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Needle Exchange May Be Closer to Operating in Covington, Newport

It has been a year and a half since the City of Covington and Kenton County governments each adopted an ordinance allowing the operation of a needle exchange. Two months later, the Campbell County government followed suit.

But there is still no needle exchange/syringe access program in either Kenton or Campbell County.

That's because a state law adopted in 2015 requires approval by the local health department, county, and city where the program would operate. In Campbell County, no city has stepped up.

And Covington's ordinance stipulates that it would only allow a program to operate if three of the four counties belonging to the Northern Kentucky Independent Health District vote to allow one. Boone County has taken no action at all.

Grant County and the City of Williamstown have led on the issue, placing no such stipulations on a program, and opening a syringe access program in March of last year.

Early next year, though, it looks like Newport will finally come around to taking up the issue.

"We're going to have a complete, thorough discussion on the needle exchange," Newport Mayor Jerry Peluso said. "The goal is to have a consensus on what the (board of city commissioners) wants to do."

That discussion could take place at the regular city commission meeting on February 26, Peluso said.

"We will have a resolution that will either spell out we don't support it or we support support and we support in this manner."

As Northern Kentucky continues to find itself gripped by a heroin crisis, with overdose deaths continuing to mount, the region also faces another dangerous potential byproduct of the drug abuse: widespread disease outbreaks like hepatitis C or HIV, such as what happened in Scott County, Indiana, where 181 people tested positive for HIV. A study in the aftermath of that outbreak showed that access to clean needles could have played a role in preventing such an outbreak.

That's part of the motivation to prepare Northern Kentucky, Peluso said.

"We need to take a hard look at reducing - we can't eliminate it - reducing the infectious diseases like hep C and AIDS," he said. "I think a lot of people focused in on the term needle exchange, and I think people really need to be focused on the possibility of a total outbreak of infectious disease."

Part of the pushback in Campbell County has been about where such a program would be operated. The likely target is the Campbell County government building on Monmouth Street, a block south from the Newport city building. The Northern Kentucky Health Department's Campbell County office is there and health officials have argued that its offices are best equipped to handle such a program.

In Covington, the health department offices on Madison Avenue were rejected for such a program, and instead, city leaders voted to allow a mobile unit to operate no more than three hours a week on the campus of St. Elizabeth Hospital, which has been a major proponent of a syringe access program.

“At St. Elizabeth Healthcare, we strongly support syringe exchange as a critical disease prevention program that will save taxpayer funded Medicaid dollars and build connection to treatment programs," said Gary Blank, St. Elizabeth Healthcare's chief operating officer, in a statement to RCN. "Northern Kentucky’s hepatitis C rates are nineteen times higher than the national average. The cost of treating hepatitis C can reach well over $80,000 per case.

"We have to protect our community from potential harm. Dirty needles not only impact those who are sharing but our police, fire fighters, other first responders, and our general public when needles are not properly disposed."

Blank said that the syringe access program in Grant County has been successful, with 129 patients moving on to drug treatment programs and with no calls to the police from the program after eighteen months of operation.

"We appreciate the Newport Mayor and (city commissioners) for addressing this much needed tool to prevent the spread of disease in our community and look forward to working with them to help protect our community,” Blank said.

Dr. Lynne Saddler, district director of health at the Northern Kentucky Health Department, also cited success in Grant County and emphasized that such programs are critical in fighting infectious disease.

