Wednesday, May 29, 2019

Closure of syringe exchange in Kanawha County, West Virginia, increased health risks, study concludes

Intravenous drug users in Charleston, West Virginia, and the rest of Kanawha County are at a higher risk of bloodborne diseases and overdoses after the local health department stopped providing clean needles and other "harm reduction" measures, according to a study from Johns Hopkins University. Their increased risk raises the risk of an outbreak of HIV and hepatitis C in the wider population.

The Kanawha-Charleston Health Department opened the program in December 2015, and provided a syringe exchange, doses of the overdose-reversing drug naloxone, and testing for infectious diseases associated with intravenous drug users like HIV and hepatitis C," but the politics shifted, Ashton Marra reports for 100 Days in Appalachia. "Restrictions were placed on the syringe services . . . and local politicians began criticizing the health department in the media, claiming the city was experiencing a spike in crime because of the syringe program." It closed in early 2018.

The researchers interviewed 27 adults who had used the program. Most participants were homeless and had used intravenous drugs within the past month. They said they had engaged in riskier behavior since the program closed because it's now more difficult to access clean needles. "One participant said he found used needles on the street and would bleach them before use," Marra reports.

Female participants said they believed they were at a greater risk of contracting HIV since the program's closure, and both genders said they were less likely to seek testing for HIV and other infectious diseases. Many said they knew testing was available elsewhere, but said they had been treated poorly at other clinics or nearby hospitals. They preferred the Charleston program, they said, because staff there treated them with respect and compassion.

"The study attempted to fill a gap in the research about how these programs affect rural areas, but existing studies showed that a syringe exchange program reduces the rates and spread of HIV and other infectious diseases in a place, which leads to not just healthier communities, but also cost savings," Marra reports. "The programs also provide access to overdose-reversing drugs that save lives and allow for greater access to information that can lead to rehabilitation and recovery."

The researchers urged rural policymakers to "take a stand against inaccurate and misleading reports" about syringe exchanges and "ensure access to sterile injection equipment and overdose prevention resources." Ignoring the evidence that exchanges work "not only presents an ethical and moral dilemma, but also sets the stage for an HIV outbreak and worsening overdose epidemic."

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