Pubdate: Sat, 20 Jun 2015
Source: Wall Street Journal (US)
Copyright: 2015 Dow Jones & Company, Inc.
Contact:  http://www.wsj.com/
Details: http://www.mapinc.org/media/487
Author: Jeanne Whalen

A MOBILE NEEDLE EXCHANGE IN CINCINNATI WAS SHUNNED BY SEVERAL 
NEIGHBORHOODS BEFORE IT FINALLY GOT ROLLING

It took Judith Feinberg years to gain political backing to open a 
needle exchange for injection-drug users in Ohio's Hamilton County, 
even as heroin and painkiller abuse spurred a flood of hepatitis C 
infections in the region.

Six weeks after it opened last year in a recreational vehicle in a 
Cincinnati suburb, the local government shut it down, saying 
residents felt it encouraged drug use and attracted addicts to the 
neighborhood. Several other communities also rejected the project. 
Eventually, a church offered its parking lot.

The struggles of Dr. Feinberg, an infectious-disease specialist at 
University of Cincinnati, highlight the challenge of fighting the 
plague of blood-borne infections like hepatitis and HIV hitting small 
cities and rural areas.

Needle exchanges, where users can swap dirty syringes for clean ones, 
are one of few effective tools for curbing the spread of disease 
among drug users who share needles. Since HIV's arrival in the 1980s, 
exchanges have been operating in big cities such as New York. One 
analysis there found that drug injectors who didn't participate in 
the programs were 3.35 times more likely to become infected with HIV 
than those who did. Advocates say the programs also can steer addicts 
into treatment for addiction or infection.

Supporters are pushing to open such programs in Midwestern and 
Appalachian areas that have become hotbeds of drug abuse and 
infections. But federal funding for needle exchanges is banned, and 
in most states they face legal barriers and political and community opposition.

Dr. Feinberg, who first faced opposition from Cincinnati officials, 
got a break when a suburb just north of the city - Springdale, 
population 11,000 - offered to host the project. "You'd have to be a 
member of the Flat Earth Society not to believe we have a heroin 
epidemic in this country and region,"  says Springdale Mayor Doyle Webster.

The Cincinnati Exchange Project first opened for business in a 
Springdale parking lot in February 2014, in a recreational vehicle 
donated by Planned Parenthood. "Immediately I started getting a lot 
of complaints,"  Mr. Webster says.

Discontent boiled over at a city council meeting that March, when 
more than a dozen residents took the floor to denounce the program. 
"We want this program out of Springdale tonight!"  Julie Matheny 
said. The council voted that night to eject the RV from Springdale.

By early 2014, Cincinnati had a new police chief and city manager, 
who seemed more sympathetic to the needle exchange, according to Dr. 
Feinberg and her partner on the project, local HIV activist Adam 
Reilly. They decided to try Cincinnati again. They first tried a 
low-income neighborhood called Lower Price Hill, but the community's 
council voted to block the RV.

Paula Jackson, the rector of an Episcopal Church in Cincinnati's 
Mount Auburn neighborhood, emailed Dr. Feinberg to offer a parking 
lot. A member of the church had died a few months earlier after using 
heroin. "We're talking about our people,"  says Rev. Jackson. 
"Anybody can be an addict."

The needle exchange parks next to the church every Wednesday, and has 
since won permission to park in two other Cincinnati neighborhoods.

A counter top in the vehicle is covered with pamphlets on disease 
prevention and addiction treatment, along with baskets of free 
condoms and heroin cookers. The RV also offers finger-prick screening 
for hepatitis C, HIV and syphilis, with results available in 10 
minutes. The program encourages users to get treated for infections 
and addiction, and refers for treatment anyone who is willing.

About 350 addicts have used the RV so far, sometimes driving more 
than an hour from rural areas in Ohio and Kentucky. About 35 have 
entered addiction treatment, sometimes accompanied to appointments by 
Libby Harrison, who helps run the RV. About 70% of the users who have 
agreed to screening have tested positive for hepatitis C, and about 
4% positive for HIV, Dr. Feinberg says.

The project gets no government funding, aside from a supply of a 
heroin-overdose antidote, which it gets from the state and 
distributes to drug users. It cobbled together a $50,000 budget this 
year with money from a local charitable foundation, individual 
donations and T-shirt sales.

"We try to make every buck we can,"  Ms. Harrison says.
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MAP posted-by: Jay Bergstrom