"Syringe access exchange programs are needed throughout Northern Kentucky first and foremost to stop the spread of infectious diseases spread by IV drug use. Our region continues to have some of the highest rates of hepatitis C in the country. While HIV cases have remained steady, we are at risk for an outbreak of that disease as well," Saddler said. "In fact, the (Center for Disease Control) identified Campbell and Grant Counties as being among 220 counties nationwide at risk for an outbreak of HIV, similar to the one seen in Scott County, Indiana, in 2015."
In that report, 54 Kentucky counties were listed among 220 counties nationwide most at risk for such outbreaks. Grant County was ranked 77th while Campbell County was ranked 212th. Nearby Gallatin County, which is not in the Northern Kentucky Health District, was ranked 108th.
What a program would look like in Campbell County or where it would operate will likely be major parts of the discussion in February. As for Covington, the stipulations adopted for such a program include:
  • The program must be adopted in three of the four counties served by the NKY Health Department.
  • Only residents of the Kenton, Campbell, Boone, or Grant counties would be served at the Covington program.
  • The program would be a true needle exchange, meaning that a clean needle is given to a user only if a dirty needle is turned in. It was noted at last year's meeting that new exchange programs struggle at first, and often users are given new needles regardless of whether any needles are turned in. In Covington, the program will be 1-to-1 and users would get only one needle for each dirty needle turned in.
  • Participants in the program must be tested for diseases like hepatitis C and HIV.
  • The program will operate on days and times approved by St. Elizabeth not to exceed three hours per week.
  • Any materials distributed by the Health Department must be approved by St. Elizabeth.
  • The Health Department will give annual program updates to the Covington city commission on or around June 1 of each year.

Attorney General Andy Beshear spoke in favor of syringe access/needle exchange programs in an exclusive interview with The River City News ​that originally aired on Northern Kentucky Focus last Sunday on 106.7 WNKR.

"We are focused on this drug epidemic," Beshear said. His office recently filed suit against Endo Pharmaceuticals, maker of opioid painkiller Opana ER, which Beshear said killed more than 191 Kentuckians. "Outside of Oxycontin, there may not be another drug that has ravaged our communities like Opana and Opana ER."

The drug is used intravenously. 

Beshear also cited the CDC's alarming report about Kentucky counties at risk for widespread HIV infection, noting Campbell, Grant, and Gallatin Counties' positions on the list.

"I strongly support needle exchanges," Beshear said. "Your listeners are at ground zero of this drug epidemic. The most dangerous drugs we have ever seen in history are right here in your listeners' areas. They can kill you the first time you try them. This is no longer a political issue. This is a health issue and a survival issue for this area."

The Democrat said that needle exchanges are necessary to stave off outbreaks like what was experienced in Scott County, In. "Without one, if you have an outbreak like we saw in southern Indiana, the cost would bankrupt in county or city," he said. The situation is urgent, he said. "If something broke out tomorrow how many steps and how much time would have to be taken or would elapse until you could start doing something about it? You've got needles, sadly, lying around. Do we want those to be cleaner? Do we want those to be the type of needles that wont effect other people?

"This affects all of us."

Listen to the entire interview with Attorney General Andy Beshear here:

The Northern Kentucky Health Department provided the following details:

Syringe Access/Needle Exchange Programs:

  • Reduce the risk to the community and first responders from discarded needles and equipment, as such programs provide individuals who use drugs with the means for safe disposal.
  • Such programs provide individuals who use injection drugs with access to health care services and substance abuse treatment programs. Those who use syringe exchanges are 25 times more likely to enroll in substance abuse treatment programs. At the Health Department's program in Grant County, more than 120 referrals have been made to treatment since the program started in March 2016.
  • Syringe Access Exchange Programs connect high-risk individuals to the health care system, and can provide access to testing, immunizations and other health services.  Programs can provide individuals with access to life-saving naloxone overdose reversal kits as well.  These kinds of services (that go beyond just exchange of needles and equipment) are best provided from a program based in a health care setting, like a county health center. 
  • Programs are cost effective. The average lifetime treatment cost for HIV is more than $300,000. The Grant County Syringe Access Exchange Program's first-year operating costs were just over $27,000. 

Numbers from Grant County (from its start in March 2016 through Dec. 16, 2017):

Total clients: 276

Naloxone overdose reversal kits distributed through program: 377, with 49 reported lives saved

Police or EMS runs to program: 0

Vaccines provided: 44

Tests provided (HIV, hepatitis C, pregnancy and other STDs): 90

Referrals to addictions treatment: 129

Written by Michael Monks, editor & publisher

Photo via Wiki Commons