.

Last month, Watts said he was “on the fence” about it, but he thought that if Indiana had acted earlier, it might not have seen such a rapid rise in the number of HIV cases.

Nelson County Sheriff Ed Mattingly said he favors having a needle exchange, but not without reservations.

“I see the good from doing the exchange, but I also see it’s enabling. You’re providing tools for somebody to do something illegal,” he said. But if it slows the increase in diseases, he added, “it’ll be worth it.”

He added that his officers have been seeing discarded syringes in Nelson County.

Sara Jo Best, the public health director for Lincoln Trail, said the fear that giving heroin addicts clean needles will encourage more people to use drugs intravenously is a common one, but there is no evidence that it does.

“That’s not supported by any research,” she said.

The Louisville-Jefferson County public health department was one of the first to offer a needle exchange, and it tracks where participants come from by zip code. Many are from Nelson County and other counties in the district.

“It tells me we already have people using injectable drugs,” she said. “I think the problem’s already here.”

Bardstown Police Chief Steve Uram said he thinks needle exchanges are good from a public health perspective, but not from a law enforcement officer’s point of view.

As a longtime police administrator, he has had experience with needle exchanges in other cities, including the Seattle, Wash., and Portland, Ore., areas.

The academic studies, he said, are “a whole lot different than life on the streets.”

“I know it helps some people, but I think it’s a minority,” Uram said. “I think the majority of people use it to their own advantage rather than to try to get off of narcotics.”

Best said reducing drug abuse isn’t the main emphasis of the program.

“The biggest misconception … is that a syringe exchange program will stop drug use in a community,” she said. “The main goal of that is to reduce the risk of an outbreak of HIV and hepatitis C.”

Best said health officials want to prevent a disease outbreak like that in Indiana.

In Austin, a city of 4,000, the number of HIV cases reported increased from 30 in February 2015 to 190 in April 2016.

Donny Gill, a health educator for the Lincoln Trail District Health Department, said attitudes toward needle exchanges have evolved in Central Kentucky because the problem is greater now.

“It seemed like for a while we were in a safe spot. It was going on all around us,” but not here, he said. Now it’s here.

So far, there are no counties in the six-county district that have needle exchanges, but several are considering it.

“I know there’s a lot that are wanting to do it, it’s just getting through all of the hurdles,” he said.

Scott Lockard, public health director for Clark County, and its city of Winchester, said his health department’s needle exchange, which has been operating since July 15 of this year, has been “a highly contentious thing.”

As of Nov. 18, the Clark program has had 60 “unduplicated patients” and 174 visits.

So far, only three people have enrolled in drug treatment as a result of the face-to-face encounters with health officials.

The program is anonymous, so health officials can’t tell how many people are from Clark County and how many are from other places.

Lockard said the program seems to be working.

“We’ve picked up needles in our parking lot before we started the exchange, and we have not seen any needles since the exchange started,” he said.

“We’ve had broad community support for this,” he said, adding that it has been endorsed by Winchester’s police chief, Kevin Palmer, and Clark County’s sheriff, Berl Perdue.

Lockard said Clark County does a one-on-one exchange in which addicts bring the dirty needles back in sharps containers provided by the health department, and in return get clean ones that automatically retract into the syringe after one use.

The resolution will be presented to the Fiscal Court at its meeting Tuesday at 9 a.m.

The Bardstown City Council must also approve a resolution for the Health Department to launch the program.