A study by Johns Hopkins University of the abandonment of the needle exchange program by city leaders in Charleston last year should give pause to any public official thinking of following in those misguided policy footsteps.
According to the study released Monday and reported by Erin Beck in The Register-Herald, the incidence of needle-sharing, which escalates the risk for contracting certain diseases, increased after the closure of the Charleston program.
As a result, there are people in the city now injecting with used syringes more frequently and are less likely to be tested for HIV. The study calls it, in part, “a new era of increased risks for acquiring blood-borne infections.”
But, really, the conclusion comes as no surprise. As reported by Wendy Holdren in The Register-Herald a year ago March, the Centers for Disease Control and Prevention in Atlanta reported that after the implementation of a needle exchange program in an Indiana county in 2015, a sharp decline in needle sharing was reported one year later – from 74 percent down to 22 percent.
What remains troubling, upsetting and dangerous, however, is the litter of needles left in the wake of this well-intentioned program – often in public places where citizens of all ages go about their daily lives. In Charleston, 651,000 needles were distributed and only 415,800 returned. That left over 235,000 needles unaccounted for.
Further, there is a lack of evidence that suggests any large percentage of people making use of a needle exchange are taking the next steps into counseling and then treatment.
In Milwaukee, Wisconsin, needle exchange clients are encouraged to trade their needles for clean ones but – as in Charleston – are not required to do so. Like clients in other such programs, they’re given information on safe needle use, local drug treatment programs and detox, and free HIV and hepatitis C testing.
As of late last year, according to a story in the Milwaukee Journal Sentinel, only a handful of participants in that city’s program have gone into treatment or have been tested for socially transmitted diseases. Officials believe those numbers will grow – but there is no guarantee.
The most alarming statistic out of the CDC study in Indiana may be this: 185 of 200 respondents were tested for HIV – and 39 percent were HIV positive. In other words, nearly two of every five people in the program were carrying the HIV virus – and were sharing contaminated needles. A needle exchange program can and will reduce the spread of HIV and hepatitis C. That is its intended purpose and it works.
But, to be clear, a needle exchange program is not the end-all, be-all cure for the drug epidemic. It is only one piece of what should be a coordinated and comprehensive plan. If anyone was looking for a quick fix, well, that was never, ever, going to happen.
What is clear is this: Communities, counties and the state will need to develop a multifaceted strategy to address drug addiction. Truly, an approach involving law enforcement, treatment and prevention is needed. So, too, is a method of collecting used needles.
The state Department of Health and Human Resources needs to lead the charge in this effort, probing the possibilities of private-public partnerships, and bringing other entities into the fix, from health classes in our schools to harm reduction programs in our counties, from drug courts at the courthouse to treatment centers in our communities.
Now is not the time to throw our hands up in frustration and pull back in our efforts to address the opioid crisis infecting every corner of society. In fact, our resolve should only be stiffened. Clearly, we have work to do.
Yes, we, too, are tiring of dealing with a drug epidemic that seems to know no end and is exhausting state and local resources. We are especially frustrated with those who casually discard used needles where they are a threat to the general public.
But we also understand, and further stigmatizing these folks only stalls a recovery. Their addiction is beyond their power to master. As such, it would be easy – and mistaken – to treat addiction as criminal instead of what it is: both a medical and mental health issue.
Theirs is a terrible reality and our basic humanity requires that we respond with compassion, care and expertise. To expect them to feel any sense of social responsibility, to turn in their used needles, to distinguish between right and wrong while under the influence of their opioid of choice, is ignoring the potency of the drugs coursing through their veins and warping rational thought. They are not in control.
But we are. And what we can do is lean on medical science and treatment and devote more resources to develop a comprehensive plan to address it all.
What we cannot do is surrender.