After months and months of tense debate and votes, Scott County’s syringe exchange program launches Monday, July 1, from noon to 4:30 p.m. It will be open at the Scott County Health Center at 300 E. Washington Street.
WEDCO Public Health Director Dr. Crystal Miller said because they have been doing this program in Harrison County for more than two years, they knew how to set up Georgetown’s syringe exchange program (SEP).
“We have spent a majority of the time bringing on community partners and getting the clinical side to deliver services,” she said. “For example, I wanted a higher level provider in the clinic on the days we have the syringe exchange program because there are other services we provide, for instance STI checks or birth control. There are a host of other programs we do in the health department a SEP participant may want to take advantage of.”
Monday was also chosen to fit in when surrounding counties offer SEPs, she said. Friday is Lexington-Fayette County’s, and Thursdays are in Harrison County, so she wanted Scott County to fill a gap.
“This is very much a collective effort across many agencies and all health departments working together, so a syringe exchange program participant can go to a different county if they need too,” she said.
Most calls they are getting now are when will the program start, and they have spent a great deal of time working with partners, including infectious disease training with law enforcement agencies and the victim advocates through the Georgetown Police Department and its Angel Program, Miller said.
“We wanted them on board knowing what we provide, so if someone comes into the SEP and says they want to get treatment, we will call the Angel Program right then,” she said. “We have been trying to educate our partners because there is a stigma with a syringe exchange program.”
If someone wants to participate in the SEP, they would come into the clinic as if they were receiving any other provided service. They will follow the signs to the office, the needle exchange program coordinator is notified and takes the person to a clinical room to begin the assessment. From the assessment, the coordinator, Amber Broaddus, will then determine what other services and information the person could receive.
“We do a lot of education. People think we are just dispensing syringes, and that is how we get them in the door,” Miller said. “Once we get a participant in there, we spend a lot of time talking about harm reduction and keeping them and the community safe. If they are ready to talk about recovery, we are always ready to meet them where they are.
“If they ask them questions that lead us to believe they are ready to go down that road, then we will work with them. But we don’t force treatment on them. That is not what we do. Harm reduction is about meeting people where they are, educate them and get to a point where they want better for their lives.”
When a person comes in for the exchange program each week, they return the sharps container with the syringes they have deposited, get 40 syringes along with alcohol pads, ointment, band-aids, tourniquets, condoms and a sharps container, Broaddus said. She also goes through the rights and responsibilities of participating in the program with the person, including not using the needles on WEDCO property and surrounding areas, picking up needles and encouraging people they are with to also drop syringes in the sharps container, in addition to the importance of getting HIV and Hepatitis C testing. She said if they didn’t bring 40 syringes back they discuss again the importance of safely putting their syringes into the container.
Leading up to the votes approving the program, many residents expressed concerns over discarded needles.
“We go over with them what happened to provide this service to them, and they take it seriously. If they are hanging around others they can collect those syringes and put them in the sharps container,” Miller said. “They are a great educator about the program to other users. They educate us and we educate them and they let others know we are there to remove barriers to getting the help they need.”
Research shows that there is actually a decrease in syringes in communities that have syringe exchange programs, she said.
“We want to get needles off the street, educate participants how we can help them and the dangers of sharing needles with other people and how to dispose of them,” she said. “There used to be a stigma with crime, and that seems to have decreased. We have a great relationship with law enforcement in Georgetown and Harrison County and if we see something we can discuss it with our partners.”
They meet frequently with those partners to prepare for infectious disease training and what to do if there is a mass overdose, she said.
“People assume EMS handles all that, but if there is a mass overdose they can’t do it all,” Miller said.
The success of the program relies on building relationships, Broaddus said.
“Ninety-five percent of what I do is relationships and working with the person to bring about a positive change,” she said. “This is a population that is already stigmatized. They have to feel safe to talk to us so we can help them. They are not going to tell me what they need if they don’t trust me.”
She said during the assessment, she can tell if someone needs medical care for an abscess at the injection site or other services. She added the number of Hep C and HIV and endocarditis (inflammation of the heart lining from germs that get into the blood stream) have all increased over the last few years.
They celebrate every success, such as using fewer syringes each week when they come back in, Broaddus said. If that is happening, it is a sign that they are making progress toward treatment, she said.
Miller said they will track numbers monthly and will be posted on the WEDCO website.
“We usually have a slow uptake historically in communities when SEPs start because of the stigma attached to them. They may walk in, look at the environment and leave. Or they may come in and tell a story that they are a diabetic and need syringes,” Miller said. “But we have been trained on what the indicators are that tell us you need to get someone privately in the room.
“But we don’t know what to expect because there is so much awareness right now of SEPs. There are 56 of these around the state now and people will come in and say I need help. This is about community partners and not just educating the people who come in but the community that if someone is brave enough to come in and say I need help and I don’t want to endanger someone or the community, we need to embrace that.”
It is no secret that Kentucky is in the throes of an opioid crisis, and the state held an opioid summit this week hosted by the state Chamber of Commerce to highlight how addiction is affecting Kentucky’s business climate.
“There is a lot of awareness coming around from the business world about the opioid crisis, and the conference was about removing barriers for people who have an addiction, whether it be alcohol or illicit drugs, and get them back in the workforce once they have been through treatment and placed back in what we call normal living,” Miller said. “Essentially this summit was more from the business aspect and to say the business world needs to be concerned about this too. Methamphetamines are of great concern, more than heroin now, but regardless we have an opioid issue and the business community is wrapping their heads around how we can be involved and help people. How can we find housing for them because many people won’t rent to people who has a record or addiction.
“I’m excited the business community has it on their radar. There was powerful testimony from a person who said he wouldn’t be there it it wasn’t for you all because now he works for the Hope Center. He said now he can show up at his family’s Christmas celebration and people won’t wonder if he was going to be stealing from them.”
The timing is right for the program to launch, Miller said.
“Agencies are understanding the importance of the need to get involved and that we can’t just turn our backs and arrest our way out of the opioid epidemic.”
Steve McClain can be reached at firstname.lastname@example.org.