AUSTIN, Ind. – An Indiana county that was once home to America’s worst drug-fueled HIV outbreak voted Wednesday. Syringe exchange program credited for stopping epidemic.
In the Scott County Commission vote, two out of three members argued that the exchange could contribute to drug use and overdose deaths, calling for opposition from health advocates who predicted it would lead to a resurgence of HIV cases. Will happen.
“I know people who drink, and I don’t buy them a bottle of whiskey. And I know people who want to kill themselves, and I don’t buy them a bullet for their gun,” Commissioner Mike Jones, who voted to end the program by January 1, 2022.
The move comes amid a nationwide rise in drug overdoses attributed to the pandemic, with leading proponents arguing that there may hardly have been a worse time to abandon the harm-reduction program that served the once-epicentre of the US opioid crisis. .
Commissioners rejected arguments from local law enforcement, state officials and former Trump administration surgeon general Jerome Adams in voting to close the exchange, opened to fight the 2015 HIV outbreak, fueled by injectable opioids. In which cases skyrocketed from a small handful in a county to 237. just 24,000.
The rural nature of the outbreak made global headlines, attracting journalists from as far as Asia, as it symbolized the explosive dangers of an opioid crisis in rural areas with inadequate health care and treatment.
Randy Julian, one of the commissioners who voted against it in a packed meeting room Wednesday night, said he believes it does more harm than good, fueling overdoses despite a track record of reducing HIV and hepatitis C. gives.
He and other critics have argued that exchange facilitates drug use when more treatment efforts are needed.
“With proper care, people can live with HIV and hepatitis. (They) cannot come back from death,” he said in a message before the vote. I didn’t help them.”
The syringe exchange opened on initial opposition from the then government. Mike Pence works by offering customers clean needles should they return to limit the sharing of infected needles. In addition, customers get access to treatment and overdose reversal drugs.
Dr. William Cook, who opened the city’s only primary care physician’s office in 2004 and worked to help contain the outbreak, said the exchange had proven successful and became a national model that helped drive the program’s spread. has been promoted.
In 2018, CDC researchers found that the proportion of people sharing syringes in Scott County fell from 74 percent to 22 percent between 2015 and 2018.
Last year, the county had just one HIV case, up more than 150 in a year, officials said.
At a hearing last month, advocates cited decades of research showing that syringe exchanges prevent disease and reduce health care costs without increasing crime. Cook said, and it serves as an important “touchpoint” with drug users to treat and reverse naloxone overdose.
Several residents, speaking at Wednesday’s meeting, said that they were first addicted and treated through exchange when they found the needle.
“It kept me clean,” Rick Williams said. “And that guided me to recover.”
Scott County’s drug poisoning deaths declined most of the time exchange operations, from 21 in 2016 to 8 in 2019, the latest statewide figures available. But last year, they turned 24, according to Scott County Coroner Lonnie Noble.
This is probably a reflection of the drug’s mortality rate that has soared nationally amid the pandemic. Officials blamed poor access to treatment.
In 2020, the US saw more than 80,000 drug overdose deaths, the highest number ever since May 2020, according to the Centers for Disease Control and Prevention.
Advocates said the exchanges are needed more than ever as part of a one-stop-shop set up by the state that provides not only syringes but also HIV testing, vaccinations and referrals for substance abuse and counseling.
The outbreak also brought an influx of new drug treatment centers and community and nonprofit addiction support to the area.
The Needle program had 350 participants in 2020 and cost $190,000 per year, all funded by grants without any local tax contributions.
While some complained of finding needles on the streets, customers return 92% of the free syringes they receive.
The exchanges are not meant to reduce drug abuse, proponents argued, but rather to reduce life-threatening diseases caused by the reuse of contaminated needles.
Without it, an increase in HIV and other drug-related infections such as hepatitis C is almost inevitable, Cook and others argued.
This is what happened in West Virginia, where access to needle exchanges has been reduced in recent years, leading to increased HIV rates.
The CDC identified 220 U.S. counties as vulnerable to similar outbreaks because of overdose death rates, prescription opioid sales volume, and other data associated with injection drugs.
Yet a Kaiser Health News analysis shows that syringe exchanges are functioning in less than a third of those counties.
While Scott County’s 2015 outbreak was fueled by Opana, the injectable drug of choice, which has faded as fentanyl-less heroin and meth, has become the most popular.
In addition, county doctors still prescribe opioid prescriptions at a higher rate than the state average, state health officials said.
Jones said he worried that county-supplied needles could be involved in overdose deaths, which Julian echoed, saying a research paper he read suggested a connection. The Department of Health said that health privacy means not tracked.
Julian argued that it was not certain that there was a rapid decline in new HIV cases, rather than public awareness. Jones also said he was skeptical of the state’s figures on the number of reported HIV cases.
While he argued that all other aspects of drug treatment would remain the same, exchange officials said many people only use them because they get the needles – and possibly not otherwise.
And while people who use intravenous drugs can order syringes online, one person who recovers said many people will simply “pick one off the street, use it.”
Only a few opponents of the program turned up for the meeting, but they declined to give their names or let a reporter outline their protest.
Supporters of the area’s drug treatment community – which filled the meeting room – said the move was a disappointing rollback after hard-earned efforts to reverse the health repercussions of the region’s addiction crisis.
The local health director said he feared for the health of the county. State health officials said Wednesday night that Scott County has the most drug users with HIV in the state.
A health official argued that private groups could come into the county and hand out needles, as it is legal.
The commissioners decided that the program would end by January 1, 2022. He said he would like to consider a community center and additional mental health resources for residents, and added that the deadline could be delayed if more time is needed.
“We need to come up with something different than ‘a needle in here,'” Jones said.
Cook welcomed any new resources but said community centers are not a substitute for needle exchange in reducing disease rates. Efforts will continue to change the views of the commission before the closing date on January 1, he said.
“Scott County experienced the worst drug-related HIV outbreak in US history in 2015 because elected officials ignored medical and public health experts,” Cook said. “Without access to sterile syringes, cases of HIV, hepatitis C, endocarditis and other infections will start to rise again — reversing our six-year successes.”
Follow Chris Kenning on Twitter @chris_kenning
Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of knews.uk and knews.uk does not assume any responsibility or liability for the same.