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The Journal Gazette

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    An Allen County needle exchange similar to this one in southern Indiana’s Scott County is being planned for519 Oxford St.
October 10, 2016 1:01 AM

Moving the needle

Exchange program finally gains state's approval

The state has finally approved Allen County’s request for permission to begin a needle-exchange program.  Dr. Deborah McMahan, the county health commissioner, said her department hopes to be operating an exchange center at 519 Oxford St. by next month. The program will provide clean needles to drug addicts to discourage the spread of HIV and hepatitis C.

This is good news. But it is a shame the process couldn’t have moved faster.

The spread of those diseases has been a cruel and costly byproduct of the opioid crisis: Addicts who take heroin intravenously often share dirty needles, and nothing allows HIV and hepatitis C to spread more rapidly. Treatment can cost as much as $100,000 for one case of hepatitis or up to $500,000 for one case of HIV.

Years of experience in other states has shown exchange programs to be effective in reducing the spread of disease. Experience has also shown that giving out clean needles does not encourage drug use. Indeed, such programs allow health officials the opportunity to offer drug users counseling and treatment for their addiction. But all of this is counterintuitive, and there has been much skepticism to overcome at both the state and local levels.

Indiana first saw how quickly the problem can overwhelm communities in the early months of 2015, when impoverished, drug-ravaged Scott County in southern Indiana recorded the worst HIV epidemic in state history. As opioid addicts crushed and injected Opana and oxycodone pills meant to relieve severe pain, the disease quickly spread through the cities of Austin and Scottsburg.

That March, though he had previously opposed needle-exchange programs, Gov. Mike Pence declared a health emergency and allowed Scott County to distribute needles.

With other counties also facing a crisis, the legislature briefly considered allowing any county that wanted a needle-exchange program to proceed. But the law that eventually emerged set up more hurdles than an Olympic track event.

Allen County health officials first began talking publicly about the possibility of a needle-exchange program in summer 2015. That Oct. 5, with the hepatitis-C rate rising rapidly, the county’s Board of Health voted unanimously to begin the process of setting up a program here.  

“It took us about one year to complete the entire approval process for a number of reasons,” Mindy Waldron, the health department administrator, wrote in an email Friday. First, she wrote, McMahan established a task force to develop protocol for the program. 

“We then wanted to ensure we had plenty of time to have one-on-one conversations with all involved entities and elected officials to answer questions and educate about the reasons such a program is needed locally. This took a few months on its own,” Waldron continued.

“Secondly, we had to seek external funding for staffing the program which took a little time to coordinate. And finally, we had to follow all of the outlined steps of the statute for these programs which takes several months to navigate as well.”

Finally, a year after McMahan originally asked for permission to start a needle exchange program, things are under way.

“We are ultimately very pleased with the outcome and feel we were as transparent and responsive as possible and are looking forward to the implementation phase at this point,” Waldron wrote.

All good. But the state’s drug crisis, unfortunately, doesn’t show any sign of going away. Allen is the eighth Indiana county to receive permission to set up a program; it won’t be the last. Perhaps the legislature should revisit the needle-exchange legislation and find a way to streamline the process.