A state-ordered needle exchange program opened in Scott County over the weekend in response to a public health emergency there. An HIV epidemic in southern Indiana led Gov. Mike Pence to authorize counties at risk of outbreak to start needle exchange programs. In just over a month, the number of cases in southern Indiana has shot up–in late February, about 30 cases had been confirmed. Now that number is up to about 90, according to the Indy Star. This 30-day order provides an exemption from state law, which otherwise restricts needle exchange programs. Scott County’s program is located in what is called a Community Outreach Center in Austin, Ind. The program is only for Scott County residents. Cody Keith of the Indiana Department of Health says each person in the exchange program will receive a week’s worth of clean needles. Once used, those will be exchanged for a new supply.
Keith states, “And as far as that specific amount per person is concerned that is going to be worked out with the representatives in the Community Outreach Center in Austin. So there might be a difference between each individual with how many they get for that week, but all of that counseling will be taking place in the Community Outreach Center in Austin.”
Although Governor Pence has temporarily legalized this particular program, he says he generally opposes these kinds of initiatives. Indiana is one of 23 states that effectively outlaw needle exchange programs. Daniel Raymond, the policy director at the Harm Reduction Coalition in New York City, says those prohibitions have negative effects on public health.
Raymond says, “Where we don’t have needle exchange programs, we don’t have that early intervention strategy to reach people who are at risk and get them help… in New York we have seen a 75% decline in HIV amongst drug injectors since we passed our law enabling needle exchange programs.”
Laws like Indiana’s date back to the beginning of the War On Drugs in the early 1970s. Raymond says Indiana is one of many states that outlawed possession of paraphernalia such as syringes.
He continues, “Way before anybody ever dreamed of needle exchange, states passed these laws to attempt to cut down drug use… They ended up with more HIV and Hepatitis C.”
In states that have legalized needle exchange, the programs often offer other public health services as well. Alisa Solberg is the executive director at the Point Defiance Aids Projects in Tacoma, Washington.
Solberg states, “We link people with health insurance, we connect people with medical coverage and care with legal services… I think it may be difficult in Indiana where this type of intervention has not been considered previously so it may be difficult to see that.”
Injection of the painkiller Opana has been cited as a potential cause of the epidemic in Scott County. The needle exchange program there is scheduled to expire April 25th unless the governor issues another executive order.