Saturday, August 20, 2016

Woodford County explores a syringe exchange; county attorney says local heroin problem is 'only going to get worse'

By Melissa Patrick
Kentucky Health News

VERSAILLES -- The Woodford County Board of Health is educating itself about syringe-exchange programs, with plans to begin the process of creating a plan for one in the county.

"We do have a horrible, insidious heroin problem," County Attorney Alan George said at the board's Aug. 18 meeting. "We are no different than any other county, but we are no worse. . . . It's only going to get worse."

George encouraged the board to take some time to learn more about how syringe exchanges work in other counties and then, if they wanted to proceed, to format a detailed plan to present to the Versailles City Council and and the Woodford County Fiscal Court, because they too must approve the program.

Syringe exchanges were authorized by the state's 2015 anti-heroin law, in an effort to thwart the spread of HIV and hepatitis C, which are commonly spread by the sharing of needles among intravenous drug users.

So far, 15 counties have approved syringe exchanges, according to a presentation by Greg Lee, who serves as the state Department of Public Health's point person for syringe exchanges.

Lee told the board that such programs have been around for 30 years, and are proven effective to discourage the spread of HIV and hepatitis C. Kentucky leads the nation in percentage of the population infected with acute hepatitis C.

"One of the things we know works is syringe exchange programs," Lee said. "Year after year studies show that these programs do not increase drug use, they actually decrease crime in the area, they increase community safety, they reduce spread of infection, increase first-responder safety and connect people who use drugs to drug treatment."

One Kentuckian is infected with HIV and two are infected with hepatitis C every day, mostly from intravenous drug use, Lee said.

Lee also noted several other benefits of syringe exchanges, including: Police departments in communities with the programs have seen a 66 percent drop in needle sticks; people in the programs are four times as likely to get into drug treatment; and for every dollar spent on these programs, seven dollars are saved in treatment costs.

Several Woodford County health board members asked about funding. Lee said syringe exchanges are "not an expensive program," because of the low cost of needles and because they are typically only open one day a week for a few hours.

Lee said some counties fund the programs through the state's Agency for Substance Abuse Policy program and that Operation UNITE had also helped some Appalachian counties fund their programs. He noted that while federal funds can now be used, so far no federal funding has been specifically allocated.

George wanted to know how other counties made sure participants in the program were from that county, noting that health departments are meant to only serve the people in that given county.

Lee said most programs don't ask people where they live. "One of the things that you want to be sure of is to not have any barriers to scare people from coming in to these programs," he said.

George also asked about whether programs were required to have a one-for-one exchange and if counseling was required.

Lee said that initially participants are typically given as many needles as they need to get through the week, but that as they become regular participants, the exchange rate becomes closer to one-for-one.

As for counseling and educational materials, Lee said that that is up to each individual needle exchange, but also said that the counseling aspect of the program works best after a level of trust has been developed between the staff and the participant.

Lee cautioned the board about the importance of involving local law enforcement.

"These programs will not work if you don't have local law enforcement behind it. Even though you don't need their official approval, you certainly need their understanding of what we are doing," he said.

Judge-Executive John Coyle, the board chair, said he supported a syringe exchange in Woodford County because the "health benefits outweigh any of the other concerns." And when asked if the local law enforcement would be on board, he said, "I don't think they will be opposed to it." Coyle is a former sheriff.

The next Woodford County Board of Health meeting will be Nov. 17, with plans to have another guest speaker on the topic.

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