Letcher County and the state of Kentucky are part of a growing epidemic of hepatitis C and HIV, with both diseases spreading by an increase in the sharing of needles for intravenous drug use.
That was the message delivered to the Whitesburg City Council Tuesday night by Danielle King, a public health practitioner with the Kentucky River District Health Department. King attended the meeting to give the council an update on local and regional efforts to start a needle exchange program and reported that Kentucky was number one in rural cases of both HIV and hepati- tis C through intravenous drug use in the three-state area of Kentucky, Indiana, and Virginia.
Hazard-based Kentucky River District Health Department oversees the Letcher County Health Department. King, a graduate of Berea College, was making her second appearance before the council, having first appeared in August 2015 when she asked the council to support the local needle exchange effort, called Letcher County Stands Together. She told the council that after that meeting, a petition to support the effort only garnered 100 signatures. She also said that Karen Cooper, director of the Kentucky River Health District, had opposed further efforts at that time, stating that there was no need for a program in Letcher County or in the City of Whitesburg.
In the months since Cooper’s decision, the U.S. Center for Disease Control (CDC) conducted the study that placed Kentucky at the top of the three-state group. King said the state has been in denial about the prevalence of IV drug use in rural areas. Although Kentucky’s rapidly growing heroin problem has resulting in an increase in IV drug use, eastern Kentucky addicts have been injecting “broken down” prescription opiates for many. With the addition of heroin, said King, there is much more IV drug use in Letcher County and elsewhere in rural America today and it is increasing at an alarming rate.
King said Cooper has changed her mind because of conversations with the CDC and now advocates needle exchange programs in Letcher and Perry counties. King said the health district hopes that communities in both counties will participate in the exchange program. Needle exchange programs do not promote drug use, but do help to prevent the spread of disease, she said.
The new effort is still a needle exchange, but King called it a harm reduction program because it addresses all the possible sources the spread of infection. King showed the council a package of equipment that will go with needles when the exchange program becomes reality. It includes a “cooker,” a small metal cup where drugs can be heated for injection, a cotton ball, sterile water, and disposable rubber gloves. All of these are designed to prevent infection, which she said could come from sharing any of the items in the package. The cotton balls used to wipe needles are particularly dangerous if they are re-used and King said that bacteria from the needle would grow and multiply in the cotton.
King added that drugs are usually injected by groups of users when needles are shared and that the number of people in the group is multiplied by the number of times a day they inject drugs in terms of exposure to infection. She said it could add up to almost 100 shares a day and has led to an exponential increase in needle-borne disease. King said hepatitis C can lay dormant for up to 30 years before the victim shows signs of the disease — meaning the person can spread it every time they share a needle during that dormant period.
King showed the council and audience a picture from a public service announcement video that the health department has prepared for release the second week of June. It is entitled “Keeping Our Communities Protected,” with the subtitle of “Practice Needle Safety.” It is sponsored by Kentucky ASAP, UNITE, and the Letcher County USAP.
King also told the council that needle sharing is not the only way of spreading infection from dirty needles, pointing to the number of needles disposed of in garbage bags and discarded along roadways.
Mayor James Wiley Craft said that Chris Caudill, who manages the county’s recycling center, has already reported several incidences where workers at the recycling center have found syringes and needles in recyclables and that sometimes needles work their way through garbage bags as well.
“It constitutes a danger to our workers,” said Craft, who agreed the program would have the added benefit of protecting sanitation workers.
Council member Earlene Cornett also said she has grandchildren who participate with other school-aged children in trash pick-up efforts alongside the roadways as fundraisers, and that their parents accompany them to make sure they don’t pickup discarded needles. Craft asked if the council needed to take any action, but King said the program is not completely underway yet and it will be a project of the Kentucky River Health District when it gets started. Each community has the option of participating, but at this time, no decision was required.
The needle exchange program is made possible through Kentucky’s Senate Bill 192 and is administered by Dr. Stephanie Mayfield Gibson, commissioner of the Kentucky Department of Public Health, which drew up the guidelines for the program. The needle exchange program also will provide counseling for addicts and health departments can help to arrange treatment as well if the addict desires it. The needle exchange will not increase drug addiction but will simply help to prevent the spread of disease.
In other business, Councilman Derek Barto conducted the second reading of a summary of Ordinance 2016-01. The main points of the new ordinance, which are unchanged from the first reading held last month, concern taxation of alcoholic beverages and the closure of a loophole that has allowed Sunday sales of package malt beverages in the city for several months. The new ordinance sets tax rates at 5 percent for alcohol sold by the drink, 4 percent for package liquor sales, and 3 percent for package malt beverages. The highly unpopular added tax for food was removed to comply with legislation passed in last year’s General Assembly session, and the new ordinance is fully in compliance with state law. It also prohibits alcohol sales in the city between the hours of 12:01 a.m. on Sunday and 12 p.m. Monday, except on special occasions approved by the council such as Super Bowl Sunday.
The council voted unanimously to approve the revised ordinance. It will become law after it is published in The Mountain Eagle.
Leanne Mullins of the Mountain Heritage Festival Committee approached the council with a request from a carnival group asking to set up either at the Veterans Museum parking lot or in the city park for a weekend run. Mullins said she was approached by the carnival to make the request because of the carnival’s’ connection with the Heritage Festival committee.
Craft noted that both BikeNite events at the Veterans Museum parking lot and the MayFest, which will be held in front of the courthouse, are set for May 14, but said he would be opposed to allowing the carnival to set up regardless. Craft said carnivals are not what the city needs. The council agreed and voted unanimously not to allow it.
“ This is my opinion,” said Craft. “A carnival is a vacuum to suck money up. Then they pick up the next day and leave.”
Council member Sheila Shortt, who acts as liaison between the council and BikeNite, said that the event would conflict with the carnival anyway.
“We don’t need a carnival,” said Shortt.
Craft directed Police Chief Tyrone Fields to inform the carnival workers parked in the old high school parking lot to be out of town by noon on Wednesday, May 11.
Craft explained that the reason Mullins approached the council in the first place was because the festival committee is $2,000 short of its budget goal for the 2016 festival. He then asked the council to authorize the city to make a donation to the committee of $2,000.
Craft said the festival committee is an arm of the city government, making it is legal for the city to make the donation. The council voted unanimously to make the donation, providing that no legal reason to prevent it comes up.
The council also voted unanimously to allow Mountain Comprehensive Health Care Corporation and Food City to use a field behind the old city sewer plant in West Whitesburg for parking, since a significant amount of parking space is taken up by constriction equipment being used for the expansion of the Food City grocery store.
MCHC CEO Mike Caudill also asked the council to authorize a city easement through property belonging to the Whitesburg Appalachian Regional Hospital that will be used for the Tanglewood Trail for bicycling and hiking.
Caudill, an avid proponent of a bicycle trail, said that ARH President Joe Strossman has told him that he believes the ARH Board of Directors will agree to cede an easement to some of the property for the trail, but that the easement will need to go to the city. The council voted to accept it.