Dr. Michael Kilkenny didn’t know what to expect last September when the Cabell-Huntington Health Department launched a needle exchange. But it’s been mind blowing, to say the least.
“I thought we’d see 150 people by the end of a year,” he told us. That’s how smart I am, because we now see 150 a week and we have given away well over 100,000 syringes.”
Approximately 1,500 heroin users have been served since they launched, and the number is growing.
“We’ve gotten back more syringes than our original allotment of donations and that was 13,500. We’ve probably gotten 80,000 of them back, so I guess you could say my math was way off.” Not that he’s complaining.
Kilkenny sees it as a hopeful sign. Area drug users want help. One by one they continue to come, and are a little less shy each time about opening the door. They’ve found there’s no judgement inside, only help.
Clean needles are provided and old ones can be returned. Recovery coaches are ready to talk. Immunizations are available and referrals can be made to treatment facilities.
In just a few months, relationships have been formed that are beginning to change lives.
“The ability to interact with the clients is huge, because early on there is so much distrust and concern that they wouldn’t even look up from the floor. Now we can greet each other, exchange pleasantries and talk so that’s a huge advance,” he said.
There are now at least four active needle exchanges active in West Virginia: Huntington, Charleston, Wheeling and Morgantown. Martinsburg is considering a program.
Cabell County has seen a 40 percent decline in overdose deaths compared to the same time period last year. Twenty four people died from overdoses in the first quarter of 2015; 14 died for the same period this year.
While there is no conclusive evidence linking the needle exchange to the drop in overdose deaths, the U.S. Centers for Disease Control say they provide a gateway to drug treatment and HIV prevention services. They do not increase crime or drug use.
Dr. Sharon Stancliff, medical director with the Harm Reduction Coalition, a national organization based in New York City, said syringe availability generally improves the situation.
“We don’t have any study from anywhere showing there is any increase in injectable drug use or drug use in general associated with providing syringes to people,” she said.
There are now 228 needle exchange programs across 35 states, American Indian tribal lands and Puerto Rico, according to the North American Syringe Exchange Network.
In addition to providing access to treatment and recovery programs, these exchanges also cut down on diseases spread through dirty needles. A growing number of addicts have hepatitis B and C; they are transmitted through shared dirty needles used by already infected users.
Both the CDC and the U.S. Department of Health and Human Services have determined that needle exchange programs have been an “effective component” in reducing the rates of communicable diseases including hepatitis B, hepatitis C and HIV.
“There has been no negative reaction from local residents who don’t want this kind of program, or people who refuse to acknowledge there’s a problem here,” Kilkenny said.
“Other areas seem to just want to fight about their heroin addicts. Some even go as far as trying to run these people off so that they can go die somewhere else, and not show up as their city or county’s statistic,” he said.
State Health Officer Dr. Rahul Gupta is impressed with the growing number of syringe exchange programs in the state and the benefits provided to state residents.
“Not only are they getting help for opioid addiction, but can also get screened for hepatitis B, hepatitis C and HIV which can be a life-long burden to the individual, as well as society, when it comes to public health costs,” he said.
Technical assistance is now being provided to these programs from the state, he said.
“We’re working to develop standards when it comes to needle exchanges so that it is not just about handing in syringes, but is also linked to screening for diseases as well as linked to counseling and referrals. These services may not exist at the local health department level.”
Reducing the number of dirty needles and helping addicts receive help are important parts of the Wheeling–Ohio County Health Department’s program. It launched last September administrator Howard Gamble told us.
Five to 10 people are usually seen at the weekly session that lasts about three hours. They have given away approximately 600 needles so far in the Northern Panhandle.
“We’ve probably collected even more needles than we’ve distributed, and that’s an important part of harm reduction. The more needles you can eliminate in the community, the better,” he said.
“It has also gone well here because people see that needle exchanges can lead to a reduction in the number of cases of diseases being spread among users. And also possibly help an individual talk to someone which may lead to treatment, and even stopping their drug use,” he said.
Northwood Health Systems and the U.S. Attorney’s Office are partnering with the program to help with the mental health component and to provide an on-site location for the needle exchange.
“There’s no pressure. We try to make people feel comfortable. There’s no security. It’s a matter of giving them what they need, beginning with needles and other things like antiseptic wipes or even condoms. We put them in a brown bag with some simple information they can walk away with.”
Since getting started in December 2015, the Kanawha-Charleston Health Department’s weekly two-hour clinic began with eight people and has served as many as 88 people at one session, said Ciara Moore, agency prevention and wellness coordinator.
“We’ve seen about 12 people go into rehabilitation from our clinic,” she said.
It is run entirely by volunteers, and citizens have been receptive to the program. Approximately 36,000 needles have been distributed and nearly 17,000 needles returned.
“What’s important to know is that we have about a 70 percent return rate for the needles among our returning patients,” she said.
Morgantown was home to the state’s first syringe exchange program which got underway in August 2015 at the Milan Puskar Health Right Free Clinic.
Items offered to heroin addicts through its Living in Good Health Together (LIGHT) Program include a cooker, alcohol swabs, cotton balls, clean needles and containers for used needles.
Implementing a similar program in the Eastern Panhandle is important since Berkeley County has been declared by federal officials to have a heroin epidemic, but the costs associated with it are a concern locally.
Berkeley County Health Department Administrator Bill Kearns said there have been discussions but the most viable option now seems to be working in conjunction with the county’s new community recovery services coordinator.
“We’ve wanted to get this kind of program off the ground for a while because of what we are facing locally in terms of heroin abuse and overdose deaths, but it just mainly comes back to being a funding issue and how you can make it a sustainable program,” he said.
“But by working with the city and the county some type of harm reduction program might be possible because they have more resources than just a single department.”