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Board of Health considering needle exchange program

4/28/2017

By Tom Marshall
Senior Advocate writer

In an effort to reduce the spread of communicable diseases among local IV drug users, the Montgomery County Board of Health is considering a needle exchange.

The board discussed the possibility at its meeting last Friday.

As part of the program proposal presented to the board, public health director Jan Chamness said that IV drug users would be given new needles in exchange for used ones, but would also be given cookers, tourniquets and Neosporin.

Prior to injection, drugs in powder, solid and tablet form must be mixed with water and broken down into a liquid solution. Cookers are the containers used for this drug preparation process, often heated to create a desired drug consistency.

The needles would be exchanged near the health dept. at times when the clinic is closed, she said. Participants would be given a week’s supply of needles in exchange for their used ones.

The plan would have to be approved by the board of health, the Mt. Sterling City Council and the Montgomery County Fiscal Court before it could go into effect.

The health dept. distributed a flier to board of health members explaining the reasoning behind the program.

First, the health dept. says needle exchange programs do not encourage the initiation of drug use nor do they increase the frequency of drug use among current users.

Chamness said IV drug users already know where to obtain the drugs, the health dept. is simply trying to encourage them to do so safely.
The goal, according to the flier, is to reduce the spread of infections like HIV and viral hepatitis. A presentation to the board at Friday’s meeting noted that Kentucky leads the nation in cases of hepatitis C.

The flier also tries to dispel the notion that the exchanges lead to an increase in crime.

“Community residents may worry that syringe exchange locations will increase theft, sex trades, assaults and an increase of contaminated needles on the street,” the flier states. “However studies have shown that syringe exchange programs actually decrease crimes in the area they are located.”

In fact, the flier states that the programs lead to an increase in community safety.

“Research shows that SEPs (Syringe Exchange Programs) promote public health and safety by taking syringes off the streets and protecting law enforcement personnel from needle stick injuries, which can result in the transmission of diseases such as HIV/AIDS and hepatitis B and C,” the flier states.

The programs also connect people to treatment, the flier says.
“One study found that SEP participants are five times more likely to enter a drug treatment program than nonparticipants,” according to the health dept.

Not only would the health dept. provide information on rehabilitation opportunities, but it would also offer testing for communicable diseases to those who want them and education on how to properly dispose of used needles, Chamness said.

According to the health dept., most IV drug users have no idea if they have contracted a communicable disease.
The proposed program is not without critics.

Judge-Executive Wally Johnson, who is a member of the board, asked when it will reach a point when we are injecting drugs into users.
Other critics still insist the program encourages drug use and question how many drug users will actually take part in the program. They contend providing tourniquets in addition to the needles goes too far.

Board member Jeff Garrison, speaking for many critics, told the board that going down this road is a slippery slope for the health dept. to get involved.

“Where do you stop this thing,” he asked.

Board chair Dr. Danielle King said it is indeed a slippery slope, but one in which the health dept. has to act to prevent the spread of deadly communicable diseases.

It protects not just the user, but everyone they come into contact with, she said.

Chamness said it will take time for word of the program to spread and truly become effective.
“I don’t expect a big rush just initially,” she said.

Chamness said there is currently no state level funding available for needle exchange programs.

The local program, the same as others statewide, she said, would be funded through a combination of grant money and local tax dollars.
The health dept. estimates that the program cost would be around $5,000 annually to start. The primary expenses would be staff training and supplies, Chamness said.

“We receive supplies at a discount through group purchasing agreements as well as state pricing contracts,” she noted.

In other action, Kelly Allen with the health dept. gave board members an overview of the services offered through the dept.’s clinic. They include:
• WIC: A federal program that offers healthy food to pregnant or postpartum women and children up to the age of 5.

The program currently serves 900 local families.

• Pregnancy Testing and Emergency Contraception.

• HIV and STD Testing (gonorrhea, chlamydia, syphilis and HIV).
• Well Child Exams (school physicals) for ages 0-21.

• Fluoride Varnish: With eruption of first tooth through age 5. The program also provides children with information on good oral hygiene.
• Adult and Childhood Immunizations: Examples include vaccines for rabies, shingles, HPV, HepB MenB, flu, pneumonia and DTaP.
• Childhood Lead Screening for ages 1 though 5.

• Humana Vitality Screenings for State (KHEP) Employees.
• Family Planning: Provided by Sterling Health at 859-404-7686.
• Medical Nutrition Counseling.

• TB Testing and Case Management.
• Reportable Diseases: The dept. tracks diseases in the community such as meningitis and salmonella, for example, that it reports to the state. The dept. tracks trends and provides case management.

The health dept. is located on East Locust Street next to the Montgomery County Extension Service. You can reach the dept. at 498-3808.