Although some local officials — as well as a growing number of citizens — appear to be warming to the idea of Letcher County becoming the state’s 15th county to approve a needle-exchange program, the service would not be open to drug addicts here for at least six months after it was formally approved.
“At this point we don’t have a funding source,” Kentucky River District Health Department Director Karen Cooper told The Mountain Eagle recently. “And if everything was in place and funding was secured, it would still take three to six months to put everything in place so we could implement it.”
Discussion of a needle exchange is expected to be on the agenda this week during a community awareness event being held to address “needle safety.” The gathering, scheduled for 6 p.m., Thursday, at the Letcher County Extension Office in Whitesburg, is being sponsored by the Kentucky Agency for Substance Abuse Policy (ASAP) and Letcher County United for Substance Abuse Prevention (USAP), whose membership includes Sheriff Danny Webb.
In early May, Letcher USAP member Danielle King appeared before the Whitesburg City Council to talk about the need for a needle exchange for intravenous drug users in order to protect the public from a growing outbreak of HIV and hepatitis C. Also in May, the federal Centers for Disease Control and Prevention (CDC) named Letcher County as one of the nation’s 50 most vulnerable to an outbreak of HIV or hepatitis C.
Because the Letcher County Health Department is located in Whitesburg, members of the city council and Letcher Fiscal Court would have to give their approval before a needle exchange could be started. The district and local health departments would also have to approve and operate the exchange.
Cooper, whose office oversees the Letcher Health Department, said that in addition to funding, many other “logistical questions” would have to be answered before a needle exchange could be started.
Top among those questions, Cooper said, is where such an exchange would be located. She said that news reports of King’s appearance before the Whitesburg council immediately drew the attention of some young mothers who said they didn’t want addicts visiting the health department while babies and young children were there.
“One of the conversations we’ve had is where would you have this,” Cooper said, adding that some mothers asked, “You’re not going to have them in there with our babies?”
While larger counties such as Jefferson County (Louisville) have purchased vans to take the needle exchanges out into neighborhoods, Cooper said that would not be affordable in Letcher and most other eastern Kentucky counties.
Cooper said the health department in Fayette County ( Lexington) is closed to regular patients for half a day each Friday so that addicts can exchange their dirty needles for clean ones, but that such a plan probably couldn’t work here either.
Noting the concerns voiced by one local physician, Cooper said she, too, worries about where some addicts might decide to use their new needles after driving several miles to the health department in downtown Whitesburg.
“Chances are they’re not going to wait until they get home to do it,” she said. “There’s just a lot to consider.”
Calling the current threats of widespread HIV and hepatitis C outbreaks “scarier than anything we’ve dealt with” during her 23 years at the health department, Cooper said the district and local health boards are “open to” setting up a needle exchange even though some board members “may be opposed on a personal level.”
“We’re not opposed to it; we do recognize it’s a problem,” she said. “Hep C is rampant and has been for many years.”
Needle exchanges were authorized by the Kentucky General Assembly in 2015 as part on an anti-heroin bill. The legislation did not include state funding.