Facts about needle exchanges and Hepatitis C


The Centers for Disease Control and Prevention documented a 364 percent increase in new cases of Hepatitis C in Kentucky, Tennessee, West Virginia and Virginia. Of the four states, only Kentucky has passed legislation to allow for syringe exchanges. Such programs remain illegal in Virginia. West Virginia is considering implementing a pilot program, citing the Hepatitis C epidemic. Ron Crowder, a recovered drug addict, runs an underground needle exchange program out of a public housing apartment in Nashville, Tennessee. For 15 years, he has delivered clean syringes to addicts. But his state’s law does not explicitly allow for needle exchange programs. Crowder contracted both Hepatitis C and HIV while injecting drugs decades ago, "so I’m willing to risk it," he says.


With a new law in Kentucky, counties can set up their own needle exchanges, and it looks like the state’s largest cities, Louisville and Lexington, will be the first adopters. Along with free needles, the programs would seek to foster relationships with users in order to invite them to get treatment and apply for insurance coverage, said Dr. Stephanie Mayfield Gibson, commissioner for Kentucky’s state health department. Drug users may be reticent about making contact with public officials, but the need to avoid infections like Hepatitis and HIV will outweigh those fears for most users, Gibson says. Officials say syringe exchanges also keep dirty, infected needles from being discarded on streets, parks or other public places.


A concentrated outbreak of HIV cases in a small Indiana county prompted officials last month to institute a yearlong needle exchange program there. Indiana Gov. Mike Pence had ordered a temporary needle exchange for Scott County in April, after an outbreak of 135 new HIV cases in the first four months of this year. Most of the infected IV drug users had injected a liquefied form of a prescription painkiller. About 170 people have signed up for Scott County’s program.


Needle exchange programs exist around the world, and have many different variations. There were about 200 syringe exchange programs in 34 U.S. states, Puerto Rico and Indian nations in 2012, according to the Foundation for AIDS Research. Many exchanges operate at fixed locations, but others use vehicles to reach clients. Germany, Italy, Australia and the Netherlands have syringe vending machines. The machines accept coins or tokens that are typically given out by outreach workers.


More than three million Americans live with the Hepatitis C virus, also known as HCV, and about 12,000 die each year from liver complications associated with the virus. Kentucky has the nation’s highest rate of new Hepatitis C infections, at 4.1 cases per 100,000 people, according to the CDC. Up to 85 percent of the people infected with HCV will develop a chronic infection, and 1 to 5 percent will die from liver complications associated with HCV. The virus can be transmitted through needle sharing, sexual contact and expecting mothers can pass it on to their unborn children.


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