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Up to 20 Indiana counties may soon have needle exchange

Shari Rudavsky
shari.rudavsky@indystar.com

Only three counties to date have received state approval to start syringe exchange programs, but that could change dramatically soon, state lawmakers learned Monday at a hearing on the new law that makes clean needle programs legal in Indiana.

Fifteen counties have been moving toward potentially implementing a needle exchange program; one county, Clark, has approved a needle exchange program but has not gotten the nod from the state to implement it; and within the past week, Monroe County started exploring the idea.

Within the next month, about 20 counties may have needle exchange programs in place or on the way, said Beth Meyerson, co-director of Indiana University’s Rural Center for AIDS/STD Prevention. Studies have shown that needle exchange can halt the spread of diseases such as HIV and hepatitis C among intravenous drug-using populations.

These programs differ somewhat from those of needle exchanges in place elsewhere in the country as they are in rural, not urban, areas, Meyerson said.

“They represent a new generation of syringe exchange,” she said.

Because the Indiana programs that have been approved are still in their infancy, it’s difficult to gauge success, said Joey Fox, legislative director of the Indiana State Department of Health.

Scott County, whose HIV outbreak linked to intravenous drug use sparked the change in the law, is the senior member of the group, with a needle exchange program that went into place in early April on a temporary basis. The program was renewed temporarily until the law took effect.

The state approved Madison County’s needle exchange program June 23, but the county did not open its first site until Aug. 5. Fayette County received approval for its program Aug. 14.

Early lessons from Madison County include the fact that many who use the needle exchange program live within a short distance of one another, said Kellie Kelley, public information officer for Madison County Health. It’s not unlike the situation in Scott County, where public health officials discovered a cluster of HIV cases among drug users in the small town of Austin.

“All of our counties, I believe, have an Austin, Indiana, in them,” Kelley said.

Madison County decided to seek permission to start a needle exchange after noticing a dramatic increase in hepatitis C among minors. When health workers started interviewing people they served, they heard some disturbing stories, she said.

One person interviewed told the health department worker, “People don’t really look for Xanax or meth or coke much anymore. It’s all about the pain pills.”

Another told how easy it was to find elderly people desperate to make money off their prescription narcotics: “Seniors are selling their pain pills just to pay the light bill.”

Not everyone came to the hearing to talk needle exchange, however.

David Powell, executive director of the Indiana Prosecuting Attorneys Council, came to talk about stiffening penalties for drug offenders. A few years ago, state legislators amended the law to allow for lighter sentences for those involved with illicit substances.

Now, it’s time to change them back, Powell argued.

Legal officials can hold the prospect of stiffer penalties over offenders’ heads to persuade them to seek treatment. He cited the case of California, where, he said, penalties even lighter than those of Indiana led those who were arrested to opt for punishment rather than considering treatment.

“We should not assume that folks who are addicted to meth (or) heroin want treatment,” he said. “Without treatment, they will re-offend.”

When Kentucky approved needle exchanges for that state, the legislature implemented tougher drug penalties at the same time, Powell said.

The measures that Powell’s group proposed did not represent a complete reversion to previous laws, just a step or two back toward the previous law. These include raising the offense to a Level 1 felony if a person’s drug dealing results in a person’s death, and considering possession of 5 grams or more of a drug intent to deal it.

“We’re trying to put a little fear in the folks that deal opiates,” he said.

Others, however, say Powell’s proposals would accomplish something very different.

For the first time, better treatment options, which Indiana has long lacked, are on the horizon, said Larry Landis, executive director of the Indiana Public Defender Council.

“I’m about ready to explode,” he said of Powell’s suggestions. “We don’t need to go back to those days.”

Call Star reporter Shari Rudavsky at (317) 444-6354. Follow her on Twitter: @srudavsky.