When a small, rural county in Indiana had an HIV outbreak, many states started to take a second look at implementing needle exchange programs. But two communities close to the outbreak say these programs can be more harmful than helpful if dirty needles are not collected.
“It became such a burden for the other people that live in this community and risked them to exposure to heroin injections from used needles that our community wasn’t going to support it anymore," said Madison County, Indiana, County Prosecutor Rodney Cummings.
Supporters of needle exchange programs say they provide clean needles to injection drug users to prevent the spread of disease, but Cummings said the exchange program in his community brought a different set of issues.
“We were having children getting stuck with needles in our park. We were having people trying to mow their grass, picking up bags with used heroin needles and getting stuck," Cummings said.
The Madison County Health Department said 220,000 needles were given out in two years, and because the exchange program did not require dirty needles to be exchanged for clean ones, only about half were turned in.
Cummings said this led to an increase in injection drug use and overdoses in his community, and in August the Madison County Council voted to defund the exchange program.
“A needle exchange program shouldn’t make it easier for people to do heroin, it should educate people, it should provide treatment options that are available and it should be responsible," Cummings said.
One of Cummings' main criticisms of his county’s exchange program was the lack of treatment-related resources. Other needle exchange programs around the country do offer treatment options as part of their exchange program, and one of them is located in Washington, D.C., at a free clinic called HIPS.
"We foster a non-judgmental environment where if somebody eventually was interested in stopping using drugs, we could help facilitate that in a way that most spaces could not," said Shayla Schlossenberg, mobile services manager at HIPS.
Schlossenberg said HIPS does not push anyone to go into treatment, but if injection drug users come to the clinic and are interested in seeking help, HIPS is there to guide them in the right direction.
“We try to offer them a buffet of options. It's kind of, here's different steps you could do. You could try stopping cold turkey. Let's talk about what you've done before. You could try a methadone program, you could try suboxone, we could try a detox,” Schlossenberg said.
But HIPS does not require a clean needle to be exchanged for a dirty needle, and each month they give out about 26,0000 needles.
Heroin-related overdose deaths in the nation's capital more than doubled between 2014 and 2016, according to Washington, D.C.'s chief medical examiner.
Delaware County, Indiana, had its own discussion about starting a needle exchange program in the spring, but County Prosecutor Jeff Arnold said that after what he heard about neighboring community Madison County’s exchange program, he argued against it.
“It was never an exchange program to start with. It was a needle giveaway,” Arnold said.
Both Cummings and Arnold agree the exchange programs help stop the spread of diseases like Hepatitis C and HIV, but if the program does not have a one-to-one exchange rate for clean and dirty needles and does not include treatment resources, they cannot support it.
“If you’re firing up more you’re overdosing more. With the heroin that we have. The HIV, it did help that. I’m not trying to say it didn’t help with that, but that’s a treatable disease. Death is not," Arnold said.
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