Sunday, September 11, 2016

Sept. 23 is deadline to apply for grants that can be used for syringe exchanges; 17 approved, but few in high-risk counties

By Melissa Patrick
Kentucky Health News

The state Office of Drug Control Policy is offering competitive grants to local boards of the Agency for Substance Abuse Policy for them to use toward harm-reduction programs for 2017. The deadline to apply is Sept. 23.

The grant money can be used for syringe exchanges (with some restrictions), Narcan (naloxone) programs, community education and other harm-reduction efforts. While local health, fire and police departments cannot apply directly for the grant, ASAP boards can apply on their behalf. Grant amounts will be considered up to $20,000, depending on the proposal, according to the Office of Drug Control Policy. Click here for a link to your local ASAP chairperson.

This is the second year the grants have been offered. Last year, all 37 ASAP boards that applied got some funds. Elliott and Harlan counties are the only two in the state without ASAP boards.

A 2015 federal Centers for Disease Control and Prevention analysis identified the 220 U.S. counties most vulnerable to an HIV or hepatitis C outbreak among intravenous drug users, and 54 of those counties are in Kentucky.

So far, 17 Kentucky counties have approved syringe exchange programs, according to the Cabinet for Health and Family Services. But only six (Knox, Pike, Grant, Carter, Boyd and Mercer) are in the most vulnerable group.

Stars locate syringe exchanges; green counties are deemed most at risk for HIV and hepatitis outbreaks
Syringe exchanges were authorized in Kentucky under a 2015 anti-heroin law and require local approval and funding. They are meant to slow the spread of HIV and hepatitis C, commonly spread by the sharing of syringes and needles.

"The key to needle exchange is that it is an opportunity to engage someone in treatment," Allen Brenzel, medical director of the state Department for Behavioral Health, Development and Intellectual Disabilities, said in an interview. "There is no evidence to support that they cause people to use more often or to use more drugs. What they do is they help people begin the process of engaging and trusting that people will help them. . . . They are very, very important."

Brenzel said the federal report alone is reason enough for counties to adopt syringe exchange programs. "An HIV epidemic would cost us, in addition to the human lives, millions and millions of dollars to treat and contain," he said.

Hepatitis treatment is also expensive. Dr. John Ward, director of the CDC's Division of Viral Hepatitis, said at a recent conference in Lexington that the cost of testing and treatment for hepatitis C is between $32,000 and $56,000 on most health plans.

Kerry Steinhofer of The Advocate-Messenger in Danville reports that Boyle County, which is considered the 35th most vulnerable by the CDC, is in the early stages of planning a syringe exchange. Its ASAP board plans to apply for one of the aforementioned grants and is hopeful they will be chosen.

Brent Blevins, the county health department, told Steinhofer that he did not expect any problems with the Danville City Commission or the Boyle County Fiscal Court in getting approval of a syringe exchange.

Lincoln County Judge-Executive Jim Adams told Abigail Whitehouse of The Interior Journal in Stanford that he expects some political pushback. The county is ranked 97th most vulnerable nationwide, and is in the early stages of learning about syringe exchange, Whitehouse reports.

Clark County started its exchange program about eight weeks ago and has already seen more clients than it anticipated seeing after six months, indicating a higher number of drug users in the community than expected, Health Director Scott Lockard said in a telephone interview. (On Sept. 2, the exchange saw 14 total clients, collected 199 needles and gave out 289.)

What's important is that disease is being prevented, Lockard said. "We are truly farther along and doing much better than I thought we would be at the six-month window," he said. "Obviously there is a need."

Lockard said Kentuckians are becoming more accepting of syringe exchange programs, and predicted that more counties will soon follow with their own. A Kentucky Health Department Association survey taken in December found that 75 health departments, out of 109 who answered the question, were in some phase of the education process or approval of syringe exchange programs.

"This is an example of public health at its finest," Lockard said. "I think we are going to see positive impacts on our hepatitis C rates in our communities, and hopefully prevention of any HIV outbreaks."

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