Pubdate: Mon, 06 Jul 2015
Source: Columbus Dispatch (OH)
Copyright: 2015 The Columbus Dispatch
Contact:  http://www.dispatch.com/
Details: http://www.mapinc.org/media/93
Author: Misti Crane
Bookmark: http://www.mapinc.org/find?137 (Needle Exchange)

DISEASE MAY SPUR NEEDLE PROGRAM

Health Officials Say That Needlesharing by Drug Users Is Spreading 
Hepatitis C Locally and Statewide.

The boom in heroin use paired with a surge in hepatitis C infections 
in Franklin County and across Ohio have heightened worries about the 
spread of other diseases, particularly HIV, and sparked conversations 
about a local needle exchange.

Hepatitis C, a treatable but sometimes deadly viral disease that 
attacks the liver, was diagnosed in 719 people in Franklin County 
five years ago. The number had nearly doubled by last year, to 1,369, 
according to data from Columbus Public Health. So far this year, the 
county is on pace to record more than 1,400 cases. In just one year, 
the number of hepatitis C cases statewide grew from 10,020 in 2013 to 
15,887 in 2014.

Some of that most certainly is due to a push for testing at-risk baby 
boomers that has been fueled by better treatments. But there's little 
question among doctors and public-health leaders that needle-sharing 
by people using heroin and other drugs is playing a role. Last year, 
603 of the cases in Franklin County were in people 34 or younger.

The Ohio Department of Health reported this year that heroin-related 
deaths increased statewide from 697 in 2012 to 983 in 2013, 
surpassing prescription-drug deaths. In 2013, there were 197 
drug-overdose deaths (including from heroin and pills) in Franklin 
County, up from 63 a decade before, state data show.

There are a handful of needle-exchange programs in Ohio that aim to 
prevent illness and engage people who could benefit from other 
services, including counseling.

Under current Ohio law, a community has to declare an emergency 
before offering clean needles. That has never happened in Columbus, 
primarily because the city's HIV burden could be linked mostly to 
sex, not intravenous drugs, said Columbus Health Commissioner Dr. Teresa Long.

Long and others are discussing how to start a comprehensive program 
here to address heroin use and disease that could include a needle 
exchange, she said last week. There is no formal plan.

"We are learning about it. We are interested in anything that would 
protect people," she said. "We are interested in considering all the options."

Long said one area that interests her is increasing the distribution 
of naloxone (sold as Narcan), a drug that can save heroin and other 
opioid users from a fatal overdose. It already is being used in 
Franklin County, but there is more opportunity to get it into the 
right hands, Long said.

Coupling needle exchange with access to treatment has proved 
successful elsewhere, she said.

Long's mind also is on Indiana, where intravenous drug use and shared 
needles have led to the largest outbreak of HIV in that state's 
history and have HIV doctors and advocates nationwide on alert.

"There is genuine concern over the number of overdoses that are 
happening, over seeing things like what happened in Indiana and 
knowing that syringe exchange has the potential to combat that," said 
Tania Peterson, director of prevention at AIDS Resource Center Ohio.

Cleveland, Cincinnati, Portsmouth and Dayton have needle-exchange 
programs. Dayton's, which is operated by the combined city and county 
health department, started in April after health officials, 
law-enforcement agencies and others became alarmed by overdose-death 
numbers that jumped from 127 in 2010 to 264 last year.

Peterson's group worked with officials in Montgomery County and is 
eager to see similar efforts elsewhere, including in Columbus, she said.

Jeff Cooper, health commissioner at Public Health - Dayton & 
Montgomery County, said the once-a-week exchange program there, 
called CarePoint, had seen 43 clients and exchanged 650 needles as of 
late last month.

Two people have entered treatment, and one has finished, based on the 
program's referral.

"It's too soon to determine the long-term implications. ... We know 
that it's going to take some time," said Cooper, who emphasized the 
importance of having a program that helps people with a multitude of 
services and doesn't simply exchange needles.

He said the department budgeted $40,000 for the program's first year 
and has met no resistance.

CarePoint refers users to drug-treatment and mental-health agencies 
and provides condoms and sexual-health education, pregnancy testing 
and help enrolling in Medicaid. It refers people to housing 
authorities and food pantries, too.

Long said an effective program here would be one that also takes a 
comprehensive approach.

 From where she sits, family physician Dr. Krisanna Deppen said she'd 
love to see a local intravenous-drug program, including one offering 
clean needles.

"I've been working with a small group of folks who've been advocating 
for that," Deppen said. "Indiana is weighing heavily on these people's minds."

She said she sees many pregnant drug users in her family practice in 
Grove City and at a Nationwide Children's Hospital clinic. About 30 
to 40 percent of them have hepatitis C, which they can pass to their babies.

"It's good that we don't have pill mills, but as people have gone 
from pills to injecting heroin, we've seen a lot of things, and 
hepatitis C is one of them," Deppen said.
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MAP posted-by: Jay Bergstrom