With Scott County Fiscal Court approving a needle-exchange program and Georgetown City Council set to start discussions on approving it, would drug users take advantage of the program?
Kevin Hall, communications officer for the Lexington-Fayette County Health Department, believes residents would. Since 2015, 163 people with Scott County zip codes have traveled to Lexington to exchange needles.
“From the beginning we have had people coming from Scott County coming here,” he said. “That number does not indicate if they are making return visits to exchange needles. But it does indicate that most weeks, someone from Scott County is coming in.”
Hall has been a vocal proponent of needle-exchange programs, traveling to other counties considering implementing their own system. Needle-exchange programs are aimed at those drug users who are more likely to share needles, mostly heroin users. Hall said one common question that he has heard concerns diabetics and whether they have to exchange their needles. He said diabetics don’t share needles and are not considered a health risk.
“This is 100 percent about stopping the spread of infectious diseases, such as HIV or Hepatitis C,” he said. “Each community needs to decide what type of program works best for them while meeting the needs and desires of local government and the community. There does need to be a level of flexibility because the program will be different on Day 366 from Day 1.
“Lexington intentionally started small to build trust with those coming in. A person has to feel like they are respected or they won’t come back,” he said.
On average, 220 people a week come to the Lexington-Fayette County Health Department to exchange needles on Wednesdays and Saturdays during set hours. Of those 220 a week, about 10 percent each week are new.
“The challenge when we started was what type of program did we want. We started thinking you have to bring needles to get needles, but we didn’t want it confined to a one-to-one exchange. Also, if you don’t have needles to start with to exchange, how do you get new needles,” Hall said. “So we did a focus group of people in jail. Who better to ask about a needle exchange program than people who use? And what they told us was three needles a day is a good place to start. So we start with a maximum of 21 needles. What we have seen is it levels off to about a one-to-one exchange.”
The program had to be tweaked when Fentanyl came into central Kentucky as people started spiking heroin with it and discovered you could inject smaller doses but have to inject more frequently.
He said it takes about 3-5 years to start noticing any decrease in diseases, but you can track if there has been an outbreak of a disease. And needle-exchange programs also open the door for users to enter rehab.
“We have on-site counselors available to people who come in and say I’m ready to get clean,” Hall said. “We have had 164 people enter rehab programs. To me, that’s 164 families that have a second or third chance to get their loved ones back.”
He knows needle-exchange programs can be controversial. Some people choose to believe there isn’t a need in the community or these programs just enable drug users to keep using.
“We applaud any agency looking at taking this step. This is about keeping needles off the streets. If you are finding needles in your communities or still finding needles in your community after you start an exchange program, there is a need for it. That means people are using. And not everyone is going to come in. But you can help those who are coming in,” Hall said. “And if Scott County and Georgetown start a program, we will still see people from Scott County come here. It may be more convenient for them on their way to work or shop. There’s also a level of anonymity in going to a program out of the county. A user may be afraid a relative or someone they know may see them going in to exchange needles. We have people now that go from Lexington to Clark County or Bourbon County or Frankfort and people from there come here because of that.
“And needle-exchange programs are statistically proven to get people in recovery programs. It is about building trust and believing in them. People who are struggling with addiction want to see these programs work because they say you believed in us and treated us like a person.”
Hall said part of the challenge in getting programs approved is changing the stigma of who is a drug user.
“We have to get past the idea these are junkies behind the dumpster. These are people you see every day and don’t know they are using. We have homeless people come in and we have businesspeople in expensive suits come in,” he said. “One of my favorite stories involved one of our health department employees who was checking out at a store, and the employee checking them out asked if they worked at the health department. The person said yes, and the person checking them out said you saved my life.
“It is not uncommon at all to hear a former user say you kept me alive long enough until I wanted to go into recovery.”
Steve McClain can be reached at email@example.com.