Ken de la Bastide and Devan Filchak, Herald Bulletin
BLOOMINGTON – Since the Monroe County Health Department struggles with limited funding and staffing like many Indiana counties, it turned to a Bloomington-based nonprofit to run the needle exchange program.
The department declared a local public health emergency in August 2015 in the county because of an epidemic of hepatitis C, which often indicates an HIV outbreak is on its way.
During the past five years, the number of hepatitis C cases has risen over 50 percent, according to the emergency declaration written by Monroe County Health Commissioner Thomas Sharp in August. One reason cited for the rise was an increase of drug use.
The needle exchange program, the fourth in Indiana, started operations in February 2016 and was the first to be operated by a nonprofit agency.
The Monroe County Health Department signed a contract with Indiana Recovery Alliance, which now handles Lawrence County's syringe exchange program as well.
“We determined the need for the program, and there was input from the community," said Kathy Hewett, lead health educator for the Monroe County Health Department. “As far as the state is concerned, we’re responsible for the program."
The health department oversees the program, and the alliance abides by a contract. Hewett said the county has allocated $12,000 for the program and pays her salary but stressed no tax dollars are used to buy syringes and other supplies.
Chris Abert, founder and coordinator of the Indiana Recovery Alliance, said only 10 percent of the funding comes from government grants.
The Indiana Recovery Alliance has an estimated budget of $170,000 this year.
Since the program started, it has seen 1,600 unique participants and an average of 268 visits per month.
The alliance operates from a storefront not far from the Indiana University campus. It is open seven days a week and operates a van that visits to other areas of Monroe County.
Abert insists every item in the kits being distributed including the “cooker,” tourniquet, water and alcohol swabs is needed.
“It’s the point of contact,” he said of the items. “People are more likely to contract hepatitis C from the cooker and tourniquet than from the syringe.”
He said he was disappointed to hear that the Madison County Board of Health has voted to remove certain items from the harm reduction kit, first the cooker and now the tourniquet, since each item is proven to stop the spread of disease if a new one is used each time.
Abert said there is no limit on the syringes that are distributed to participants and people are free to take any supplies that are needed. He said the return rate on the syringes is about 90 percent.
“We ask how many do you need (needles) before you come back in a week,” Abert said. “The artificial limiting of syringes is problematic.”
'Putting officers at risk'
Monroe County Sheriff Brad Swain said the program is a good idea to minimize the spread of disease but expressed concerns about the distribution of the needles.
"Needles are being found and we're having to send deputies to clean up the areas," Swain said. "I'm not sure that's a role we should be playing. We're putting officers at risk of a needle poke.
"The more readily the needles are being distributed, the more we're finding," he said. "It's frustrating because supporters of the program are dismissing the concerns."
Abert contends that research has shown that through the exchange program police officers are 66 percent less likely to be stuck by a needle.
“The police are still making arrests for possession of a syringe,” Abert said. “We do provide an identification card. There have been multiple people arrested.”
Swain said there was a meeting last year in which the law enforcement community was asked to give people found with a syringe a "free pass" if they had a card on them indicating the person is in the needle exchange program.
"We're not buying into it," he said. "Police are coming into contact with people for other reasons. We're not being inundated with arrests for the possession of a syringe."
Hewett said the Monroe County prosecutor and sheriff are supportive of the needle exchange program.
“It’s a matter of training,” she said.
County has done a lot of work
Abert believes the drug abuse is not a criminal justice issue, maintaining that if the possession of a syringe was decriminalized the problem would eventually decline on its own, as in other countries.
“We have done a lot of work,” he said. “We’re active on social media and twice a year conduct educational programs.”
Both Hewitt and Abert agree there is a need for more treatment programs in Monroe County.
“Our detox location is the Hoosier National Forest,” Abert said. “Right now, there is a waiting list for the not-for-profit treatment centers. If the treatment was available, we could fill them up.”
Hewitt said each county has to determine what program model works best.
Abert said the Indiana Recovery Alliance has students and active members of the Monroe County community participating in the needle exchange program.
“The question is: what are you going to offer to replace the drug use?” he said. “There has to be a social safety net. The hepatitis C and HIV outbreak is not being connected to the rest of the community. They need to have a purpose outside of their drug life.”
Abert said when the nation became concerned about illnesses from smoking, the tobacco companies were sued and funds were established to help people stop smoking.
“We should sue the pharmaceutical companies that promoted opioid use,” he said. “Make them pay for the treatment because drug abuse has varied and complex causes.”