Researchers ask Congress to lift ban on needle-exchange funding

Because of dirty needles, Kentucky has the highest rate of hepatitis C in the nation, and public officials say it will get worse. The state legislature recently allowed localities to start needle-exchange programs, but Congress banned federal funding for such programs in 2011.

Congress should remove the ban to fight sudden outbreaks like the one among citizens in Scott County, Indiana, near Louisville, according to Chris Beyrer, a professor at Johns Hopkins Bloomberg School of Public Health in Baltimore, and Steffanie Strathdee, director of the Institute of Global Health at the University of California-San Diego.

“There are going to be more of these outbreaks, and what’s urgently needed is a public health response before things get even worse,” Beyrer said. “We can’t put politics above public health. We have a cheap tool to prevent this.”

Drug abuse is a problem affecting people in many demographics, and overuse of prescription drugs can be a gateway to heroin. In Indiana, needle exchanges are illegal but can be authorized by the governor; Gov. Mike Pence did that to address an HIV-AIDS outbreak in Southeast Indiana. The area has been recording only about five new cases of HIV per year, but by June 10 of this year, 169 people had been diagnosed and more than 80 percent also had hepatitis C.

“Regrettably in the case of needle-exchange programs, other Indiana counties contemplating authorizing them must first demonstrate the existence of a public health emergency—a requirement that ensures that they can only respond to, rather than prevent, new outbreaks,” the researchers write. Another issue, the authors write, is that to obtain clean needles, people have to provide their initials and birthday, which could deter some people.

Another way to curb the outbreak is to screen more people for HIV and ask them about their drug use. A third way is to increase use of opioid replacement therapies, which involve replacing those drugs with methadone or buprenorphine, less dangerous alternatives.

“Drug use is changing, and before this gets any worse, we need to change our approach to fighting it,” Beyrer said.

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