Needle exchange

office of the Surgeon General

U.S. Surgeon General Jerome Adams threw his support behind syringe exchange services as an important tool to address the Ohio Valley’s high risk of needle-borne disease associated with the opioid epidemic.

Adams visited Florence, in northern Kentucky, for an event to encourage more people to get trained to administer the overdose-reversal drug naloxone. Dressed in a full, dark uniform with gold stripes on his sleeves, Adams demonstrated his technique with the potentially life-saving nasal spray.

“Let’s show them how this works,” he told a crowd of health officials and media. 


Mary Meehan

Greg Lee, Kentucky’s HIV/AIDS educator, started the town hall on a somber note.

“How many people in this room know someone who has died of an overdose death?”

It was a standing-room only crowd. Most hands went up.

“Amazing,” he said, sadly.

The meeting was at the Bourbon County Public Health Department, just next to the county’s drug rehab center and down the hill from a playground where used needles are found far too often.


Alexandra Kanik

Health officials in the Ohio Valley are investigating outbreaks of disease associated with needle drug use in what is emerging as a new public health threat from the region’s profound opioid addiction crisis.

In northern Kentucky the health department is tracking a cluster of 43 recent HIV cases, about half of which are related to needle drug use. In West Virginia, the Centers for Disease Control and Prevention just released a report on 40 new HIV cases diagnosed in 2017 in 15 mostly rural counties.


Lisa Autry

City leaders in Glasgow have signed off on a syringe exchange for intravenous drug users.  The program would allow addicts to swap dirty needles for clean ones at the local health department. 

The measure narrowly passed Monday evening on a 5-4 vote.  Two council members were absent and another abstained from voting.

One south central Kentucky community has moved a step closer toward establishing a needle exchange for drug addicts. 

In a 4-3 vote with one abstention, the Barren County Fiscal Court approved a program Tuesday that will allow intravenous drug users to anonymously swap dirty syringes for clean ones at the local health department. 

Kentucky already has a high rate of Hepatitis-C, and health experts say needle exchanges can help reduce the spread of blood-borne diseases likes Hep-C and HIV. 

Fuse/Getty Images

A new report finds doctors in Kentucky diagnosed more cases of opioid addiction for people with private insurance than any other state in 2016.

 

The report is by Amino, a health-care transparency company that aims to estimate the costs of care. The Courier-Journal reports 23 of every 1,000 Kentuckians were diagnosed with an opioid use disorder in 2016. Nationally, 1.4 million privately insured patients were diagnosed with opioid use disorder--that’s six times more than in 2012.

Mary Meehan

The coordinator of a needle exchange program in Bowling Green is hoping other southern Kentucky counties will start similar efforts.

The Barren River District Health Department started the anonymous needle exchange program nine months ago in hopes of combating the spread of diseases such as HIV and Hepatitis-C.

From January 2014 to April 2016, the region saw more than 600 cases of Hepatitis-C. The health department’s Public Health Services Coordinator, Chip Krause, says it’s too early to know if the district has seen a decrease in the spread of disease, but he says those who use the needle exchange program are five times more likely to enter a treatment program.

Kentucky LRC

The Secretary of Kentucky’s Justice and Public Safety Cabinet says he’s thrilled with the impact of the state’s needle exchange programs.

John Tilley believes the 32 local needle exchange efforts in Kentucky represent a change in how the state is facing the growing problems of opioid addiction, and diseases spread through the use of infected syringes.

Tilley says many of the addicts participating in needle exchanges are deciding to get help.

“They are five times—five times—more likely to enter treatment. And we’ve had great success in getting people who go to these programs into treatment, so that’s a public health win. We have to do it to battle back Hepatitis C—that’s a public health nightmare in Kentucky.”

Mary Meehan

A new report shows Kentucky, Tennessee, and Indiana are among seven states with twice the national rate of Hepatitis C cases.

The Centers for Disease Control reported new cases of Hep C have increased nationwide by nearly 300 percent from 2010 to 2015. Hepatitis C is still associated with more deaths than 60 other diseases.

According to the Kentucky Department for Public Health, the state had the highest rate of new acute Hepatitis C infections from 2008 to 2015, with more than 1,000 cases. The CDC report said intravenous drug use is the primary risk factor for new infections.

