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Cincinnati Area's first needle exchange program targets AIDS, hepatitis C
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"The Cincinnati Exchange Program was created to help fight a dramatic increase in hepatitis C cases linked to intravenous heroin use......The program also will provide rapid testing for HIV, hepatitis C and pregnancy....This is a medical health-care facility on wheels.....The clean injection supplies are needed because hepatitis C can remain infectious on surfaces such as cotton for up to nine weeks."
Feb. 11, 2014 5:10 PM
Written by Kelly McBride
The Cincinnati Exchange Program mobile van parked at Olde Gate Plaza on Northland Boulevard in Springdale Feb. 10, the first day for the needle exchange program. / Kelly McBride/The Community Press
SPRINGDALE - The first needle exchange program in Southwest Ohio and Northern Kentucky opened for business here Monday.
The Cincinnati Exchange Program was created to help fight a dramatic increase in hepatitis C cases linked to intravenous heroin use. The program is the third in Ohio, following the lead of Cleveland and Portsmouth.
The short-term goal of the needle exchange, now housed in a large white van parked twice a week on a shopping center's parking lot, is to help drug users who are not yet ready for recovery stay alive and as healthy as possible until they can enter drug treatment. The ultimate goal is seeing them clean from drugs and disease-free.
"We don't want people using heroin, and we certainly want to encourage them to enter drug treatment," Dr. Judith Feinberg, who works at the Infectious Diseases Center at the University of Cincinnati Medical Center, said in a press release announcing the program. "If they're not yet ready for recovery, then we want to keep them healthy and alive until they are."
Public health departments are seeing a dramatic increase in hepatitis C cases, and some have attributed the rise to increased IV drug use, and more specifically, the heroin epidemic in the region.
Twenty-three cases of acute hepatitis C were reported in Northern Kentucky in 2010, but the number increased to 42 in 2011, according to health department records.
Hamilton County's health department reported an increase from 941 hepatitis C cases in 2010 to 1,141 a year later.
Hamilton County suffered 204 drug overdose deaths in 2012, according to new data from the county coroner's office, up from 189 in 2011 and most of them from opioids such as heroin and prescription painkillers such as OxyContin and Percocet. The 204 overdose deaths are the most on record in Hamilton County.
Heroin users frequently use the same needle again and again, and many share needles. The hepatitis C virus can live in the hub of a syringe for up to two weeks, Feinberg said. And it can be passed along from person to person.
Feinberg and others, including Dr. Jeremy Engel, who is at the forefront of the heroin battle in Northern Kentucky, cautioned that an increasing number of discarded needles in the region has the potential to cause an even greater public health hazard if non-users are accidentally stuck.
While many of the new heroin epidemic's users snort the drug, intravenous use can spread blood-borne diseases if users share needles. Needle exchanges have been used in some cities and other countries, but have opponents who see them as condoning drug abuse.
Feinberg asked Springdale City Council in June to support the project, though the city's health commissioner had the authority to make the decision.
Springdale was one of five local health departments that Feinberg approached about the program. The others that either declined or made no decision were Cincinnati, Hamilton County, Norwood and Sharonville.
Feinberg still hopes to expand the program to other areas, once community support is obtained.
"The board (of health) at this time supports Springdale's efforts," Sharonville Health Commissioner Dennis Propes said. "With the van being in such close proximity to our jurisdiction, they felt it would be best to take a wait-and-see approach to better gauge the need and effectiveness of the program."
Springdale's City Council supported the initiative, and after Feinberg secured money for the first year, the RV rolled into Springdale Feb. 10, settling into the corner of the shopping plaza. The van will be parked there on Mondays from 10 a.m. to 2 p.m., and Thursdays from 3 p.m. to 7 p.m.
People using heroin often work and have families. "That gives people an opportunity to come on their lunch hour, or after they get kids off from school," Feinberg told members of council, "or between work and going home.
"People work and have families, unlike maybe a popular vision of what people who use drugs are like," she said.
"To me, it's a public health thing," Feinberg said. "We're losing almost a person every day in Hamilton County."
Placing the program in a van was a conscious choice, said project manager Adam Reilly. "Brick-and-mortar sites have become outdated and aren't the best model for helping drug users in Greater Cincinnati because our epidemic is so dispersed Ð it really affects suburban and rural areas," Reilly said in a news release.
The Cincinnati Exchange Program has set up a website, www.cincyep.org,with more information as well as directions to the Olde Gate Plaza on Northland Boulevard.
Clients, referred by health care professionals and those who hear about the van through word of mouth and media coverage, can exchange one dirty, or used, needle for a new one.
Norwood-based Interact for Health provided a $50,000 one-year grant to pay for the project manager and pay for sterile syringes supplies and to provide sterile cotton and other items to area drug users. The clean injection supplies are needed because hepatitis C can remain infectious on surfaces such as cotton for up to nine weeks.
"Reducing infections caused by using dirty needles is one step in battling our heroin epidemic," said Ann Barnum, senior program officer at Interact for Health, the successor to the Health Foundation of Greater Cincinnati.
Clients will receive counseling and will be offered a prescription for naloxone, an antidote in case of overdose. The prescription would be filled at Hart Pharmacy in West Price Hill. The nasal naloxone is being paid for by a $48,000 two-year grant from the Ohio Department of Health. Injected naloxone is typically used when an overdose patient is taken to a hospital emergency room.
The program also will provide rapid testing for HIV, hepatitis C and pregnancy. Those tests also are paid for by grants from the state Department of Health.
"This is a medical health-care facility on wheels," Police Chief Michael Mathis said of the mobile van. "People go to medical health-care facilities for counseling already."
"We're not going to sit outside anybody's doctor office where they're trying to get health treatment for a very real problem. But we won't tolerate lawlessness," the chief said. "If we catch people selling drugs or using drugs or coming into the community and causing problems, they're going to get arrested."
"Don't bring drugs to this site," Feinberg said, echoing Mathis. "Don't use drugs at this site. We will not continue people as clients or serve people who don't abide by that."
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