Syringe service has pros, cons
Published 4:20 pm Friday, September 27, 2019
In 2015, Senate Bill 192 was signed into law by Gov. Steve Beshear establishing the Harm Reduction and Syringe Exchange Program. The legislation came in response to an outbreak of HIV in a small southeastern Indiana community near Louisville, largely caused by needle sharing among intravenous drug users.
Previously banned, Kentucky communities now are allowed to operate syringe service programs based upon locally defined need.
The priority intent of the SSPs is reduction of transmitted infectious diseases such HIV and viral hepatitis by providing intravenous drug addicts free access to sterile syringes while encouraging and facilitating safe disposal of used needles.
Those who come to the centers for free syringes are given access to education on practices to lower their risk of contracting disease and experiencing overdose. Counseling and referral to substance abuse treatment services; disease screenings; and other medical, social and mental health services are offered. They also leave with a sharps disposal container and instruction on how to use it to dispose of used syringes in a safe manner.
An abundance of reputable research supports effectiveness and benefits these programs can provide. However, they still are fraught with controversy and opposition. Such is the case with Lincoln Trail District Health Department’s proposed expansion the program into Hardin County.
Criticism and opposition typically centers on the view these programs do little more than enable addicts to continue, or even increase the frequency of their drug use habit while pumping more contaminated needles into the community on the taxpayers’ dime. Fear of potential increased rates of disease infection and crime near exchange centers also creates resistance.
County Attorney Jenny Oldham shares such concerns.
Oldham voices opposition saying there is no safe way for an addict to use illegal drugs. She points out there is no requirement nor guarantee the needles handed out won’t be shared or dangerously discarded. And she calls attention to the societal and judicial system toll drug abuse is having on Hardin County.
Oldham is right. All these problems are present. But so are the very real public health and safety risks for the community without them.
The most effective way for an addict to avoid the physical, emotional, mental and social health-risk consequences of injected drug use is to break the drug abuse cycle. And the most effective way for a community to erase direct and indirect health risks associated with IV drug abuse is to rid the drugs, pushers and addicts from its streets.
Unfortunately, there is no easy way to accomplish either task.
According to the Centers for Decease Control and Prevention, the surging opioid abuse epidemic has resulted in marked increases in IV drug abuse including heroin and fentanyl.
CDC statistics show 775,000 Americans report having injected an illegal drug in the past year. In 2017, 14 percent of high school teens reported illegal abuse of opioids while 1.5 percent reported injecting an illegal drug. This sobering statistics lead to large increases in overdose deaths and tens of thousands of viral hepatitis infections annually. The CDC warns it also threatens progress made in HIV prevention.
Of 220 counties across the U.S. determined by the CDC to have high risk of HIV outbreak related to illicit IV drug abuse, 54 are in Kentucky. And 47 of these 54 counties have syringe programs in place.
Lincoln Trail District Health Department already operates a syringe service in Nelson County. According to its data from July 2017 through July 2019, the branch provided 28,639 clean syringes while taking in 17,489 used ones, a ratio of 1:64.
While a user isn’t required to exchange a dirty syringe for new one, those brought in are properly disposed of by health department employees.
The health department knows how to effectively operate a program and has processes and training in place to do so. Officials in county and city government along with law enforcement and health services should support expansion into Hardin County for the benefit of the public’s health and safety.
While opposition is understandable, it is also an emotionally driven reaction to a very real public health risk reduction opportunity.