Barren River District Health Department

Kentucky ranks first in the U.S. for its rates of Hepatitis-C, a liver disease that can be deadly.  Despite that, only about two dozen Kentucky communities have needle exchange programs that allow intravenous drug users to anonymously swap dirty needles for clean ones at local health departments. 

A 2015 CDC analysis of 220 counties in the nation found 54 Kentucky counties were vulnerable for an outbreak of Hepatitis-C and HIV. 

"That right there tells you that the state as a whole is in terrible shape," said Ben Chandler, President and CEO of The Foundation for a Healthy Kentucky.  "Almost a quarter of the counties in the country as a whole are right here in Kentucky."

Alexandra Kanik

The Ohio Valley’s addiction crisis has brought another health problem, as rising numbers of needle drug users are contracting a serious form of heart infection called endocarditis. The rate of endocarditis doubled in the region over a decade, and many patients require repeated, expensive treatment and surgery as they return to drug use and once again become infected.

According to the Centers for Disease Control and Prevention, annual Medicaid spending on endocarditis is more than $700 million, a number likely to rise if treatment does not change to also address the growing health impact of substance abuse.

Doctors at the University of Kentucky are creating a team approach to address endocarditis and the addiction contributing to it. It’s a challenge that has forced them to change traditional practices, break down walls between different medical practices, and get to the heart of the problem.

Mary Meehan

Sitting on top of the Bible on Pastor Brad Epperson’s desk at the Clay City First Church of God is a list of goals for his small congregation written in a looping cursive hand.

“Our community ought to see the love of God in us, not just by our understanding of a compassionate Gospel, but our public acts of love,” is near the top.

Epperson was born and raised in Powell County in the mountains of eastern Kentucky.

It is one of nearly 100 counties in Kentucky, Ohio, and West Virginia designated at high risk for HIV infection by the Centers for Disease Control and Prevention. The 10 counties the CDC identified as highest risk are all in eastern Kentucky and southern West Virginia. Powell County ranks 15th in the nation. Wolfe County, next door, ranks a sad number one.

Flickr/Creative Commons/Eric Molina

Indiana’s health commissioner has declared a public health emergency in Southern Indiana’s Clark County that allows local officials to start a needle exchange to curb the spread of hepatitis C and HIV.

Commissioner Dr. Jerome Adams declared the emergency Monday, making the county the sixth in Indiana to win permission for a needle-exchange following an HIV outbreak in Southern Indiana linked to intravenous drug use. The five others are Fayette, Madison, Monroe, Scott and Wayne counties.

Clark County spent eight months trying to work out problems with its initial needle-exchange application. The county submitted a second application after ending talks with the Los Angeles-based AIDS Healthcare Foundation to pay for the program.

County health Commissioner Kevin Burke said state health officials didn’t support how that foundation would have funded the program.

Bowling Green and Warren County are joining a growing list of communities establishing needle exchange programs. 

In 2015, the Kentucky General Assembly approved a measure allowing local governments to set up the exchanges in response to the state’s heroin epidemic.  The aim is to prevent the spread of disease such as HIV and Hepatitis. 

The Barren River District Health Department serves an eight-county region including Barren, Butler, Edmonson, Hart, Logan, Metcalfe, Simpson, and Warren Counties.  From January 2014 to April of this year, the region saw more than 600 cases of Hepatitis-C. 

Warren County's needle exchange, which begins Thursday, will allow any drug user to come to the health department and anonymously swap dirty needles for clean ones. 

In this interview, Lisa Autry spoke with Dennis Chaney, director of the Barren River District Health Department.

Flickr/Creative Commons/Eric Molina

The leader of Bowling Green-based health group says a needle exchange for intravenous drug users is the best way to fight the state’s addiction problems.

Dennis Chaney, director of the Barren River District Health Department, is applauding the Bowling Green city commission’s decision Tuesday to approve a needle exchange program.

The exchange must now be approved by Warren County Fiscal Court. It has already been authorized by the Warren County Board of Health.

Chaney said he understands those who feel a needle exchange will enable drug users.

But he thinks it’s the best way to break down barriers and start the healing process.

“The opportunity is for those folks who would participate in the program, the responsibility is for us to try to develop a relationship with those folks just like what you may have and you may enjoy with your primary care physician,” Chaney said.

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