A locally-produced film allowed a group of Letcher County citizens to see firsthand why many addiction and disease experts are interested in setting up a local needle exchange program for intravenous (IV) drug users.
People who visited the Letcher County Extension Office to hear about needle exchange on the evening of May 16 saw the premiere of an Appalachian Media Institute video that was produced to bring attention to how a needle exchange could help reduce the harm IV drug users do to themselves and their community by sharing needles.
Danielle King, who works with Letcher County USAP (United for Substance Abuse Prevention), told the audience that Letcher County and much of the rest of eastern Kentucky are at the epicenter of a national epidemic of HIV and hepatitis C, because of the increased use of injectable drugs, such as prescription opiods and heroin. (Addicts are also shooting home-cooked methamphetamine.)
A pamphlet was given to every attendee with a message from Dr. John Ward, director of the Division of Viral Hepatitis at the Centers for Disease Control in Atlanta, who warned that, “we’re in the midst of a national epidemic of hepatitis C.”
“The CDC views hepatitis C as a major public health problem,” Ward said.
The video production, which lasted about five minutes, featured film footage of local and regional scenes with poignant voiceover statements from addicts who told about how their fears of becoming infected from sharing needles were overcome by their need for the drugs they inject. One addict told of his fear of the pain of withdrawal and said that death would be a relief. Another said shooting drugs had gone from being fun to being a necessity in a relatively short time. Others interviewed by filmmakers said they knew they were placing themselves in terrible danger by sharing needles, often with as many as 10 or 12 people at once, but the need for drugs to satisfy their addiction overcame their fear. More than one said they would prefer to die than to keep on using IV drugs.
The possibility of jail did not deter many of the addicts interviewed, either, although several commented that a prison sentence without a treatment program may temporarily suspend drug use, but without treating the root cause of addiction it rarely affects an addict’s long term behavior. One participant stated that as long as drug addiction is treated as a crime, the problem would stay underground.
After the film, King, who also serves as the local coordinator for the national Harm Reduction Coalition, talked about the needle exchange program she and other Letcher County USAP members, including Letcher County Sheriff Danny Webb, would like to get started here and said that while the program would expose addicts to the opportunity for treatment, the purpose is to give those addicts an opportunity to use clean sterile equipment to inject themselves to prevent the spread of disease.
While those addicts using the needle exchange would not be required to seek treatment, King said that at least when an addict is in a program the door to counseling would always open if the addict wished to seek treatment. King also said the availability of clean needles was not a factor that would make anyone decide to become an addict, pointing out that addictive behavior usually starts with a less addictive substance used irregularly that for some grows to be the central factor in their lives.
King also said that a needle exchange would help to protect children who are inadvertently exposed to dirty needles that have been discarded around playgrounds or on roadsides. She said that trash pickup programs now pose an especially severe risk to youth and adults who volunteer to pick up trash along highways as a source of funding for their clubs or other programs and that in some instances people who pick a discarded needle up accidentally get exposed to HIV or HCV.
Letcher County currently ranks in the top 50 in the United States in county level vulnerability to an outbreak of HIV or HCV infection among persons who inject drugs. Wolfe County is number one, followed by Breathitt, Perry, Clay and Bell. Pike County is number 21 and Knott County is 17th.
King emphasized that the availability of clean needle and other equipment such as clean cotton, cookers, and bandages would not increase addiction rates, but would help reduce the spread of needle-borne disease. She added that the HIV virus could live in needles for up to 63 days.
“We don’t know where these people have been,” said King. “But they are all human. Drugs are the problem and they affect everything. We have to do this for people who can’t do it for themselves.”
Sheriff Webb was unable to attend the meeting, but was represented by Deputy Sheriff Eugene Slone, who also works with Letcher County USAP. Slone said the needle exchange is needed for public safety.
“Not everybody is going to agree,” Slone told the audience. “You are going to have people for it, you are going to have people against it, but the one thing we can agree on is making our community safer, and that has got to be our goal.”
Neighboring Pike County recently authorized a needle exchange program that will start operating next month. Before such a program could be started in Letcher County, it would have to be approved by the Letcher County Fiscal Court, the City of Whitesburg, the Letcher County Health Department and the Kentucky River Health Department.
Citing a lack of funding, District Health Department Director Karen Cooper told The Mountain Eagle recently that if the needle exchange gets the proper approval, it would still take several months to get the program operational in Letcher or in any of the other Kentucky River District counties.